MOUNT SINAI HOSPITAL
Purpose We examined the association of habitual caffeine intake with intraocular pressure (IOP) and glaucoma and whether genetic predisposition to higher IOP modified these associations. We also assessed whether genetic predisposition to higher coffee consumption was related to IOP. Design Cross-sectional study in the UK Biobank. Participants 121,374 participants (baseline ages, 39 to 73 years) with data on coffee and tea intake (collected between 2006 and 2010) and corneal-compensated IOP measurements in 2009 were included. In a subset of 77,906 participants with up to 5 of 24 hourly recall food frequency questionnaires (2009-2012), we assessed total caffeine intake. We also evaluated the same relationships with glaucoma (9,286 cases and 189,763 controls). Methods We evaluated multivariable-adjusted associations with IOP using linear regression and with glaucoma using logistic regression. For both outcomes, we examined gene-diet interactions using a polygenic risk score (PRS) that combined the effects of 111 genetic variants associated with IOP. We also performed Mendelian randomization using 8 genetic variants associated with coffee intake to evaluate potential causal effects of coffee consumption on IOP. Main measures Intraocular pressure and glaucoma Results Mendelian randomization analysis did not support a causal effect of coffee consumption on IOP (P > 0.1). Higher caffeine intake was weakly associated with lower IOP: highest (≥232 mg/day) versus lowest (<87 mg/day) caffeine intake was associated with 0.10 mmHg lower IOP (Ptrend = 0.01). However, IOP-PRS modified this association: among those in the highest quartile of IOP-PRS, consuming >480 mg/day versus <80 mg/day was associated with a 0.35 mmHg higher IOP (Pinteraction = 0.01) . The relationship between caffeine intake and glaucoma was null (P ≥ 0.1). However, IOP PRS also modified this relationship: compared to those in the lowest quartile of IOP PRS who did not consume caffeine, those in the highest quartile of IOP PRS who consumed ≥ 321 mg/day showed a prevalence of glaucoma 3 .90 times higher (Pinteraction = 0.0003). Conclusions Habitual caffeine consumption was weakly associated with lower IOP, and the association between caffeine consumption and glaucoma was null. However, among participants with the strongest genetic predisposition to elevated IOP, higher caffeine consumption was associated with higher IOP and a higher prevalence of glaucoma. |
Comments
Consuming large amounts of caffeine daily may increase the risk of glaucoma more than threefold for those with a genetic predisposition to higher eye pressure, according to a multicenter international study.
The research led by the Icahn School of Medicine at Mount Sinai is the first to demonstrate a genetic-diet interaction in glaucoma. Study results published in the June print issue of Ophthalmology may suggest that patients with a strong family history of glaucoma should reduce their caffeine consumption.
The study is important because glaucoma is the leading cause of blindness in the United States. It looks at the impact of caffeine intake on glaucoma and intraocular pressure (IOP), which is the pressure inside the eye. Elevated IOP is an integral risk factor for glaucoma, although other factors contribute to this condition. With glaucoma, patients usually experience few or no symptoms until the disease progresses and they have vision loss.
"We previously published work suggesting that high caffeine intake increased the risk of high-tension open-angle glaucoma among people with a family history of the disease. In this study, we showed that an adverse relationship between high caffeine intake and "Glaucoma was evident only among those with the highest genetic risk score for elevated eye pressure," says senior/corresponding author Louis R. Pasquale, MD, FARVO, vice president of Ophthalmology Research at Mount Sinai Health System.
A team of researchers used the UK Biobank, a large-scale population-based biomedical database supported by several government and health agencies. They analyzed the records of more than 120,000 participants between 2006 and 2010.
The participants were between 39 and 73 years old and provided their health records along with DNA samples, collected to generate data. They responded to repeated dietary questionnaires that focused on the number of caffeinated beverages they drink daily, the amount of caffeine-containing foods they eat, the specific types, and portion sizes.
They also answered questions about their vision, including details about whether they have glaucoma or a family history of glaucoma. Three years after the study began, their IOP was checked and their eyes were measured.
The researchers first looked at the relationship between caffeine intake, IOP, and self-reported glaucoma by running multivariable analyses. They then evaluated whether accounting for genetic data modified these relationships. They assigned each subject a genetic risk score for IOP and performed interaction analyses.
The researchers found that high caffeine intake was not associated with an increased risk of higher IOP or glaucoma overall; However, among participants with the strongest genetic predisposition to elevated IOP, in the top 25th percentile, higher caffeine consumption was associated with higher IOP and a higher prevalence of glaucoma.
More specifically, those who consumed the most daily caffeine, more than 480 milligrams, which is about four cups of coffee , had a 0.35 mmHg higher IOP.
Additionally, those in the highest genetic risk score category who consumed more than 321 milligrams of caffeine per day, about three cups of coffee, had a 3.9 times higher prevalence of glaucoma compared to those who drank little or no caffeine and in the lowest genetic risk score. cluster.
"Patients with glaucoma often ask if they can help protect their sight through lifestyle changes, however, this has been a relatively understudied area until now. This study suggested that those with the highest genetic risk of "Glaucoma patients may benefit from moderating their caffeine intake. It is worth noting that the link between caffeine and glaucoma risk was only seen with a lot of caffeine and in those with the highest genetic risk," says co-author Anthony Khawaja, MD, PhD, associate professor at Ophthalmology University College London (UCL) Institute of Ophthalmology and ophthalmic surgeon at Moorfields Eye Hospital. "The UK Biobank study is helping us learn more than ever about how our genes affect our risk of glaucoma and the role our behaviors and environment might play. We hope to continue to expand our knowledge in this area."
This study suggests that a large panel of genetic IOP biomarkers could modify the relationship between dietary caffeine intake and glaucoma risk. Currently, there are no approved genetic tests to identify which subset of patients may be predisposed to higher IOP and glaucoma. More research is needed to confirm these gene-diet interactions and to determine whether specific genetic markers are modifying the propensity for higher IOP and glaucoma or whether it is a nonspecific critical number of any IOP marker that modifies disease risk. If confirmed, our data suggest that precision nutrition approaches that incorporate genomic data may be necessary to make recommendations regarding caffeine consumption and glaucoma risk. |
