Chronic Stress May Increase Glaucoma Risk and Contribute to Racial Disparities, reveals research

This retrospective case-control study utilized the AL biomarker data between December 1984 and June 2022 for patients in the AoU program. The study cohort comprised 349 participants with primary glaucoma (16.1%) and 1,819 controls with no glaucoma (83.9%). Participants were primarily diverse, consisting of 52.7% females, 2.2% Asians, 10.7% Blacks, 10.0% Hispanics, and 72.5% non-Hispanic Whites. In this study, researchers used an adapted Seeman AL scale to calculate the AL scores and used 10 biomarkers that reflect systemic stress through measurements like body mass index, blood pressure, cholesterol, and C-reactive protein.

The main results obtained from the analysis of data are:

• Participants who later developed glaucoma had a statistically significantly higher AL score than the controls, who did not acquire the disease. At a median of 6.4 years before diagnosis, the ones that developed the disease had an AL score of 3 (IQR 1-4) whereas the controls were at 2 (IQR 1-3), (p <0.001).

• Elevated AL was associated with an increased risk of developing glaucoma. The results of the multivariate logistic regression analysis showed that a one-point increase in the AL score raised the risk of glaucoma by 9% ( p ≤0.02).

• The risk of glaucoma was more than double when compared with non-Hispanic Whites for Black participants, and more than double for Hispanic participants (OR = 2.58 and OR = 2.12, respectively). The AL score partially mediated racial/ethnic differences in risk of glaucoma, accounting for 7.5% of the higher risk among Blacks, and 5.0% among Hispanics.

• While analyzing the various kinds of glaucoma, it was also determined that individuals with higher AL scores were considerably related to having primary open-angle glaucoma (POAG) (p = 0.01). On the other hand, a non-significant association between AL scores and primary angle-closure glaucoma (PACG) (p=0.87).

This study, therefore, gives a strong indication that greater AL, or the physiological effects of chronic stress, is associated with increased risk of glaucoma. Secondly, AL partially mediated racial and ethnic disparities in risk of glaucoma, suggesting that one contributor to a higher burden among Blacks and Hispanics is chronic stress. These findings emphasize the need to address chronic stress as part of efforts to prevent glaucoma and contribute to reduction of racial disparities in prevalence.

Reference:

Yoo, K., Lee, C., Baxter, S. L., & Xu, B. Y. (2024). Relationship between glaucoma and chronic stress quantified by allostatic load score in the all of Us Research Program. American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2024.09.009