ASSOCIATION OF HBA1C AND NEUTROPHIL LYMPHOCYTE RATIO WITH NORMAL-TENSION GLAUCOMA IN METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA RISK PATIENTS

Seskoati Prayitnaningsih, Virna Dwi Oktariana Asrory, Synthia Nusanti, Erlin Listyaningsih, Bambang Budi Siswanto, Anwar Santoso
  MNJ, pp. 149-155  

Abstract


Background: Normal-Tension_Glaucoma (NTG) is an eye disease and characterize with low intraocular pressure (IOP) levels. In population-based settings, the diagnose of glaucoma is based on the IOP levels of 21 mmHg, and its usually delayed. A recent study HbA1c levels could lead to IOP changes. Obstructive Sleep Apnea (OSA) result oxidative stress that results an altered function of neutrophil in patients with NTG.

Objective: To_evaluate the association of HbA1c, Netrophil-to-Lymphocyte Ratio_(NLR) toward NTG as its novel early detection.

Methods: This study divided into two groups consisted of Metabolic Syndrome ( MS) + OSA without eye disorder as control (15 subjects) and MS + OSA + NTG patients (14 subjects). IDF criteria was used to established MS, and risk of OSA determined by STOP-BANG Questionnaire. The diagnosis of NTG was confirmed by normal IOP measured by Tonopen. Mean Defect (MD) of visual field evaluated by Automated Humphrey Perimetry, Retinal Nerve Fiber Layer (RNFL) established by OCT. HbA1c measured by ELISA and NLR by flowcytometry. Statistical analysis consisted of comparison and correlation test

Results: The ratio of CD was significantly higher in NTG patients (0.54 ± 0.13) compared to control (0.26 ± 0.07; p<0.001). MD was also higher in subjects with NTG (6.80 ± 3.90) compared to control (4.97 ± 2.28; p=0.134). Mean RNFL was lower in subjects with NTG (87.95 ± 28.29) compared to control (95.07 ± 26.66; p=0.035). Positive correlation between HbA1C-MD (r = 0.456, p = 0.013) and NLR-RNFL thinning (r = 0.525, p = 0.003) was existed in Metabolic Syndrome (MS) patients.

Conclusion: Patients with MS and OSA risk have an increased risk of NTG. A novel association between Hba1C levels, NLR and NTG was also identified.


Keywords


HbA1c, normal-tension glaucoma, neutrophil-lymphocyte ratio, metabolic syndrome

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References


Evans K, Holden B, Nicholls C. VISION 2020: The Right to Sight-Australia. N S W Public Health Bull; 2001. 12(1):14-15. DOI : 10.1071/nb01006.

Pararajasegaram R. VISION 2020-The Right to Sight: from strategies to action. Am J Ophthal-mol; 1999. 128(3):359-360.

DOI : 10.1016/s0002-9394(99)00251-2.

Ahmad, SS. Controversies in the vascular theory of glaucomatous optic nerve degeneration. Taiwan Journal of Ophthalmology; 2016. 6(4): 182–186.

DOI : 10.1016/j.tjo.2016.05.009.

Shields MB. Normal-tension glaucoma: is it different from primary open-angle glaucoma? Curr Opin Ophthalmol; 2008. 19: 85 –88.

DOI : 10.1097/ICU.0b013e3282f3919b

Caprioli_J & Spaeth GL. _Comparison of visual field defects in the low-tension glaucomas with those in the high-tension glaucomas. Am J Ophthalmol; 1984. 97(6): 730–737. DOI : 10.1016/0002-9394(84)90505-1.

Begg IS, Drance SM & Sweeney VP. Ischaemic optic neuropathy in chronic simple glaucoma. Br J Ophthalmol; 1971. 55(2): 73–90.

DOI : 10.1136/bjo.55.2.73.

Sonnsjo B & Krakau CE. Arguments for a vascular glaucoma etiology. Acta Ophthalmol; 1993. 71(4): 433–444. DOI : 10.1111/j.1755-3768.1993.tb04615.x.

