Xiao-Yang Luo1,2, Nicholas Y Q Tan2,3, Miao-Li Chee2, Yuan Shi2, Yih-Chung Tham2, Tien Yin Wong2,3,4, Jie Jin Wang5, Ching-Yu Cheng2,3,4. 1. Department of Ophthalmology, Guangdong Eye Institute, Guangdong Academic of Medical Sciences, Guangdong General Hospital, Guangzhou, China. 2. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. 3. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 4. Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-National University of Singapore Medical School, Singapore. 5. Duke-National University of Singapore Medical School, Singapore.
Abstract
Purpose: The association between diabetes and IOP is controversial; diabetes is associated with thicker central corneal thickness (CCT), and thicker CCT is associated with higher IOP. We therefore aimed to clarify the diabetes-IOP association, considering CCT as a potential mediator. Methods: We included 8636 participants from the Singapore Epidemiology of Eye Diseases (SEED) Study. Associations of diabetes, serum glucose, or HbA1c with IOP were assessed using regressions models, with adjustments for potential confounding factors. Regression-based mediation (path) analyses were further performed to evaluate the indirect effects of diabetes on IOP through the mediator (CCT), in addition to the direct effect of diabetes on IOP. Results: Of the 8636 participants, 2524 (29.23%) had diabetes. Diabetes, higher serum glucose, or HbA1c levels were all associated with higher IOP (all P < 0.01). The effect of diabetes on IOP was partially and minimally mediated through CCT; the proportion of mediating effect of CCT was 11.09% of the total effect of diabetes on IOP. Axial length and spherical equivalent were not mediating variables in the diabetes-IOP association. Findings were consistent across three ethnicity groups. Conclusions: Diabetes or higher long-term hyperglycemia was associated with higher IOP. CCT contributed a small proportion of mediating effect to the total effect of diabetes on IOP. We conclude that high IOP observed in diabetes is mainly due to the direct association of diabetes and IOP, and this finding may have pathophysiologic significance with respect to the risk of glaucoma among persons with diabetes.
Purpose: The association between diabetes and IOP is controversial; diabetes is associated with thicker central corneal thickness (CCT), and thicker CCT is associated with higher IOP. We therefore aimed to clarify the diabetes-IOP association, considering CCT as a potential mediator. Methods: We included 8636 participants from the Singapore Epidemiology of Eye Diseases (SEED) Study. Associations of diabetes, serum glucose, or HbA1c with IOP were assessed using regressions models, with adjustments for potential confounding factors. Regression-based mediation (path) analyses were further performed to evaluate the indirect effects of diabetes on IOP through the mediator (CCT), in addition to the direct effect of diabetes on IOP. Results: Of the 8636 participants, 2524 (29.23%) had diabetes. Diabetes, higher serum glucose, or HbA1c levels were all associated with higher IOP (all P < 0.01). The effect of diabetes on IOP was partially and minimally mediated through CCT; the proportion of mediating effect of CCT was 11.09% of the total effect of diabetes on IOP. Axial length and spherical equivalent were not mediating variables in the diabetes-IOP association. Findings were consistent across three ethnicity groups. Conclusions: Diabetes or higher long-term hyperglycemia was associated with higher IOP. CCT contributed a small proportion of mediating effect to the total effect of diabetes on IOP. We conclude that high IOP observed in diabetes is mainly due to the direct association of diabetes and IOP, and this finding may have pathophysiologic significance with respect to the risk of glaucoma among persons with diabetes.
Authors: Vincent Laville; Jae H Kang; Clara C Cousins; Adriana I Iglesias; Réka Nagy; Jessica N Cooke Bailey; Robert P Igo; Yeunjoo E Song; Daniel I Chasman; William G Christen; Peter Kraft; Bernard A Rosner; Frank Hu; James F Wilson; Puya Gharahkhani; Alex W Hewitt; David A Mackey; Pirro G Hysi; Christopher J Hammond; Cornelia M vanDuijn; Jonathan L Haines; Veronique Vitart; John H Fingert; Michael A Hauser; Hugues Aschard; Janey L Wiggs; Anthony P Khawaja; Stuart MacGregor; Louis R Pasquale Journal: Am J Ophthalmol Date: 2019-05-20 Impact factor: 5.258
Authors: Andrzej Grzybowski; Mariusz Och; Piotr Kanclerz; Christopher Leffler; Carlos Gustavo De Moraes Journal: J Clin Med Date: 2020-03-11 Impact factor: 4.241