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Elevated testosterone levels in postmenopausal women may promote POAG, higher IOP

26 Jun 2018

Plasma sex hormone concentration overall does not have any effect on the risk of primary open-angle glaucoma (POAG) in postmenopausal women, according to a study. However, elevated testosterone levels appear to be associated with POAG and higher intraocular pressure (IOP).

Researchers looked at 189 POAG patients and the same number of matched controls. They analysed plasma concentrations of estrone sulfate, oestradiol, testosterone, sex hormone binding globulin and dehydroepiandrosterone sulfate in relation to POAG (primary outcome) and IOP (secondary analyses; in POAG patients only).

Among patients, POAG risk or maximum IOP at glaucoma diagnosis showed no significant associations with estrone, oestradiol, sex hormone binding globulin or dehydroepiandrosterone sulfate.

However, there were nonsignificant associations between POAG risk and sex hormone binding globulin (highest vs lowest tertile: multivariable odds ratio [OR], 1.73; 95 percent CI, 0.93–3.21; p=0.07 for trend) and dehydroepiandrosterone sulfate (highest vs lowest tertile: multivariable OR, 1.39; 0.77–2.51; p=0.41 for trend). Of note, the highest testosterone levels were significantly associated with greater POAG risk (highest vs lowest tertile: multivariable OR, 1.84; 1.02–3.33), although the p-trend was not significant.

Higher testosterone levels were also associated with maximum IOP at diagnosis (highest vs lowest tertile: mean difference, 2.17 mm Hg; 0.34–3.99; p=0.02 for trend). While unknown, the biological mechanisms underlying this association might involve other factors associated with higher testosterone levels, such as higher central corneal thickness and higher insulin resistance. These factors, in turn, could increase IOP in postmenopausal women, researchers pointed out.

Additional studies are needed to confirm and elucidate the association of higher testosterone levels with higher POAG risk and higher IOP at glaucoma diagnosis, researchers said.

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