Systemic Metabolic and Skeletal Muscle-Related Profiles Associated with Annual Axial Elongation Across Optical Myopia-Control Strategies in Adolescents: A Retrospective Cohort Study
- 1Cangzhou Central Hospital
- 2Hejian Traditional Chinese Medicine Hospital
- 3Cangzhou Eye Hospital
Abstract
Introduction Axial elongation varies among adolescents receiving myopia-control treatment, but the contribution of systemic metabolic and skeletal muscle-related characteristics remains uncertain. We examined these associations, treating recorded glucagon-like peptide 1 receptor agonist (GLP-1RA) status as a clinical marker rather than an independent drug exposure. Methods This retrospective study included 3270 adolescents aged 7–18 years receiving single-vision spectacles, defocus incorporated multiple segments (DIMS) lenses, or orthokeratology. The primary outcome was annual axial elongation; composite treatment failure was exploratory. Multivariable regression, spline models, treatment-stratified analyses, and stabilized inverse probability of treatment weighting (IPTW) were performed. Primary adjusted analyses included 2267 complete cases. The revised exploratory muscle-vulnerability score excluded GLP-1RA status and duration. Results Among 3270 participants, 484 had recorded GLP-1RA use and showed greater obesity and insulin-resistance burden and less favorable muscle and activity profiles. In the comprehensive model, BMI z-score (β = 0.020 mm/year per unit; 95% CI 0.014–0.026) and HOMA-IR (β = 0.007 mm/year per unit; 95% CI 0.004–0.009) were associated with greater annual axial elongation. Skeletal muscle index was not independently associated, whereas handgrip strength showed a nonlinear association (P for nonlinearity = 0.002). Recorded GLP-1RA status was associated with 0.040 mm/year greater elongation (95% CI 0.031–0.049), without heterogeneity across myopia-control strategies (P for interaction = 0.646). After IPTW and comprehensive adjustment, the estimate attenuated to 0.032 mm/year (95% CI 0.021–0.043), with residual imbalance in four of 17 covariates. Associations with exploratory composite treatment failure were statistically uncertain in the comprehensive model (OR 1.23; 95% CI 0.93–1.63) and after IPTW (OR 1.17; 95% CI 0.80–1.70). Conclusions Metabolic vulnerability was associated with modestly greater annual axial elongation, although the clinical importance of the observed difference remains uncertain. Recorded GLP-1RA status identified a metabolically higher-risk subgroup but did not establish a drug effect. Muscle-related findings were not uniform, and residual confounding remained.
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BibTeX
@article{wang2026systemic,
title = {{Systemic Metabolic and Skeletal Muscle-Related Profiles Associated with Annual Axial Elongation Across Optical Myopia-Control Strategies in Adolescents: A Retrospective Cohort Study}},
author = {Xue Wang and Wenying Wang and Fengmei Han and Ting Li and Weiwei Kang and Xiaorui Yang and Jian Wang and Lidong Yang},
journal = {Ophthalmology and Therapy},
year = {2026},
month = sep,
doi = {10.1007/s40123-026-01505-y},
url = {https://doi.org/10.1007/s40123-026-01505-y},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Systemic Metabolic and Skeletal Muscle-Related Profiles Associated with Annual Axial Elongation Across Optical Myopia-Control Strategies in Adolescents: A Retrospective Cohort Study
AU - Xue Wang
AU - Wenying Wang
AU - Fengmei Han
AU - Ting Li
AU - Weiwei Kang
AU - Xiaorui Yang
AU - Jian Wang
AU - Lidong Yang
PY - 2026
DA - 2026/09/01
JO - Ophthalmology and Therapy
DO - 10.1007/s40123-026-01505-y
UR - https://doi.org/10.1007/s40123-026-01505-y
AB - Introduction Axial elongation varies among adolescents receiving myopia-control treatment, but the contribution of systemic metabolic and skeletal muscle-related characteristics remains uncertain. We examined these associations, treating recorded glucagon-like peptide 1 receptor agonist (GLP-1RA) status as a clinical marker rather than an independent drug exposure. Methods This retrospective study included 3270 adolescents aged 7–18 years receiving single-vision spectacles, defocus incorporated multiple segments (DIMS) lenses, or orthokeratology. The primary outcome was annual axial elongation; composite treatment failure was exploratory. Multivariable regression, spline models, treatment-stratified analyses, and stabilized inverse probability of treatment weighting (IPTW) were performed. Primary adjusted analyses included 2267 complete cases. The revised exploratory muscle-vulnerability score excluded GLP-1RA status and duration. Results Among 3270 participants, 484 had recorded GLP-1RA use and showed greater obesity and insulin-resistance burden and less favorable muscle and activity profiles. In the comprehensive model, BMI z-score (β = 0.020 mm/year per unit; 95% CI 0.014–0.026) and HOMA-IR (β = 0.007 mm/year per unit; 95% CI 0.004–0.009) were associated with greater annual axial elongation. Skeletal muscle index was not independently associated, whereas handgrip strength showed a nonlinear association (P for nonlinearity = 0.002). Recorded GLP-1RA status was associated with 0.040 mm/year greater elongation (95% CI 0.031–0.049), without heterogeneity across myopia-control strategies (P for interaction = 0.646). After IPTW and comprehensive adjustment, the estimate attenuated to 0.032 mm/year (95% CI 0.021–0.043), with residual imbalance in four of 17 covariates. Associations with exploratory composite treatment failure were statistically uncertain in the comprehensive model (OR 1.23; 95% CI 0.93–1.63) and after IPTW (OR 1.17; 95% CI 0.80–1.70). Conclusions Metabolic vulnerability was associated with modestly greater annual axial elongation, although the clinical importance of the observed difference remains uncertain. Recorded GLP-1RA status identified a metabolically higher-risk subgroup but did not establish a drug effect. Muscle-related findings were not uniform, and residual confounding remained.
SN - 2193-8245
SN - 2193-6528
ER -