Kurvinen L, Harju M, Saari J &Vesti E. Altered temporal peripapillary retinal flow in patients with disc hemorrhages. Graefes Arch Clin Exp Ophthalmol; 2010. 248(12): 1771–1775.

DOI : 10.1007/s00417-010-1441-7.

Grieshaber MC, Mozaffarieh M, Flammer J. What is the link between vascular dysregulation and glaucoma? Surv Ophthalmol; 2007. 52(2):144-154. DOI : 10.1016/j.survophthal.2007.08.010.

Iwashima Y, Horio T, Kamide K et al. Additive interaction of metabolic syndrome and chronic kidney disease_on cardiac hypertrophy,¬_and risk of cardiovascular disease in hypertension. Am J Hypertens; 2010. 23: 290–298.

DOI : https://doi.org/10.1038/ajh.2009.253

Grundy SM. Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol; 1999. 83: 25F–29F. DOI : 10.1016/s0002-9149(99)00211-8.

Wilson PW, Kannel WB, Silbershatz H & D'Agostino RB. Clustering of metabolic factors and coronary heart disease. Arch Intern Med; 1999. 159: 1104–1109. DOI : 10.1001/archinte.159.10.1104

Kass MA,¬_Heuer DK, Higginbotham EJ, et al. The Ocular_Hypertension Treatment¬_Study : A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Archives of Ophthalmology; 2002. 120(6): 701–713.

DOI : 10.1001/archopht.120.6.701

Sommer, A J. M. Tielsch, J. Katz et al. Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans: The Baltimore eye survey. Archives of Ophthalmology; 1991. 109(8): 1090–1095.

DOI : 10.1001/archopht.1991.01080080050026

Wong WT, Wong WL, Tian XY, Huang Y. Endothelial dysfunction: The common consequence in diabetes and hypertension. J Cardiovasc Pharmacol; 2010. 55(4):300-307.

DOI : 10.1097/fjc.0b013e3181d7671c

Karaca EE, Ozmen MC, Ekici F, Yuksel E, Turkoglu Z. Neutrophil-to-lymphocyteratio may predict progression in patients with keratoconus. Cornea; 2014. 33:1168–7.

DOI : 10.1097/ICO.0000000000000260

He Z, Vingrys AJ, Armitage JA, Bui BV. The role of blood pressure in glaucoma. Clin Exp Optom; 2011. 94(2):133-149.

DOI : 10.1111/j.1444-0938.2010.00564.x

Lee JS, Lee SH, Oum BS, Chung JS, Cho BM, Hong JW. Relationship between intraocular pressure and systemic health parameters in a Korean population. Clinical & Experimental Ophthalmology; 2002. 30(4):237–241. DOI : 10.1046/j.1442-9071.2002.00527.x

Wang YX, Xu L, Zhang XH, You QS, Zhao L, Jonas JB. Five-year change in intraocular pressure associated with changes in arterial blood pressure and body mass index. The Beijing eye study. PLoS ONE; 2013. 8(10):77180.

DOI : https://doi.org/10.1371/journal.pone.0077180

Memarzadeh, Ying-Lai M, Azen SP, and Varma R. Associations with intraocular pressure in Latinos: The Los Angeles Latino Eye Study. American Journal of Ophthalmology; 2008. 146(1): 69–76.

DOI : 10.1016/j.ajo.2008.03.015

Castro DP, Prata TS, Lima VC, Biteli LG, de Moraes CGV, and Paranhos A. Corneal viscoelasticity differences between diabetic and nondiabetic glaucomatous patients. Journal of Glaucoma; 2010. 19(5):341–343. DOI : 10.1097/ijg.0b013e3181b4caa1

Ulu SM, Dogan M, Ahsen A, et al. Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy. Diabetes Technol Ther; 2013. 15:942–7. DOI : 10.1089/dia.2013.0097

Karaca EE, Ozmen MC, Ekici F, Yuksel E, Turkoglu Z. Neutrophil-to-lymphocyte ratio may predict progression in patients with keratoconus. Cornea; 2014. 33:1168–73.

