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Epidemiology and Population Health

Obesity and risk of age-related eye diseases: a systematic review of prospective population-based studies

Abstract

Background

Obesity is a public health challenge worldwide. The relationship between obesity and age-related eye diseases including cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR) have remained elusive.

Design and methods

We conducted a systematic review of three electronic databases for longitudinal population-based studies that described associations between measures of obesity including body mass index (BMI), waist-circumference (WC), and waist-to-hip ratio (WHR), and age-related eye diseases.

Results

Our search yielded 1731 articles, of which 14, 10, 16 and 8 articles met our eligibility criteria for cataract, glaucoma, AMD and DR, respectively. BMI-defined obesity was positively associated with incident cataract, incident AMD and incident DR in Western populations, but in Asian populations associations for incident AMD were not significant and associations for incident DR were inverse. WC-defined obesity was associated with incident glaucoma in non-Western populations. WHR-defined obesity but not BMI-defined obesity was associated with the incidence or progression of AMD in two Western studies.

Conclusions

Overall, we found strong evidence supporting associations between obesity and age-related eye diseases. Further research on the association of abdominal obesity and effect of weight loss and physical activity on age-related eye diseases is warranted to support clinical and public health recommendations.

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Fig. 1: Selection of studies that assessed the prospective association between obesity and age-related eye studies in adults.
Fig. 2: Pathological mechanisms underlying the relationship between obesity and age-related eye diseases.

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Acknowledgements

This study was supported by funding from Singapore Health Services under the Medical Student Talent Development Award. The authors also appreciate the support of Duke-NUS/SingHealth Academic Medicine Research Institute. We thank Miss. Riswana Banu Binte Mohamed Abdul, Singapore Eye Research Institute, Singapore for her help with the formatting of the manuscript.

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Correspondence to Charumathi Sabanayagam.

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Ng Yin Ling, C., Lim, S.C., Jonas, J.B. et al. Obesity and risk of age-related eye diseases: a systematic review of prospective population-based studies. Int J Obes 45, 1863–1885 (2021). https://doi.org/10.1038/s41366-021-00829-y

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