title: A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study.
abstract: OBJECTIVE
  Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma.
  
  
  OBJECTIVE
  To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults.
  
  
  METHODS
  Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits).
  
  
  METHODS
  BMI, waist circumference, and percent fat mass.
  
  
  METHODS
  At each visit, IOP was measured in both eyes with automated noncontact tonometers.
  
  
  RESULTS
  In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model.
  
  
  CONCLUSIONS
  Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications.
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Di
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
authors.forename: Myung Hun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: National Center for Epidemiology, Carlos III Institute of Health and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pastor-Barriuso
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine. Seoul, South Korea.|Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Yoosoo
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine. Seoul, South Korea.|Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Seungho
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Yiyi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Rampal
authors.affiliation: Department of Family Medicine, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hocheol
authors.initials: H
authors.lastname: Shin
authors.affiliation: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Joon Mo
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.|Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, South Korea.
authors.forename: Juhee
authors.initials: J
authors.lastname: Cho
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005901:Glaucoma / Q000453:epidemiology*; D006801:Humans; D007429:Intraocular Pressure; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055105:Waist Circumference