| Title: | Association Between Circulating Ketone Bodies and Primary Open-angle Glaucoma and Related Ocular Parameters |
| Journal: | Ophthalmology Science |
| Published: | 1 Jul 2026 |
| DOI: | https://doi.org/10.1016/j.xops.2026.101313 |
| URL: | https://www.ophthalmologyscience.org/article/S2666-9145(26)00251-4/pdf |
Publication 20491
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Abstract
Objective Ketone bodies are key metabolic intermediates with both neuroprotective and pro-oxidative properties; however, their role in glaucoma remains unclear. This study aimed to investigate associations between circulating ketone bodies and the incidence of primary open-angle glaucoma (POAG), as well as related ocular parameters, in the UK Biobank. Design Combined cross-sectional analysis and prospective cohort study. Participants A total of 456,499 participants were included in the cohort analysis; 104,225 were included in the baseline intraocular pressure (IOP) analysis, 41,495 in the baseline ganglion cell complex (GCC) thickness analysis, and 39,498 in the IOP-adjusted GCC thickness analysis. Methods Circulating ketone bodies were quantified using nuclear magnetic resonance-based metabolomics. Cox proportional hazards models were used to estimate hazard ratios (HRs) for POAG incidence. Linear regression models assessed associations with baseline IOP and GCC thickness. Restricted cubic spline models were applied to evaluate dose-response relationships, and subgroup analyses were conducted to explore potential effect modification. Main Outcome Measures Incidence of POAG. Results During follow-up, 2,330 participants developed POAG. Higher circulating ketone body levels were associated with an increased incidence of POAG after full adjustment (HR 1.93, 95% CI 1.25-2.99, P = 0.003). Elevated ketone body levels were also associated with higher baseline IOP (β = 1.84, 95% CI 1.57-2.10, P < 0.001) and thinner GCC both before (β = -1.62, 95% CI -2.66 to -0.57, P = 0.002) and after IOP adjustment (β = -1.48, 95% CI -2.53 to -0.42, P = 0.006), suggesting associations that are partially IOP-independent. Conclusions Elevated circulating ketone body levels were associated with a higher incidence of POAG and related ocular phenotypes. Circulating ketone body levels may serve as a potential biomarker of systemic metabolic dysregulation associated with increased POAG susceptibility.</p>
11 Authors
- Jianqi Chen
- Zhirong Wang
- Shuifeng Deng
- Zhidong Li
- Xiaohong Chen
- Jingying Liang
- Yuke Li
- Jianhong Yu
- Lei Lei
- Yehong Zhuo
- Yingting Zhu
1 Application
| Application ID | Title |
|---|---|
| 95829 | Application of Artificial Intelligence for Screening of Risk Factors and Prediction of Disease Progression for Glaucoma and Myopia |
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