DOI : 10.1097/ICO.0000000000000260

Duarte, RL de M, Fonseca, LB de M, Magalhães-da-Silveira, FJ, Silveira, EA da, & Rabahi, MF. Validation of the STOP - Bang_questionnaire as a means of screening for_obstructive sleep apnea in adults in Brazil. Jornal Brasileiro de Pneumologia; 2017. 43(6): 456–463.

DOI : 10.1590/S1806-37562017000000139

Chung, F, Abdullah, HR, & Liao, P. STOP-Bang Questionnaire. Chest; 2016. 149(3): 631–638.

DOI : 10.1378/chest.15-0903

International Diabetes Federation. The IDF consensus worldwide definition of the Metabolic Syndrome. Brussels, Belgium; 2006.

Tan GS, Wong TY, Fong CW & Aung T. Diabetes, metabolic abnormalities, and glaucoma. Arch Ophthalmol; 2009. 127: 1354–1361.

DOI : 10.1001/archophthalmol.2009.268.

Klein BE, Klein R & Jensen SC. Open‐angle glaucoma and older‐onset diabetes. The Beaver Dam Eye Study. Ophthalmology; 1994. 101: 1173–1177. DOI : 10.1016/s0161-6420(94)31191-2

Bonovas S, Filioussi K, Tsantes A & Peponis V. Epidemiological association between cigarette smoking and primary open‐angle glaucoma: a meta‐analysis. Public Health; 2004. 118: 256–261.

DOI : 10.1016/j.puhe.2003.09.009

Nakamura M, Kanamori A & Negi A. Diabetes mellitus as a risk factor for glaucomatous optic neuropathy. Ophthalmologica; 2005. 219: 1–10.

DOI : 10.1159/000081775

Chopra V, Varma R, Francis BA, Wu J, Torres M & Azen SP. Type 2 diabetes mellitus and the risk of open‐angle glaucoma the Los Angeles Latino Eye Study. Ophthalmology; 2008. 115: 227–232e221. DOI : 10.1016/j.ophtha.2007.04.049.

Pasquale LR & Kang JH. Lifestyle, nutrition, and glaucoma. J Glaucoma; 2009. 18: 423–428.

DOI : 10.1097/IJG.0b013e31818d3899

Newman‐Casey PA, Talwar N, Nan B, Musch DC & Stein JD. The relationship between components of metabolic syndrome and open‐angle glaucoma. Ophthalmology; 2011. 118: 1318–1326.

DOI : 10.1016/j.ophtha.2010.11.022

Flammer J, Orqül S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP & Stefánsson E. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res; 2002. 21: 359–393. DOI : 10.1016/s1350-9462(02)00008-3

Grieshaber MC & Flammer J. Blood flow in glaucoma. Curr Opin Ophthalmol; 2005. 16: 79–83. DOI : 10.1097/01.icu.0000156134.38495.0b.

Suh MH, Park KH & Kim DM. Effect of travoprost on intraocular pressure during 12 months of treatment for normal‐tension glaucoma. Jpn J Ophthalmol; 2009. 53: 18–23. DOI : 10.1007/s10384-008-0617-8

Tielsch JM, Katz J, Sommer A, Quigley HA& Javitt JC. Hypertension, perfusion pressure, and primary open‐angle glaucoma. A population‐based assessment. Arch Ophthalmol; 1995. 113: 216–221.

DOI : 10.1001/archopht.1995.01100020100038

Quigley HA, West SK, Rodriguez J, Munoz B, Klein R & Snyder R. The prevalence of glaucoma in a population‐based study of Hispanic subjects: Proyecto VER. Arch Ophthalmol; 2001. 119: 1819–1826.

DOI : 10.1001/archopht.119.12.1819

Gordon MO, Beiser JA, Brandt JD et al. The Ocular Hypertension Treatment Study: Baseline factors that predict the onset of primary open‐angle glaucoma. Arch Ophthalmol; 2002. 120: 714–720.

DOI : 10.1001/archopht.120.6.714.

