Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle Glaucoma (POAG). Methods: GWAS data for bibulosity, smoking, and POAG were obtained from the Social Science Genetic Association Consortium website and the IEU OpenGWAS Project website, respectively. Using a P-value threshold of <5 × 10?8, a linkage disequilibrium coefficient (r2) of 0.001, and a linkage disequilibrium region width of 10,000 kb, the data were aggregated, resulting in 6 SNPs for bibulosity and 253 SNPs for smoking. Three regression models, MR-Egger, Weighted Median Estimator (WME), and Random-Effects Inverse-Variance Weighted (IVW) were applied to analyze the causal impact of bibulosity and smoking on POAG. Results: The GWAS data for alcohol consumption and smoking were derived from European populations, while the GWAS data for Primary Open-Angle Glaucoma (POAG) were sourced from East Asian populations, with no gender restrictions. Analysis using three different regression models revealed that neither excessive alcohol consumption nor smoking significantly increased the risk of developing POAG. Specifically, the odds ratios with 95% confidence intervals for the alcohol consumption group were 0.854 (0.597 - 1.221) in MR-Egger regression, 0.922 (0.691 - 1.231) in WME regression, and 0.944 (0.711 - 1.252) in IVW regression. For the smoking group, the odds ratios were 1.146 (0.546 - 2.406) in MR-Egger regression, 0.850 (0.653 - 1.111) in WME regression, and 0.939 (0.780 - 1.131) in IVW regression. Given the significant heterogeneity in the SNPs associated with smoking, the focus was primarily on the results from the IVW regression model. Conclusion: Alcohol consumption and smoking are not significant risk factors for the development of POAG.
References
[1]
Tham, Y., Li, X., Wong, T.Y., Quigley, H.A., Aung, T. and Cheng, C. (2014) Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040. Ophthalmology, 121, 2081-2090. https://doi.org/10.1016/j.ophtha.2014.05.013
[2]
Xu, L., Wang, Y., Wang, S., Wang, Y. and Jonas, J.B. (2007) High Myopia and Glaucoma Susceptibility. Ophthalmology, 114, 216-220. https://doi.org/10.1016/j.ophtha.2006.06.050
[3]
Kang, J.H. (2003) Prospective Study of Cigarette Smoking and the Risk of Primary Open-Angle Glaucoma. Archives of Ophthalmology, 121, 1762-1768. https://doi.org/10.1001/archopht.121.12.1762
[4]
Wang, D., Huang, Y., Huang, C., Wu, P., Lin, J., Zheng, Y., et al. (2012) Association Analysis of Cigarette Smoking with Onset of Primary Open-Angle Glaucoma and Glaucoma-Related Biometric Parameters. BMC Ophthalmology, 12, Article No. 59. https://doi.org/10.1186/1471-2415-12-59
[5]
Law, S.M., Lu, X., Yu, F., Tseng, V., Law, S.K. and Coleman, A.L. (2018) Cigarette Smoking and Glaucoma in the United States Population. Eye, 32, 716-725. https://doi.org/10.1038/eye.2017.292
[6]
Lee, C.S., Owen, J.P., Yanagihara, R.T., Lorch, A., Pershing, S., Hyman, L., et al. (2020) Smoking Is Associated with Higher Intraocular Pressure Regardless of Glaucoma. Ophthalmology Glaucoma, 3, 253-261. https://doi.org/10.1016/j.ogla.2020.03.008
[7]
Stuart, K.V., Luben, R.N., Warwick, A.N., Madjedi, K.M., Patel, P.J., Biradar, M.I., et al. (2023) The Association of Alcohol Consumption with Glaucoma and Related Traits. Ophthalmology Glaucoma, 6, 366-379. https://doi.org/10.1016/j.ogla.2022.11.008
[8]
GBD 2016 Alcohol Collaborators (2018) Alcohol Use and Burden for 195 Countries and Territories, 1990-2016: A Systematic Analysis for the Global Burden of Disease Study 2016. TheLancet, 392, 1015-1035. https://doi.org/10.1016/S0140-6736(18)31310-2
[9]
World Health Organization (2019) Global Status Report on Alcohol and Health 2018.
