Association Between Intraocular Pressure and Risk Factors for Metabolic Syndrome in Korea

Glaucoma, the second leading cause of blindness worldwide, is associated with elevated intraocular pressure (IOP). Metabolic syndrome, a cluster of conditions that includes obesity, hypertension, hyperglycemia, and dyslipidemia, has been linked to increased IOP. This study investigated the relationship between IOP and metabolic syndrome risk factors in an adult Korean population.

Data from 1,896 adults (aged 19-59 years) from the 2021 Korea National Health and Nutrition Examination Survey were analyzed. The exclusion criteria were age < 19 years; use of anti-glaucoma medications or anti-inflammatory eye drops; history of glaucoma, retinal, or refractive surgery; and a diagnosis of glaucoma. Metabolic syndrome risk factors, including blood pressure, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance, body mass index, abdominal obesity, triglycerides, and high-density lipoprotein cholesterol were examined for their association with ocular hypertension (OHT) using multivariate logistic regression.

Participants with metabolic syndrome (n = 383, 20.3%) demonstrated a higher mean IOP (16.05 ± 0.15 mmHg) compared with the normal group (15.33 ± 0.09 mmHg; P < 0.001). OHT was present in 33 patients (1.2%), and its prevalence did not differ significantly between the normal and metabolic syndrome groups. In multiple linear regression, risk factors, including hyperglycemia (P = 0.037) and hypertriglyceridemia (P = 0.027), were significantly associated with IOP. Abdominal obesity showed a strong association with OHT in multivariate analysis (odds ratio, 2.90; 95% confidence interval, 1.35-6.23; P = 0.007).

Risk factors for metabolic syndrome, particularly abdominal obesity, were strongly associated with OHT. These findings emphasize the importance of regular IOP screening to prevent glaucoma progression in individuals with metabolic syndrome.