Background

The level of fasting plasma glucose (FPG) is positively associated with intraocular pressure. Diabetes causes early structural changes of retina, especially on ganglion cell layer. In this regard, the FPG level itself may also show an independent association with open angle glaucoma (OAG) development in general population. Herein, we investigate the association of the FPG level with the incidence of OAG.

Methods

Using nationally representative data from the Korean National Health Insurance System, 374,376 subjects ≥40 years of age without OAG who underwent health examinations from 2009 to 2013 were enrolled and followed to the end of 2014. Incident cases of OAG using the International Classification of Diseases 10 codes and medication information were analyzed based on the levels of FPG.

Results

Subjects with the highest FPG level (≥160 mg/dL), compared with the lowest level (<80 mg/dL), showed a higher hazard ratio (HR) [2.189; 95% confidence interval (CI): 1.779–2.695; P for trend < 0.001] for OAG after adjustments for age and sex. This result persisted after further adjustments for the presence of type 2 diabetes, current smoking, drinking, and exercise habits, diastolic blood pressure, body mass index (BMI), and total cholesterol level (HR: 1.588; 95% CI: 1.268–1.989; P for trend < 0.001). The positive association between the FPG level and the incidence of OAG was distinct in subjects 40–64 years of age, those with a BMI <25 kg/m², and those without hypertension (HR 2.022; 95% CI: 1.494–2.736; P for trend <0.001: HR 1.817; 95% CI: 1.372–2.407; P for trend < 0.001: HR 1.706; 95% CI: 1.180–2.467; P for trend <0.001, respectively).

Conclusions

This nationwide population-based cohort study showed that the fasting glucose was associated with an increased risk of OAG. These findings suggest that subjects with high FPG levels require special attention when screening for glaucoma.

中文翻译：

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空腹血糖水平和开角型青光眼的风险：韩国全国基于人群的队列研究。

背景

空腹血浆葡萄糖（FPG）的水平与眼内压呈正相关。糖尿病会引起视网膜的早期结构变化，尤其是在神经节细胞层上。在这方面，FPG水平本身也可能显示与普通人群开角型青光眼（OAG）的发展有独立的联系。在本文中，我们调查了FPG水平与OAG发生率的关系。

方法

使用韩国国家健康保险系统中具有国家代表性的数据，纳入了2009年至2013年接受健康检查且年龄在40岁以上且没有OAG的374,376名受试者，并随访至2014年底。采用国际疾病分类的OAG事件病例10根据FPG的水平分析代码和用药信息。

结果

FPG最高水平（≥160mg / dL）与最低水平（<80 mg / dL）相比，患病率（HR）更高[2.189; 95％置信区间（CI）：1.779–2.695；调整年龄和性别后，OAG的趋势<0.001]的P。在对2型糖尿病的存在，当前吸烟，饮酒和运动习惯，舒张压，体重指数（BMI）和总胆固醇水平进行进一步调整后，该结果仍然存在（HR：1.588； 95％CI：1.268-1.989 ; P表示趋势<0.001）。在40-64岁的受试者，BMI <25 kg / m ^2的受试者和没有高血压的受试者中，FPG水平与OAG的发生之间呈正相关（HR 2.022； 95％CI：1.494-2.736；P趋势<0.001：HR 1.817; 95％CI：1.372–2.407；趋势<0.001的P：HR 1.706；95％CI：1.180-2.467；P分别表示趋势<0.001。

结论

这项基于全国人群的队列研究表明，空腹血糖与OAG风险增加有关。这些发现表明，在筛查青光眼时，FPG水平高的受试者需要特别注意。