Prospective Study of Type 2 Diabetes Mellitus and Risk of Primary Open-Angle Glaucoma in Women
Presented in part at: Association for Research in Vision and Ophthalmology meeting, May 2005, Ft. Lauderdale, Florida.
Received 8 October 2005; accepted 21 January 2006. published online 05 June 2006.
Purpose
To study the relation between type 2 diabetes mellitus (T2DM) and incident primary open-angle glaucoma (POAG) in women.
Design
Prospective cohort analysis.
Participants
Seventy-six thousand three hundred eighteen women enrolled in the Nurses’ Health Study (NHS).
Methods
Women enrolled in the NHS from 1980 to 2000 were observed. Eligible participants were at least 40 years old, did not have POAG at baseline, and reported receiving eye examinations during follow-up. Potential confounders were assessed on biennial questionnaires, and a diagnosis of T2DM was confirmed on a validated supplemental questionnaire. During follow-up, 429 self-reported POAG cases confirmed by medical chart review were identified.
Main Outcome Measures
Multivariable rate ratios (RRs) of POAG and associated 95% confidence intervals (CIs) obtained from proportional hazards models.
Results
After controlling for age, race, hypertension, body mass index, physical activity, alcohol intake, smoking, and family history of glaucoma, T2DM was positively associated with POAG (RR = 1.82 [95% CI = 1.23–2.70]). Nonetheless, the association did not strengthen with longer duration of diabetes: RR = 2.24 (95% CI = 1.31–3.84) for duration < 5 years versus RR = 1.54 (95% CI = 0.90–2.62) for duration ≥ 5 years). In secondary analyses, to evaluate the potential for detection bias we controlled for additional factors such as the number of eye examinations, but T2DM remained positively associated with POAG.
Conclusion
Type 2 diabetes mellitus is associated with an increased risk of POAG in women.
1Glaucoma Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
2Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.
3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
4Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.
5Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts.
6Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts.
Correspondence to Louis R. Pasquale, MD, Glaucoma Service, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114.
Manuscript no. 2005-962.
The authors have no financial interest related to this article.
Supported by National Institutes of Health, Bethesda, Maryland (grant nos.: CA 87969, EY09611, EY015473).
ABSTRACT