Domestic Water Mineral Composition and Incident Glaucoma Risk: A Prospective Cohort Study From the UK Biobank
- 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
Abstract
Purpose: To investigate the association between geographically assigned domestic water mineral composition and incident glaucoma in a large prospective cohort.
Methods: This study included 434,112 UK Biobank participants without glaucoma at baseline. Exposures included domestic water hardness and concentrations of calcium, magnesium, and calcium carbonate. Incident glaucoma was identified through hospital inpatient records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for demographic, socioeconomic, lifestyle, and clinical covariates. Restricted cubic spline, subtype-specific, multiple imputation, proportional hazards, propensity score–matched, and biomarker analyses were conducted.
Results: During a median follow-up of 14.07 years, 3125 participants developed glaucoma. For each standard deviation increase in mineral concentration, adjusted HRs were 1.10 (95% CI, 1.06–1.14) for calcium, 1.08 (95% CI, 1.05–1.12) for calcium carbonate, and 1.12 (95% CI, 1.08–1.15) for magnesium. Very hard water (>180 vs. <60 mg/L calcium carbonate, US Geological Survey classification) and hard water (≥200 vs. <200 mg/L, World Health Organization classification) were associated with higher glaucoma risk, with adjusted HRs of 1.23 (95% CI, 1.13–1.34) and 1.22 (95% CI, 1.13–1.31), respectively. Restricted cubic spline analyses showed nonlinear associations for all three mineral indicators. For calcium and calcium carbonate, HRs increased across low to intermediate concentrations and attenuated at higher concentrations. For magnesium, HRs increased gradually, mainly across low to intermediate concentrations. Estimates were consistent across sensitivity analyses.
Conclusions: Geographically assigned domestic water mineral composition was associated with incident glaucoma, with distinct nonlinear patterns across mineral indicators. These observational findings require independent confirmation.
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BibTeX
@article{xiao2026domestic,
title = {{Domestic Water Mineral Composition and Incident Glaucoma Risk: A Prospective Cohort Study From the UK Biobank}},
author = {Yukun Xiao and Weili Xie and Yiyuan Ma and Leyi Hu and Yuman Zhang and Danying Zheng and Xinyu Zhang and Hui Chen and Zhenzhen Liu and Guangming Jin},
journal = {Investigative Ophthalmology \& Visual Science},
year = {2026},
month = oct,
doi = {10.1167/iovs.67.12.39},
url = {https://doi.org/10.1167/iovs.67.12.39},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Domestic Water Mineral Composition and Incident Glaucoma Risk: A Prospective Cohort Study From the UK Biobank
AU - Yukun Xiao
AU - Weili Xie
AU - Yiyuan Ma
AU - Leyi Hu
AU - Yuman Zhang
AU - Danying Zheng
AU - Xinyu Zhang
AU - Hui Chen
AU - Zhenzhen Liu
AU - Guangming Jin
PY - 2026
DA - 2026/10/21
JO - Investigative Ophthalmology & Visual Science
DO - 10.1167/iovs.67.12.39
UR - https://doi.org/10.1167/iovs.67.12.39
AB - Purpose: To investigate the association between geographically assigned domestic water mineral composition and incident glaucoma in a large prospective cohort. Methods: This study included 434,112 UK Biobank participants without glaucoma at baseline. Exposures included domestic water hardness and concentrations of calcium, magnesium, and calcium carbonate. Incident glaucoma was identified through hospital inpatient records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for demographic, socioeconomic, lifestyle, and clinical covariates. Restricted cubic spline, subtype-specific, multiple imputation, proportional hazards, propensity score–matched, and biomarker analyses were conducted. Results: During a median follow-up of 14.07 years, 3125 participants developed glaucoma. For each standard deviation increase in mineral concentration, adjusted HRs were 1.10 (95% CI, 1.06–1.14) for calcium, 1.08 (95% CI, 1.05–1.12) for calcium carbonate, and 1.12 (95% CI, 1.08–1.15) for magnesium. Very hard water (>180 vs. <60 mg/L calcium carbonate, US Geological Survey classification) and hard water (≥200 vs. <200 mg/L, World Health Organization classification) were associated with higher glaucoma risk, with adjusted HRs of 1.23 (95% CI, 1.13–1.34) and 1.22 (95% CI, 1.13–1.31), respectively. Restricted cubic spline analyses showed nonlinear associations for all three mineral indicators. For calcium and calcium carbonate, HRs increased across low to intermediate concentrations and attenuated at higher concentrations. For magnesium, HRs increased gradually, mainly across low to intermediate concentrations. Estimates were consistent across sensitivity analyses. Conclusions: Geographically assigned domestic water mineral composition was associated with incident glaucoma, with distinct nonlinear patterns across mineral indicators. These observational findings require independent confirmation.
SN - 0146-0404
SN - 1552-5783
ER -