ArticleAmerican journal of ophthalmology2025
Relationship Between Glaucoma and Chronic Stress Quantified by Allostatic Load Score in the All of Us Research Program.
Article in American journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Increased Risk of Intraocular Pressure-Lowering Treatment in Patients with End-Stage Renal Disease Undergoing Hemodialysis.Ophthalmology. Glaucoma · 2026Article
- Relationship Between Chronic Stress Measured by Allostatic Load and Age-Related Macular Degeneration in the All of Us Research Program.American journal of ophthalmology · 2025Article
- Impact of Physiological and Psychological Stress on Glaucoma Development and Progression: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Meeting Challenges in the Diagnosis and Treatment of Glaucoma.Bioengineering (Basel, Switzerland) · 2024Article
- Glaucoma After Dark: Sleep, Circadian Stress, and Unmeasured Drivers of Disease.Journal of current glaucoma practiceArticle
- Lifestyle Medicine for Glaucoma.Journal of current glaucoma practiceArticle
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Authors and funding
4 authors.
Funding
Abstract
purposeTo assess the relationship between glaucoma and allostatic load (AL), an established framework for quantifying the physiologic effects of chronic stress through measurements of systemic biomarkers.
designRetrospective case-control study.
methodsParticipants of the National Institutes of Health All of Us (AoU) Research Program with complete AL biomarker data between December 1984 and June 2022 and with (cases) or without (controls) primary glaucoma were identified. AL scores were calculated using the adapted Seeman AL scale consisting of 10 systemic biomarkers: body mass index, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, total cholesterol, triglycerides, glomerular filtration rate, albumin, C-reactive protein, and homocysteine. AL score was defined as the number of biomarkers with measurements in the highest risk quartiles. Age was calculated as the median age at the time of biomarker measurements. Logistic regression analysis was performed to assess the association between the earliest possible AL score and glaucoma adjusted for race or ethnicity. Mediation analysis was performed to estimate the relationship between race or ethnicity and glaucoma mediated by AL score.
resultsThe study cohort consisted of 349 cases (16.1%) and 1819 controls (83.9%) with 52.7% females, 2.2% Asians, 10.7% Blacks, 10.0% Hispanics, and 72.5% non-Hispanic Whites. At the earliest time point (median [interquartile range (IQR)] = 6.4 [1.9-12.2] years prior to diagnosis), cases had higher AL score than controls (3 [1-4] vs 2 [1-3], respectively; P < .001). On multivariable analysis, a higher AL score (OR=1.09 per point), Black race (OR=2.58), and Hispanic ethnicity (OR=2.12) conferred higher risk of glaucoma (P ≤ .02). The AL score partially mediated higher glaucoma risk among Blacks (7.5%) and Hispanics (5.0%) compared with non-Hispanic Whites. On subgroup analysis, higher AL score was significantly associated with primary open angle glaucoma (OR=1.11; P = .01) but not primary angle closure glaucoma (P = .87).
conclusionAoU participants with glaucoma had greater AL 6.4 years before diagnosis, and the AL score partially mediated racial or ethnic differences in glaucoma risk. These findings suggest chronic stress may increase risk for glaucoma and contribute to racial disparities in glaucoma burden.
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