Risk factors of primary angle-closure glaucoma: An exposome-wide association study in the China Kadoorie Biobank
14 affiliations
- 1Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- 2Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
- 3Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- 4Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
- 5Department of Ophthalmology, Peking University People's Hospital, Beijing, China
- 6Beijing Key Laboratory of Ocular Disease and Optometry Science, Peking University People’s Hospital, Beijing, China
- 7Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- 8Department of Ophthalmology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
- 9Department of Ophthalmology, Tong De Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
- 10Department of Ophthalmology and Vision Science, Eye & ENT Hospital of Fudan University, Shanghai, China
- 11Shanghai Medical College and Zhongshan Hospital Immunotherapy Translational Research Center, Shanghai, China
- 12NCDs Prevention and Control Department, Pengzhou CDC, Sichuan, China
- 13China National Center for Food Safety Risk Assessment, Beijing, China
- 14State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
Abstract
Purpose: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asia. Although traditionally considered an anatomical ocular disorder, the contribution of systemic metabolic, vascular, and lifestyle factors to PACG development remains unclear.
Methods: Using data from the China Kadoorie Biobank (CKB), involving 499,102 participants aged 30–79 years at baseline, we explored associations of 117 exposures, including socio-demographics, lifestyle patterns, medical history, and physical measurements, with probable PACG (prob PACG) incidence. Elastic-Net, XGboost, and Cox regression methods were employed.
Results: Over a median follow-up of 15.7 years, 3266 incident prob PACG cases were ascertained. After correcting for multiple testing, 26 factors were independently associated with prob PACG. Age, female sex, and postmenopausal status showed the strongest positive associations with pro PACG. Notably, several markers of metabolic and vascular ageing—including diabetes, higher random plasma glucose, larger waist circumference, and elevated pulse pressure—were independently associated with higher risk, whereas BMI was inversely associated (all P < 0.01). In addition, daily intake of dairy products and daily preserved vegetables, and peptic ulcer were associated with a higher risk, while higher physical activity and weekly tea consumption were associated with lower risk. No significant associations were found for hypertension, SBP, or DBP with prob PACG.
Conclusions: Our findings suggest that PACG may be influenced not only by anatomical susceptibility but also by broader metabolic, vascular, and lifestyle factors. The clustering of several strong associations around markers of metabolic and vascular ageing provides new insights into PACG aetiology and may help identify priorities for future studies of risk stratification and prevention.
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BibTeX
@article{shao2026risk,
title = {{Risk factors of primary angle-closure glaucoma: An exposome-wide association study in the China Kadoorie Biobank}},
author = {Zilun Shao and Shuo Gong and Charles Li and Canqing Yu and Pei Pei and Ling Yang and Yiping Chen and Enzhong Jin and Ting Shen and Jie Yu and Bin Wang and Zhi Chen and Ruoyan Wei and Jian Wang and Xiaoming Yang and Junshi Chen and Zhengming Chen and Xingtao Zhou and Yongyue Wei and Jun Lv and Liming Li and Huaidong Du and Dianjianyi Sun and on behalf of the China Kadoorie Biobank Collaborative Group},
journal = {Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.)},
year = {2026},
month = nov,
doi = {10.1016/j.apjo.2026.100378},
url = {https://doi.org/10.1016/j.apjo.2026.100378},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Risk factors of primary angle-closure glaucoma: An exposome-wide association study in the China Kadoorie Biobank
AU - Zilun Shao
AU - Shuo Gong
AU - Charles Li
AU - Canqing Yu
AU - Pei Pei
AU - Ling Yang
AU - Yiping Chen
AU - Enzhong Jin
AU - Ting Shen
AU - Jie Yu
AU - Bin Wang
AU - Zhi Chen
AU - Ruoyan Wei
AU - Jian Wang
AU - Xiaoming Yang
AU - Junshi Chen
AU - Zhengming Chen
AU - Xingtao Zhou
AU - Yongyue Wei
AU - Jun Lv
AU - Liming Li
AU - Huaidong Du
AU - Dianjianyi Sun
AU - on behalf of the China Kadoorie Biobank Collaborative Group
PY - 2026
DA - 2026/11/01
JO - Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.)
DO - 10.1016/j.apjo.2026.100378
UR - https://doi.org/10.1016/j.apjo.2026.100378
AB - Purpose: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asia. Although traditionally considered an anatomical ocular disorder, the contribution of systemic metabolic, vascular, and lifestyle factors to PACG development remains unclear. Methods: Using data from the China Kadoorie Biobank (CKB), involving 499,102 participants aged 30–79 years at baseline, we explored associations of 117 exposures, including socio-demographics, lifestyle patterns, medical history, and physical measurements, with probable PACG (prob PACG) incidence. Elastic-Net, XGboost, and Cox regression methods were employed. Results: Over a median follow-up of 15.7 years, 3266 incident prob PACG cases were ascertained. After correcting for multiple testing, 26 factors were independently associated with prob PACG. Age, female sex, and postmenopausal status showed the strongest positive associations with pro PACG. Notably, several markers of metabolic and vascular ageing—including diabetes, higher random plasma glucose, larger waist circumference, and elevated pulse pressure—were independently associated with higher risk, whereas BMI was inversely associated (all P < 0.01). In addition, daily intake of dairy products and daily preserved vegetables, and peptic ulcer were associated with a higher risk, while higher physical activity and weekly tea consumption were associated with lower risk. No significant associations were found for hypertension, SBP, or DBP with prob PACG. Conclusions: Our findings suggest that PACG may be influenced not only by anatomical susceptibility but also by broader metabolic, vascular, and lifestyle factors. The clustering of several strong associations around markers of metabolic and vascular ageing provides new insights into PACG aetiology and may help identify priorities for future studies of risk stratification and prevention.
SN - 2162-0989
ER -