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The association between obesity and glaucoma in older adults: evidence from the China Health and Retirement Longitudinal Study
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Xiaohuan Zhao, Qiyu Bo, Junran Sun, Jieqiong Chen, Tong Li, Xiaoxu Huang, Minwen Zhou, Jing Wang, Wenjia Liu, Xiaodong Sun
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Epidemiol Health. 2023;45:e2023034. Published online March 9, 2023
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DOI: https://doi.org/10.4178/epih.e2023034
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Abstract
OBJECTIVES
This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study.
METHODS Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk.
RESULTS Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05).
CONCLUSIONS This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.
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Summary
Key Message
Glaucoma is a neurodegenerative disease and the leading cause of irreversible vision loss worldwide. The diagnosis of glaucoma is frequently delayed, as it may be asymptomatic until a relatively late stage. Thus, there is a need to identify protective and risk factors for glaucoma. Glaucoma is a multifactorial disease, and the impact of obesity on glaucoma risk remains uncertain. This study evaluated the association between obesity and glaucoma in middle-aged and older people. This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease.
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Citations
Citations to this article as recorded by  - Evaluating the impact of caloric restriction, body mass index and exercise on primary open-angle glaucoma: A review
Jonathan YM Lai, Patrick Mclarnon, Carl Sheridan, Neeru A Vallabh
European Journal of Ophthalmology.2025; 35(2): 429. CrossRef - Obesity and its management in primary care setting
Mahmoud Ibrahim, Ebtesam M. Ba-Essa, Jessica A. Alvarez, Jason Baker, Vincenzo Bruni, Avivit Cahn, Antonio Ceriello, Francesco Cosentino, Melanie J. Davies, Francesco De Domenico, Robert H. Eckel, Allon N. Friedman, Jonathan Goldney, Omer Hamtzany, Scott
Journal of Diabetes and its Complications.2025; 39(7): 109045. CrossRef - The relationship between weight-adjusted-waist index, body mass index and diabetic retinopathy among American adults: a population-based analysis
Songtao Wang, Hecong Qin, Yu Zhang, Ning Yang, Jinsong Zhao
Scientific Reports.2024;[Epub] CrossRef - The Weight on Sight: Exploring the Links Between Obesity and Ocular Diseases
Ahmed Bilal, Muslim Bilal, Alia Hathaf, Danyal Usman, Nadim Haboubi
Cureus.2024;[Epub] CrossRef
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