[10]
Zhou, L., Conner, K.R., Phillips, M.R., Caine, E.D., Xiao, S., Zhang, R., et al. (2009) Epidemiology of Alcohol Abuse and Dependence in Rural Chinese Men. Alcoholism: Clinical and Experimental Research, 33, 1770-1776. https://doi.org/10.1111/j.1530-0277.2009.01014.x
[11]
Parascandola, M. and Xiao, L. (2019) Tobacco and the Lung Cancer Epidemic in China. Translational Lung Cancer Research, 8, S21-S30. https://doi.org/10.21037/tlcr.2019.03.12
[12]
Boggs, J.M., Beck, A., Ritzwoller, D.P., Battaglia, C., Anderson, H.D. and Lindrooth, R.C. (2020) A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths. Journal of General Internal Medicine, 35, 1709-1714. https://doi.org/10.1007/s11606-020-05641-4
[13]
Hartwig, F.P., Davies, N.M., Hemani, G. and Davey Smith, G. (2016) Two-Sample Mendelian Randomization: Avoiding the Downsides of a Powerful, Widely Applicable but Potentially Fallible Technique. International Journal of Epidemiology, 45, 1717-1726. https://doi.org/10.1093/ije/dyx028
[14]
Bowden, J., Spiller, W., Del Greco M, F., Sheehan, N., Thompson, J., Minelli, C., et al. (2018) Improving the Visualization, Interpretation and Analysis of Two-Sample Summary Data Mendelian Randomization via the Radial Plot and Radial Regression. International Journal of Epidemiology, 47, 2100. https://doi.org/10.1093/ije/dyy265
[15]
Rees, J.M.B., Wood, A.M., Dudbridge, F. and Burgess, S. (2019) Robust Methods in Mendelian Randomization via Penalization of Heterogeneous Causal Estimates. PLOS ONE, 14, e0222362. https://doi.org/10.1371/journal.pone.0222362
[16]
Weinreb, R.N., Aung, T. and Medeiros, F.A. (2014) The Pathophysiology and Treatment of Glaucoma. JAMA, 311, 1901-1911. https://doi.org/10.1001/jama.2014.3192
[17]
Jeong, Y., Kim, S.H., Kang, G., Yoon, H., Kim, Y.K. and Ha, A. (2023) Visual Impairment Risk after Alcohol Abstinence in Patients with Newly Diagnosed Open-Angle Glaucoma. JAMA Network Open, 6, e2338526. https://doi.org/10.1001/jamanetworkopen.2023.38526
[18]
Kwon, Y.H., Fingert, J.H., Kuehn, M.H. and Alward, W.L.M. (2009) Primary Open-Angle Glaucoma. New England Journal of Medicine, 360, 1113-1124. https://doi.org/10.1056/nejmra0804630
[19]
Stuart, K.V., Madjedi, K., Luben, R.N., Chua, S.Y.L., Warwick, A.N., Chia, M., et al. (2022) Alcohol, Intraocular Pressure, and Open-Angle Glaucoma. Ophthalmology, 129, 637-652. https://doi.org/10.1016/j.ophtha.2022.01.023
[20]
Song, J.E., Kim, J.M., Lee, M.Y., Jang, H.J. and Park, K.H. (2020) Effects of Consumption of Alcohol on Intraocular Pressure: Korea National Health and Nutrition Examination Survey 2010 to 2011. Nutrients, 12, Article 2420. https://doi.org/10.3390/nu12082420
[21]
Yoshida, M. (2003) Association of Life-Style with Intraocular Pressure in Middle-Aged and Older Japanese Residents. Japanese Journal of Ophthalmology, 47, 191-198. https://doi.org/10.1016/s0021-5155(02)00666-4
[22]
Lin, H. (2005) Intraocular Pressure Measured with a Noncontact Tonometer in an Elderly Chinese Population. Archives of Ophthalmology, 123, 381-386. https://doi.org/10.1001/archopht.123.3.381
[23]
Wu, S. (1997) Associations with Intraocular Pressure in the Barbados Eye Study. Archives of Ophthalmology, 115, 1572-1576. https://doi.org/10.1001/archopht.1997.01100160742012
[24]
Buckingham, T. and Young, R. (1986) The Rise and Fall of Intra‐Ocular Pressure: The Influence of Physiological Factors. Ophthalmic and Physiological Optics, 6, 95-99. https://doi.org/10.1111/j.1475-1313.1986.tb00707.x
[25]
Epstein, M. (1997) Alcohol’s Impact on Kidney Function. Alcohol Health and Research World, 21, 84-92.
[26]
Badrick, E., Bobak, M., Britton, A., Kirschbaum, C., Marmot, M. and Kumari, M. (2008) The Relationship between Alcohol Consumption and Cortisol Secretion in an Aging Cohort. The Journal of Clinical Endocrinology & Metabolism, 93, 750-757. https://doi.org/10.1210/jc.2007-0737
[27]
White, A.M., Orosz, A., Powell, P.A. and Koob, G.F. (2023) Alcohol and Aging—An Area of Increasing Concern. Alcohol, 107, 19-27. https://doi.org/10.1016/j.alcohol.2022.07.005
[28]
Saccà, S.C., Pulliero, A. and Izzotti, A. (2014) The Dysfunction of the Trabecular Meshwork during Glaucoma Course. Journal of Cellular Physiology, 230, 510-525. https://doi.org/10.1002/jcp.24826
[29]
Grant, A., Roy-Gagnon, M., Bastasic, J., Talekar, A., Jessri, M., Li, G., et al. (2023) Alcohol Consumption, Genetic Risk, and Intraocular Pressure and Glaucoma: The Canadian Longitudinal Study on Aging. Investigative Opthalmology & Visual Science, 64, Article 3. https://doi.org/10.1167/iovs.64.10.3
[30]
Ramdas, W.D. (2011) Lifestyle and Risk of Developing Open-Angle Glaucoma. Archives of Ophthalmology, 129, 767-772. https://doi.org/10.1001/archophthalmol.2010.373
[31]
Doshi, V., Ying-Lai, M., Azen, S.P. and Varma, R. (2008) Sociodemographic, Family History, and Lifestyle Risk Factors for Open-Angle Glaucoma and Ocular Hypertension. Ophthalmology, 115, 639-647.E2. https://doi.org/10.1016/j.ophtha.2007.05.032
[32]
Emdin, C.A., Khera, A.V. and Kathiresan, S. (2017) Mendelian Randomization. JAMA, 318, 1925-1926. https://doi.org/10.1001/jama.2017.17219