A Blurred Vision of Health: Metabolic Syndrome as a Risk Factor for Glaucoma in a Large Taiwanese Population Study

Background: Glaucoma is a leading cause of irreversible blindness that is increasingly being linked to systemic metabolic disturbances. Metabolic syndrome (MetS) is a cluster of metabolic conditions that are associated with various ocular diseases, however the relationship between MetS and glaucoma remains insufficiently explored. This study aimed to investigate the associations between MetS and its components of central obesity, impaired glucose tolerance, high blood pressure, high blood triglycerides, and low high-density lipoprotein with glaucoma in a large Taiwanese population. Methods: A cross-sectional analysis was conducted using data from the Taiwan Biobank, encompassing 93,905 participants aged 40 years and older. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria, and glaucoma status was determined through self-reported diagnoses. Statistical analyses included logistic regression models adjusted for demographic and clinical variables. Results: The prevalence of MetS in the study population was 25.6%, and the association between MetS and glaucoma was significant (adjusted odds ratio [OR] = 1.15; 95% confidence interval [CI]: 1.02-1.30). A dose-response relationship was observed, with the risk of glaucoma increasing along with the number of MetS components, with a peak OR of 1.36 for individuals with four MetS components. Among the MetS components, impaired glucose tolerance showed the strongest association with glaucoma (OR = 1.17; 95% CI: 1.03-1.32). MetS was an independent risk factor for glaucoma, and the risk increased in parallel with the number of metabolic abnormalities. Conclusions: These findings show the importance of metabolic health in preventing glaucoma and suggest that targeted screening and early interventions may help to mitigate the risk of glaucoma in individuals with MetS.