Background: We aimed to assess the effect of intraocular pressure (IOP) on incident metabolic syndrome (MetS) using a longitudinal follow-up of screening cohort in contrast to most of previous studies addressing the association between both. Methods: The empirical data were derived from a community-based integrated screening program in Matsu during the period 2003 to 2010. A total of 1347 participants older than 30 years were enrolled in this study. With the enrollment of 1056 participants with MetS free at baseline, the cohort with IOP measurement in 2003 were followed up over time to identify incident MetS to elucidate the temporal sequence of both. Results: The statistically significant effect noted was that elevated IOP (≥15 mmHg vs. <15 mmHg) had 1.46-fold risk for developing incident MetS (adjusted relative ratio [aRR]: 1.46; 95% confidence interval [CI]: 1.08-1.99) for both sex combined, particularly in men (aRR: 1.66; 95% CI: 1.13-2.45) but not in women. The finding that elevated IOP occurred before the presence of high blood pressure was noted in both men and women, whereas men with elevated IOP may be concomitant with more individual components (severity) of MetS earlier than women with elevated IOP. Conclusions: Elevated IOP leading to the risk for incident or severe MetS was noted in men but not in women. Evidence on this temporal sequence revealed the possibility of showing signs of elevated IOP before the development of MetS, which indicates the necessity of monitoring IOP in routine health check-up for prevention of MetS-related chronic diseases.
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