Association Between Adiposity Indicators and Intraocular Pressure

In a nationally representative sample, intraocular pressure was linked to multiple adiposity indicators in men but only select measures in women, with ocular hypertension significantly associated with obesity and abdominal obesity in men.

To evaluate the association between intraocular pressure (IOP) and adipose indicators and to investigate sex differences in these associations.

A population-based cross-sectional study. A total of 7407 Korean adults from the 2019 to 2021 Korea National Health and Nutrition Examination Survey VIII database. Body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI), lipid accumulation product (LAP), and cardiometabolic index (CMI) were evaluated as adiposity indicators. The IOPs in both eyes were measured using rebound tonometer. Complex sample general linear models and logistic regression analyses were performed to assess associations between adiposity indicators and IOP or ocular hypertension, adjusting for demographic, health behaviors, and clinical covariates. IOP and ocular hypertension.

IOP was positively associated with all adiposity indicators (BMI, waist circumference, LAP, VAI, and CMI) in men, whereas only BMI, WC, and LAP were associated with IOP in women. For ocular hypertension, BMI, WC, and LAP were significantly associated with increased odds in men. Notably, men with both obesity and abdominal obesity had higher odds of ocular hypertension (OR 3.24, 95% CI, 1.47-7.13), and those with abdominal obesity alone also showed elevated risk (OR 3.35, 95% CI, 1.58-7.11). In women, none of the adiposity indicators or obesity categories were significantly associated with ocular hypertension.

In this Korean population, adiposity indicators were more strongly associated with IOP and ocular hypertension in men than in women. Abdominal adiposity appeared to play a particularly important role, suggesting sex-specific pathways in IOP regulation.