title: Three Toxic Heavy Metals in Open-Angle Glaucoma with Low-Teen and High-Teen Intraocular Pressure: A Cross-Sectional Study from South Korea.
abstract: BACKGROUND
  To investigate the association between heavy metal levels and open-angle glaucoma (OAG) with low- and high-teen baseline intraocular pressure (IOP) using a population-based study design.
  
  
  METHODS
  This cross-sectional study included 5,198 participants older than 19 years of age who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2012 and had blood heavy metal levels available. The OAG with normal baseline IOP (IOP ≤ 21 mmHg) subjects were stratified into low-teen OAG (baseline IOP ≤ 15 mmHg) and high-teen OAG (15 mmHg < baseline IOP ≤ 21 mmHg), and the association between blood lead, mercury, and cadmium levels and glaucoma prevalence was assessed for low- and high-teen OAG.
  
  
  RESULTS
  The adjusted geometric mean of blood cadmium levels was significantly higher in subjects with low-teen OAG than that of the non-glaucomatous group (P = 0.028), whereas there were no significant differences in blood lead and mercury levels. After adjusting for potential confounders, the low-teen OAG was positively associated with log-transformed blood cadmium levels (OR, 1.41; 95% confidence interval (CI), 1.03-1.93; P = 0.026). For high-teen OAG, log-transformed blood levels of the three heavy metals were not associated with disease prevalence. The association between log-transformed blood cadmium levels and low-teen OAG was significant only in men (OR, 1.65; 95% CI, 1.10-2.48; P = 0.016), and not in women (OR, 1.10; 95% CI, 0.66-1.85; P = 0.709).
  
  
  CONCLUSIONS
  The results of this study suggest that cadmium toxicity could play a role in glaucoma pathogenesis, particularly in men and in OAG with low-teen baseline IOP.
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.|Department of Ophthalmology, Eulji University Hospital, Daejeon, South Korea.
authors: Si Hyung
authors: SH
authors: Lee
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors: Eun Min
authors: EM
authors: Kang
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors: Gyu Ah
authors: GA
authors: Kim
authors: Department of Statistics, University of Georgia, Athens, Georgia, United States of America.
authors: Seung Woo
authors: SW
authors: Kwak
authors: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Joon Mo
authors: JM
authors: Kim
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors: Hyoung Won
authors: HW
authors: Bae
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors: Gong Je
authors: GJ
authors: Seong
authors: Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
authors: Chan Yun
authors: CY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D019216:Metals, Heavy / Q000097:blood / Q000633:toxicity*; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019216:Metals, Heavy