Ocular Manifestations of Metabolic Syndrome

Authors

1 Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Department of Ophthalmology, Mashhad University of Medical Sciences, Mashhad, IR Iran

3 Student Research Committee, Department of Modern Sciences and New Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

4 4Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IR Iran 5 Department of Optometry, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mash

10.5812/rijm.16478

Abstract

Context: Metabolic syndrome (metabolic syndrome X) is a prevalent cluster of risk factors that include high BMI, hypertension, insulin resistance and dyslipidemia. Individuals with metabolic syndrome are at an increased risk of coronary artery disease (CAD) and diabetes mellitus. Diabetes mellitus and hypertension (HTN) are associated with retinopathy and cataract. Evidence Acquisition: Bibliographical searches were performed using MEDLINE/ScienceDirect/OVID up to October 2013 using the following keywords (all fields): (“metabolic syndrome” OR “Met syndrome”) AND [(ocular disease) OR (cataract) OR (glaucoma) OR (age- related maculopathy). Results: This review explores the relationship between metabolic syndrome, including all its components, and various ocular conditions such as retinopathy, central retinal artery occlusion, cataract and elevated intraocular pressure. Conclusions: Today, the prevalence of metabolic syndrome is increasing, because world population life in prevalence behaviors have changed. Its association with various ocular manifestations such as non-diabetic retinopathy, CRAO, cataract, and primary open angle glaucoma suggests that an epidemic of Met syndrome can have far-fetched ocular consequences as well.

Keywords


  1. 1.Expert Panel on Detection ETOHBCIA. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–97.

