High intraocular pressure is associated with cardiometabolic risk factors in South Korean men: Korean National Health and Nutrition Examination Survey, 2008–2010 Y-H Kim 1,4 , SW Jung 1,4 , G-E Nam 1 , K Do Han 2 , AR Bok 1 , SJ Baek 1 , K-H Cho 1 , YS Choi 1 , S-M Kim 1 , S-Y Ju 3 and D-H Kim 1 Abstract Objective Elevated intraocular pressure (IOP) contributes to the progression of visual defects such as glaucoma. This study determined whether metabolic syndrome (MetS) and cardiovascular risk factors are associated with IOP in South Korean men. Methods We analyzed data on 4875 men who participated in the Korean National Health and Nutrition Examination Survey 2008–2010. We recorded the values for age, weight, height, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), insulin, homeostasis model assessment of estimated insulin resistance (HOMA-IR), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), non-HDL-C (NHDL-C), and TG/HDL-C, as well as sociodemographic factors. IOP was measured using Goldmann applanation tonometry. Results Weight, BMI, WC, SBP, DBP, FBG, insulin, HOMA-IR, TC, LDL-C, TG, NHDL-C, TG/HDL-C, and the prevalence of MetS differed significantly among the three groups with IOP (Po0.05). Mean IOP was higher in subjects who were obese and had hypertension, diabetes mellitus, MetS, abdominal obesity, high TG, high FBG, or high BP compared with normal subjects (Po0.005). Analysis using Pearson’s correlation coefficient showed that all cardiometabolic risk factors were significantly associated with IOP (Po0.005), with the exception of WC and HDL-C. A multivariate linear regression analysis showed that IOP was positively correlated with BMI, SBP, DBP, FBG, HOMA-IR, TC, LDL-C, TG, NHDL-C, and TG/HDL-C after adjusting for all covariates (all Po0.05). Conclusions Cardiometabolic risk factors, including the components of MetS, are associated with increased IOP. Eye (2014) 28, 672–679; doi:10.1038/eye.2014.43; published online 7 March 2014 Introduction Glaucoma is an ophthalmological disease characterized by optic nerve injury, which can result in loss of vision. 1 The well-known risk factors for glaucoma include African ethnicity, family history of glaucoma, severe myopia, and high intraocular pressure (IOP). 1,2 Of these risk factors, high IOP is one of the strongest risk factors for glaucoma, and therefore, reducing IOP may delay the development of primary open-angle glaucoma. 3,4 Metabolic syndrome (MetS) is a collection of risk factors that increases the chance of an individual developing cardiovascular disease and diabetes mellitus (DM). 5,6 Insulin resistance is an original conceptualization of MetS and is a risk factor for the development of metabolic abnormalities, such as hypertension (HTN), obesity, impaired glucose tolerance, dyslipidemia, elevated 1 Department of Family Medicine, Korea University College of Medicine, Seoul, Korea 2 Department of Medical Statistics, Catholic University College of Medicine, Seoul, Korea 3 Department of Family Medicine, Catholic University College of Medicine, Seoul, Korea Correspondence: D-H Kim, Department of Family Medicine, Korea University College of Medicine, 516, Gojan 1-Dong, Danwon-Gu, Ansan-Si, Gyeonggi-Do, 425-707, South Korea Tel: +82 31 412 5365; Fax: +82 31 412 5364. E-mail: kmcfm@hanmail.net 4 These authors contributed equally to this work. Received: 6 November 2013 Accepted in revised form: 24 January 2014 Published online: 7 March 2014 CLINICAL STUDY Eye (2014) 28, 672–679 & 2014 Macmillan Publishers Limited All rights reserved 0950-222X/14 www.nature.com/eye