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Original article The association between obesity and glaucoma in older adults: evidence from the China Health and Retirement Longitudinal Study
Xiaohuan Zhao1orcid , Qiyu Bo1orcid , Junran Sun1orcid , Jieqiong Chen1orcid , Tong Li1orcid , Xiaoxu Huang1orcid , Minwen Zhou1orcid , Jing Wang1orcid , Wenjia Liu2orcid , Xiaodong Sun1orcid
Epidemiol Health 2023;e2023034
DOI: https://doi.org/10.4178/epih.e2023034 [Accepted]
Published online: March 9, 2023
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1Shanghai General Hospital, Shanghai, China
2Shanghai General Hospital, Shanghai, China
Corresponding author:  Jing Wang,
Email: echocroft@163.com
Wenjia Liu,
Email: echocroft@163.com
Received: 22 October 2022   • Revised: 13 February 2023   • Accepted: 22 February 2023
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Abstract

Objectives
This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study.
Methods
Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk.
Results
Older men living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all P<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all P<0.05). After the model was adjusted for demographic, socio-economic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.898; 95% CI, 0.829-0.973) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.882; 95% CI, 0.803-0.968). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all P<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all P<0.05).
Conclusions
This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.

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