Shim SH, Kim JM, Woo HY, Shin KU, Koh JW, Park KH. Association between platelet function and disc hemorrhage in patients with normal-tension K. Atalay et al./Medical Hypotheses 103 (2017) 54–56 55 glaucoma: A prospective cross-sectional study. Am J Ophthalmol; 2015. 160:1191–9.

DOI : 10.1016/j.ajo.2015.09.006

Meyer JH, Brandi-Dohrn J, Funk J. Twenty four hour blood pressure monitoring in normal tension glaucoma. Br J Ophthalmol; 1996. 80:864–7.

DOI : 10.1136/bjo.80.10.864

Cartwright MJ, Grajewski AL, Friedberg ML, Anderson DR, Richards DW. Immune-related disease and normal-tension glaucoma: A case-control study. Arch Ophthalmol; 1992. 110:500–2.

DOI : 10.1001/archopht.1992.01080160078035

Sunbul M, Gerin F, Durmus E, et al. Neutrophil to lymphocyte and platelet tolymphocyte ratio in patients

with¬dipper versus¬_non-dipper hypertension. Clin Exp Hypertens; 2014. 36:217–21.

DOI : 10.3109/10641963.2013.804547

Kaya MG, Yarlioglues M, Gunebakmaz O, et al. Platelet activation andinflammatory response in patients with non-dipper hypertension. Atherosclerosis; 2010; 209:278–82.

DOI : 10.1016/j.atherosclerosis.2009.09.010

Fan N, Wang P, Tang L, Liu X. Ocular blood flow and normal tension glaucoma. Biomed Res Int; 2015. 2015:308505.

DOI : https://doi.org/10.1155/2015/308505

Galassi F, Giambene B, Varriale R. Systemic vascular dysregulation and retrobulbar hemodynamics in normal-tension glaucoma. Invest Ophthalmol Vis Sci; 2011. 52:4467–71.

DOI : https://doi.org/10.1167/iovs.10-6710

Danese E, Montagnana M, Lippi G. Platelets and migraine. Thromb Res; 2014. 134:17–22.

DOI : 10.1016/j.thromres.2014.03.055

Karabulut KU, Egercioglu TU, Uyar M, Uçar Y. The change ofneutrophils/lymphocytes ratio in migraine attacks. Ann Med Surg; 2016. 10:52–6.

DOI : 10.1016/j.amsu.2016.07.023.

Kremmer S, Kreuzfelder E, Klein R, et al. Antiphosphatidylserine antibodies areelevated in normal tension glaucoma. Clin Exp Immunol; 2001. 125:211–5. DOI : 10.1046/j.1365-2249.2001.01578.x

Maruyama I, Ikeda Y, Nakazawa M, Ohguro H. Clinical roles of serum autoantibody against neuron-specific enolase_ in glaucoma patients. _Tohoku JExp Med; 2002. 197:125–32. DOI : 10.1016/s0021-5155(01)00455-5

Tezel G, Hernandez R, Wax MB. Immunostaining of heat shock proteins in the retina and optic nerve head of normal and glaucomatous eyes. Arch Ophthalmol; 2000. 118:511–8. DOI : 10.1001/archopht.118.4.511

Yang J, Tezel Gln, Patil RV, Romano C, Wax MB. Serum autoantibody against glutathione S-transferase in patients with glaucoma. Invest Ophthalmol Vis Sci; 2001. 42:1273–6. Avalaible from : https://pubmed.ncbi.nlm.nih.gov/11328739/

Romano C, Barrett DA, Li Z, Pestronk A, Wax MB. Anti-rhodopsin antibodies insera from patients with normal-pressure glaucoma. Invest Ophthalmol Vis Sci; 1995. 36:1968–75. Avalaible from : https://pubmed.ncbi.nlm.nih.gov/7657539/

Wax MB, Tezel G, Edward PD. Clinical and ocular histopathological findings in a patient with normal-pressure glaucoma. Arch Ophthalmol; 1998. 116:993–1001. DOI : 10.1001/archopht.116.8.993


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