    1. Mirhosseini NZ, Yusoff NA, Shahar S, Parizadeh SM, Mobarhen MG, Shakery MT. Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran. Asia Pac J Clin Nutr. 2009;18(1):131–6.
    2. WHO Expert Consultation.. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.
    3. Yazdandoust S, Parizadeh SM, Moohebati M, Yaghmaei P, Rahsepar AA, Tavallaie S, et al. Serum small dense low-density lipoprotein concentrations are elevated in patients with significant coronary artery stenosis and are related to features of the metabolic syndrome. Lipids. 2012;47(10):963–72. 5. Farahmand SK, Gang LZ, Saghebi SA, Mohammadi M, Mohammadi S, Mohammadi G, et al. The effects of wet cupping on coronary risk factors in patients with metabolic syndrome: a randomized controlled trial. Am J Chin Med. 2012;40(2):269–77.
    4. Wong TY, Klein R, Klein BEK, Tielsch JM, Hubbard L, Nieto FJ. Retinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality. Surv Ophthalmol. 2001;46(1):59–80.
    5. Tan JS, Wang JJ, Mitchell P. Influence of diabetes and cardiovascular disease on the long-term incidence of cataract: the Blue Mountains eye study. Ophthalmic Epidemiol. 2008;15(5):317–27.
    6. Mitchell P, Smith W, Chey T, Healey PR. Open-angle Glaucoma and Diabetes. Ophthalmol. 1997;104(4):712–8.
    7. Dielemans I, Vingerling JR, Algra D, Hofman A, Grobbee DE, de Jong PTVM. Primary Open-angle Glaucoma, Intraocular Pressure, and Systemic Blood Pressure in the General Elderly Population. Ophthalmol. 1995;102(1):54–60.
    8. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287(3):356–9.
    9. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005;28(11):2745–9.
    10. Masoudi-Kazemabad A, Jamialahmadi K, Moohebati M, Mojarrad M, Manshadi RD, Akhlaghi S, et al. Neuropeptide Y Leu7Pro polymorphism associated with the metabolic syndrome and its features in patients with coronary artery disease. Angiol. 2013;64(1):40–5.
    11. Azimi-Nezhad M, Herbeth B, Siest G, Dade S, Ndiaye NC, Esmaily H, et al. High prevalence of metabolic syndrome in Iran in comparison with France: what are the components that explain this? Metab Syndr Relat Disord. 2012;10(3):181–8.
    12. George SJ, Johnson J. Atherosclerosis: molecular and cellular mechanisms.United States: Wiley-VCH; 2010.
    13. Kleemann R, Zadelaar S, Kooistra T. Cytokines and atherosclerosis: a comprehensive review of studies in mice. Cardiovasc Res. 2008;79(3):360–76.
    14. Mallat Z, Ait-Oufella H, Tedgui A. Regulatory T-cell immunity in atherosclerosis. Trends Cardiovasc Med. 2007;17(4):113–8.
    15. Tedgui A, Ait-Oufella H, Mallat Z. Cytokines and Atherosclerosis. In: George SJ, editor. Atherosclerosis: Molecular and Cellular Mechanisms. United States: Wiley; 2010.
    16. Congdon NG, Friedman DS, Lietman T. Important causes of visual impairment in the world today. JAMA. 2003;290(15):2057–60.
    17. Wong TY, Loon SC, Saw SM. The epidemiology of age related eye diseases in Asia. Br J Ophthalmol. 2006;90(4):506–11.
    18. Klein BEK, Klein R, Lee KE. Diabetes, cardiovascular disease, selected cardiovascular disease risk factors, and the 5-year incidence of agerelated cataract and progression of lens opacities: the beaver dam eye study. Am J Ophthalmol. 1998;126(6):782–90.
    19. Saxena S, Mitchell P, Rochtchina E. Five-year incidence of cataract in older persons with diabetes and pre-diabetes. Ophthalmic Epidemiol. 2004;11(4):271–7.
    20. Rowe NG, Mitchell PG, Cumming RG, Wans JJ. Diabetes, fasting blood glucose and age-related cataract: the Blue Mountains Eye Study. Ophthalmic Epidemiol. 2000;7(2):103–14.
    21. Hennis A, Wu SY, Nemesure B, Leske MC, Barbados Eye Studies G. Risk factors for incident cortical and posterior subcapsular lens opacities in the Barbados Eye Studies. Arch Ophthalmol. 2004;122(4):525–30.
    22. Weintraub JM, Willett WC, Rosner B, Colditz GA, Seddon JM, Hankinson SE. A prospective study of the relationship between body mass index and cataract extraction among US women and men. Int J Obes Relat Metab Disord. 2002;26(12):1588–95.
    23. Schaumberg DA, Glynn RJ, Christen WG, Hankinson SE, Hennekens CH. Relations of body fat distribution and height with cataract in men. Am J Clin Nutr. 2000;72(6):1495–502.
    24. Jacques PF, Moeller SM, Hankinson SE, Chylack LJ, Rogers G, Tung W, et al. Weight status, abdominal adiposity, diabetes, and early age-related lens opacities. Am J Clin Nutr. 2003;78(3):400–5.
    25. Schaumberg D. A Prospective Study of Blood Pressure and Risk of Cataract in Men. Annals Epidemiol. 2001;11(2):104–10.
    26. Younan C, Mitchell P, Cumming R, Rochtchina E, Panchapakesan J, Tumuluri K. Cardiovascular disease, vascular risk factors and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study. Ophthalmic Epidemiol. 2003;10(4):227–40.
    27. Hiller R, Sperduto RD, Reed GF, D’Agostino RB, Wilson PWF. Serum lipids and age-related lens opacities: A longitudinal investigation. Ophthalmol. 2003;110(3):578–83.
    28. Klein BE, Klein R, Lee KE. Cardiovascular disease, selected cardiovascular disease risk factors, and age-related cataracts: the Beaver Dam Eye Study. Am J Ophthalmol. 1997;123(3):338–46.
    29. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. The Lancet. 2005;366(9491):1059–62.
    30. Azimi-Nezhad M, Ghayour-Mobarhan M, Safarian M, Esmailee H, Parizadeh SM, Rajabi-Moghadam M, et al. Anthropometric indices of obesity and the prediction of cardiovascular risk factors in an Iranian population. Scie World J. 2009;9:424–30.
    31. Stitt AW. Advanced glycation: an important pathological event in diabetic and age related ocular disease. Br J Ophthalmol. 2001;85(6):746–53.
    32. Klein BE, Klein R, Lee KE, Knudtson MD, Tsai MY. Markers of inflammation, vascular endothelial dysfunction, and age-related cataract. Am J Ophthalmol. 2006;141(1):116–22.
