PURPOSE Investigate the relationship between body mass index (BMI) and primary open-angle glaucoma (POAG) in an African ancestry cohort from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. DESIGN Retrospective, cross-sectional "case-control" comparison study. BACKGROUND Late diagnosis and unclear pathophysiology of POAG, the most prevalent glaucoma type, emphasize the need to identify risk factors. Prior studies on BMI and POAG yield mixed results, with several associating low BMI with increased POAG risk in European and Asian ancestry cohorts. METHODS 6,634 POAAGG study subjects were eligible: 2,977 cases and 3,657 controls. Ocular and demographic data were collected from on-site exams, standardized interviews, and electronic medical records. BMI was calculated: weight(kg)/height(m)2, and categorized as low (<18.5), moderate (18.5-24.9), high (25.0-29.9), or very high (≥30). Structural and functional POAG progression were assessed by annual rate of change in retinal nerve fiber layer thickness and visual field mean deviation, respectively, using a linear mixed-effects model. Regression analyses evaluated associations of BMI with POAG status, phenotype, and progression. RESULTS Lower BMI was associated with increased POAG risk (aOR[95% confidence interval], 1.02[1.007,1.023] per kg/m2 decrease in BMI, p=0.0003). In cases, low BMI was associated with larger cup-to-disc ratio (p=0.007) and worse visual acuity (p=0.04). Fast functional POAG progressors had a significantly lower mean BMI than slow progressors (25.7 vs. 30.0 kg/m2, p=0.04). CONCLUSIONS In this African ancestry cohort, low BMI was associated with increased POAG risk. POAG cases with low BMI were more likely to have larger cup-to-disc ratios, worse visual acuity, and faster functional progression, indicating more severe glaucoma.

中文翻译：

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低体重指数在非洲血统个体中患原发性开角型青光眼的风险更大。


目的 调查原发性开角型非裔美国人青光眼遗传学 （POAAGG） 研究的非洲血统队列中的体重指数 （BMI） 与原发性开角型青光眼 （POAG） 之间的关系。设计 回顾性、横断面“病例对照”比较研究。背景 POAG 是最普遍的青光眼类型，诊断较晚且病理生理学不明确，强调需要确定危险因素。先前关于 BMI 和 POAG 的研究得出了不同的结果，其中一些研究将低 BMI 与欧洲和亚洲血统队列中 POAG 风险增加联系起来。方法 6,634 名 POAAGG 研究对象符合条件：2,977 例和 3,657 名对照。从现场检查、标准化访谈和电子病历中收集眼部和人口统计数据。计算 BMI：体重 （kg）/身高 （m）2，分为低 （<18.5）、中度 （18.5-24.9）、高 （25.0-29.9） 或非常高 （≥30）。使用线性混合效应模型，分别通过视网膜神经纤维层厚度的年变化率和视野平均偏差来评估结构和功能 POAG 进展。回归分析评估了 BMI 与 POAG 状态、表型和进展的相关性。结果 较低的 BMI 与 POAG 风险增加相关 （aOR[95% 置信区间]，BMI 每降低 kg/m2 1.02[1.007,1.023]，p=0.0003）。在病例中，低 BMI 与较大的杯盘比 （p=0.007） 和较差的视力 （p=0.04） 相关。快速功能性 POAG 进展者的平均 BMI 显著低于慢进展者 （25.7 vs. 30.0 kg/m2，p=0.04）。结论 在这个非洲血统队列中，低 BMI 与 POAG 风险增加相关。 BMI 低的 POAG 病例更有可能具有更大的杯盘比、更差的视力和功能进展更快的情况，表明青光眼更严重。