Diabetes Metab Res Rev. 2026 Mar;42(3):e70142. doi: 10.1002/dmrr.70142.
ABSTRACT
OBJECTIVE: Obesity has been linked to elevated intraocular pressure (IOP); however, the metabolic pathways connecting body mass index (BMI) to IOP remain unclear.
METHODS: We conducted a prospective cohort study within the Jidong Eye Cohort (2022-2023, Tangshan, China) involving 2400 adults aged 18-65 years without diabetes. BMI was measured continuously, with obesity defined according to the Chinese national standard Criteria of Weight for Adults (WS/T 428-2013) (BMI ≥ 28 kg/m2), and IOP assessed bilaterally by standardised tonometry. Longitudinal associations between BMI and IOP were evaluated using linear mixed-effects models, and mediation through the triglyceride-glucose (TyG) index and hypertension was quantified by structural equation modelling.
RESULTS: At baseline, obesity was associated with higher IOP than non-obesity (right: 16.37 vs. 15.78 mmHg; left: 16.65 vs. 16.05 mmHg; p < 0.001). Higher BMI predicted increased IOP over time after adjusting for demographic, behavioural, and metabolic factors. Mediation analysis indicated that 43.4% of the total effect was indirect, mainly via TyG (0.0182), hypertension (0.0079), and their sequential path (0.0014).
CONCLUSION: The TyG index explained a larger share of the mediated effect than hypertension, while the remaining direct effect suggested additional mechanisms. These findings support incorporating metabolic profiling into early ocular risk assessment for individuals with elevated BMI.
PMID:41817120 | DOI:10.1002/dmrr.70142