The Role of Systemic Arterial Stiffness in Open-Angle Glaucoma with Diabetes Mellitus

Abstract

Purpose. To investigate the role of systemic arterial stiffness in glaucoma patients with diabetes mellitus (DM). Design. Retrospective, cross-sectional study. Participants. DM subjects who underwent brachial-ankle pulse wave velocity (baPWV) were recruited. Methods. Glaucoma patients (n = 75) and age-matched control subjects (n = 92) were enrolled. Systemic examination including BaPWV and detailed eye examination were performed. The glaucoma group was divided into subgroups of normal tension glaucoma (NTG, n = 55) and primary open-angle glaucoma (POAG) based on an IOP of 21 mmHg. BaPWV was used to stratify the population into 4 groups based on the rate. Stepwise multiple logistic regression analysis by baPWV quartiles was used to compare the glaucoma group with the control group. Main Outcome Measures. BaPWV in glaucoma with DM patients. Results. Faster baPWV was positively associated with glaucoma (odds ratio: 3.74; 95% CI: 1.03–13.56, stepwise multiple logistic regression analysis) in patients with DM. Increasing baPWV was also positively associated with glaucoma (p for trend = 0.036). The NTG subgroup showed similar results to those of the glaucoma group. Conclusions. In this study, increased arterial stiffness was shown to be associated with glaucoma and may contribute to the pathogenesis of glaucoma in DM patients.

Postprandial Glucose as a Risk Factor for Elevated Intraocular Pressure

“…Despite the lack of a clear mechanism by which hyperglycemia causes elevated IOP, insulin resistance might provide an explanation for previous studies [21,33]. Other studies revealed that systemic arterial stiffness may account for the pathogenesis of increasing IOP in patients with diabetes mellitus with related macrovascular or microvascular complications [11]. However, other studies have found that genetic factors played a role in the elevated IOP in diabetes mellitus patients [9].…”

“…Emerging evidence has illustrated the positive association of elevated IOP with a number of predisposing factors or chronic diseases, including age [5], sex [6], blood pressure [7,8], genetic linkage [9], central corneal thickness [10], arterial stiffness [11], diabetes [12] and obesity [13]. Among these predisposing factors that affect the intraocular pressure, we focused more on the metabolic variables due to their association with many systemic diseases including cardiovascular disease and diabetes [14,15], which are curable via life style modification and medication.…”

Relationships between Obesity, Nutrient Supply and Primary Open Angle Glaucoma in Koreans

“…Several studies have suggested a relationship between obesity and glaucoma [4,5], while an association between low BMI and glaucoma has also been reported [5]. Several systemic risk factors have been found to be associated with glaucoma, such as metabolic syndrome [6], diabetes mellitus [7], arterial stiffness [8], and renal disease [9]. Heavy smoking [10], low estrogen level [11], and low consumption of certain fruits, vegetables, fatty fish, and walnuts [12] have been reported to be risk factors for primary open angle glaucoma (POAG) [11][12][13].…”

A single gene connects stiffness in glaucoma and the vascular system

“…Based on this association between CFPWV and PEXG, the authors proposed that the CF-PWV outcomes may be considered a risk factor for PEXG. Likewise, in a retrospective chart review, brachial-ankle PWV (baPWV) was analyzed in four groups: diabetes patients with POAG, POAG alone, normal tension glaucoma (NTG) and matched controls (Shim et al, 2015). Increased baPWV was positively associated with glaucoma in patients with diabetes, as well as in patients with only POAG and/or NTG.…”

“…In the cell, stiffness is a physiological response that is required to resist an exogenous force. Stiffness is also associated with pathological conditions in a number of diseases such cardiovascular, cancer, chronic kidney disease (CKD), diabetes and glaucoma (Braunger et al, 2015; Kerr and Guerin, 2007; Mattace-Raso et al, 2006; Shim et al, 2015; Tiago et al, 2016; Visontai et al, 2005). Increased stiffness can be caused by a variety of cellular, cell-ECM and ECM hardening mechanisms.…”