    33. Paunksnis A, Bojarskiene F, Cimbalas A, Cerniauskiene LR, Luksiene DI, Tamosiunas A. Relation between cataract and metabolic syndrome and its components. Eur J Ophthalmol. 2007;17(4):605–14.
    34. Galeone C, Petracci E, Pelucchi C, Zucchetto A, La Vecchia C, Tavani A. Metabolic syndrome, its components and risk of age-related cataract extraction: a case-control study in Italy. Ann Epidemiol. 2010;20(5):380–4.
    35. Lindblad BE, Hakansson N, Philipson B, Wolk A. Metabolic syndrome components in relation to risk of cataract extraction: a prospective cohort study of women. Ophthalmol. 2008;115(10):1687–92.
    36. Hiller R, Sperduto RD, Ederer F. Epidemiologic associations with nuclear, cortical, and posterior subcapsular cataracts. Am J Epidemiol. 1986;124(6):916–25.
    37. Sabanayagam C, Wang JJ, Mitchell P, Tan AG, Tai ES, Aung T, et al. Metabolic syndrome components and age-related cataract: the Singapore Malay eye study. Invest Ophthalmol Vis Sci. 2011;52(5):2397–404.
    38. Lazaro C, Garcia-Feijoo J, Castillo A, Perea J, Martinez-Casa JM, Garcia-Sanchez J. Impact of intraocular pressure after filtration surgery on visual field progression in primary open-angle glaucoma. Eur J Ophthalmol. 2007;17(3):357–62.
    39. Civan MM, Macknight AD. The ins and outs of aqueous humour secretion. Exp Eye Res. 2004;78(3):625–31.
    40. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90(3):262–7.
    41. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol. 1996;80(5):389–93. 44. Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, et al. Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the Ameri- Rahimi HR et al. Razavi Int J Med. 2014;2(2):e16478 5 can Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2009;119(4):628–47.
    42. Lee JS, Lee SH, Oum BS, Chung JS, Cho BM, Hong JW. Relationship between intraocular pressure and systemic health parameters in a Korean population. Clin Experiment Ophthalmol. 2002;30(4):237–41.
    43. Memarzadeh F, Ying-Lai M, Azen SP, Varma R, Los Angeles Latino Eye Study G. Associations with intraocular pressure in Latinos: the Los Angeles Latino Eye Study. Am J Ophthalmol. 2008;146(1):69–76.
    44. Chang YC, Lin JW, Wang LC, Chen HM, Hwang JJ, Chuang LM. Association of intraocular pressure with the metabolic syndrome and novel cardiometabolic risk factors. Eye (Lond). 2010;24(6):1037–43.
    45. Oh SW, Lee S, Park C, Kim DJ. Elevated intraocular pressure is associated with insulin resistance and metabolic syndrome. Diabetes Metab Res Rev. 2005;21(5):434–40.
    46. Szaflik JP, Rusin P, Zaleska-Zmijewska A, Kowalski M, Majsterek I, Szaflik J. Reactive oxygen species promote localized DNA damage in glaucoma-iris tissues of elderly patients vulnerable to diabetic injury. Mutat Res. 2010;697(1-2):19–23.
    47. Bulpitt CJ, Hodes C, Everitt MG. Intraocular pressure and systemic blood pressure in the elderly. Br J Ophthalmol. 1975;59(12):717– 20.
    48. Shiose Y, Kawase Y. A new approach to stratified normal intraocular pressure in a general population. Am J Ophthalmol. 1986;101(6):714–21.
    49. Wolf S, Arend O, Sponsel WE, Schulte K, Cantor LB, Reim M. Retinal hemodynamics using scanning laser ophthalmoscopy and hemorheology in chronic open-angle glaucoma. Ophthalmology. 1993;100(10):1561–6.
    50. Song J, Deng PF, Stinnett SS, Epstein DL, Rao PV. Effects of cholesterol-lowering statins on the aqueous humor outflow pathway. Invest Ophthalmol Vis Sci. 2005;46(7):2424–32.
    51. Klein BE, Klein R, Linton KL. Intraocular pressure in an American community. The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1992;33(7):2224–8.
    52. Teuscher AU, Meienberg O. Ischaemic oculomotor nerve palsy. Clinical features and vascular risk factors in 23 patients. J Neurol. 1985;232(3):144–9.
    53. Raina J, Foster JA. Obesity as a cause of mechanical entropion. Am J Ophthalmol. 1996;122(1):123–5.
    54. Purvin VA, Kawasaki A, Yee RD. Papilledema and obstructive sleep apnea syndrome. Arch Ophthalmol. 2000;118(12):1626–30.
    55. McNab AA. The eye and sleep. Clin Experiment Ophthalmol. 2005;33(2):117–25. 59. Wong TY, Duncan BB, Golden SH, Klein R, Couper DJ, Klein BE, et al. Associations between the metabolic syndrome and retinal microvascular signs: the Atherosclerosis Risk In Communities study. Invest Ophthalmol Vis Sci. 2004;45(9):2949–54.
    56. Kawasaki R, Tielsch JM, Wang JJ, Wong TY, Mitchell P, Tano Y, et al. The metabolic syndrome and retinal microvascular signs in a Japanese population: the Funagata study. Br J Ophthalmol. 2008;92(2):161–6.
    57. Hayreh SS. Ischaemic optic neuropathy. Indian J Ophthalmol. 2000;48(3):171–94.
    58. Nguyen TT, Wong TY. Retinal vascular manifestations of metabolic disorders. Trends Endocrinol Metab. 2006;17(7):262–8.
    59. Monteiro ML. Anterior ischemic optic neuropathy: a comparison of the optic disc area of patients with the arteritic and non-arteritic forms of the disease and that of normal controls. Arq Bras Oftalmol. 2006;69(6):805–10.
    60. Grundy SM, Hansen B, Smith SCJ, Cleeman JI, Kahn RA, American Heart A, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Arterioscler Thromb Vasc Biol. 2004;24(2):e19–24.
    61. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol. 2005;4(4):198–203.
    62. de Simone G. State of the heart in the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2005;15(4):239–41.
    63. Mangat HS. Retinal artery occlusion. Surv Ophthalmol. 1995;40(2):145–56.
    64. Abramson N, Abramson S. Hypercoagulability: clinical assessment and treatment. South Med J. 2001;94(10):1013–20.
    65. Age-Related Eye Disease Study Research G. Risk factors associated with age-related macular degeneration. A case-control study in the age-related eye disease study: Age-Related Eye Disease Study Report Number 3. Ophthalmology. 2000;107(12):2224–32.
    66. Bouloumie A, Marumo T, Lafontan M, Busse R. Leptin induces oxidative stress in human endothelial cells. FASEB J. 1999;13(10):1231–8.