The Relationship Between Vitamin D And The Incidence Of Primary Open Angle Glaucoma

Objective: Primary open angle glaucoma is a common type of glaucoma,which is characterized by typical structural damage to the optic nerve,specific visual field defects,and often relatively higher intraocular pressure.Epidemiological studies have show that high intraocular pressure,age,race,family history,diabetes,myopia,sex,cataracts,migraine,peripheral vasospasm,cerebrospinal fluid pressure,systemic hypertension,hemorheology abnormalities and genetic factors have been regarded as critical risk factors in the pathogenesis of primary open angle glaucoma.Primary open angle glaucoma patients may be asymptomatic or symptoms are not obvious,but visual function damage is irreversible.Controlling intraocular pressure is the most important thing.Therefore,it is necessary from the genetics to explore the pathogenesis of primary open-angle glaucoma,to achieve early diagnosis and early treatment.Primary open angle glaucoma has genetic predisposition,and recent studies have shown that it is a polygene genetic disease.Therefore,the genetic pathogenesis of primary open angle glaucoma has become a hot spot in research and provides a new approach for treatment and prevention.Vitamin D and vitamin D receptor gene polymorphisms have been shown to be related to diabetes,hypertension,and myopia,which were influence factors for primary open angle glaucoma.Whether there is a relationship between vitamin D and intraocular pressure is controversial.Animal experiments show that 1,25 dihydroxyvitamin D3 as the active form of vitamin D can regulate intraocular pressure.1,25 dihydroxyvitamin D3 is required to bind to the vitamin D receptor.Vitamin D receptor gene polymorphism,may be involved in the occurrence of the disease.The high expression of aquaporin 1 is detected in the trabecular mesh and other plasma membrane,involved in aqueous humor secretion,regulation,discharge and high intraocular pressure formation.This study investigated whether 1,25-dihydroxyvitamin D3 regulated intraocular pressure by regulating aquaporin 1 in human trabecular cells,and vitamin D levels and vitamin D receptor gene polymorphisms(Cdx-2,Fok I,Bsm I,Taq I,Apa I and Tru9 I)were involved in the pathogenesis of primary open angle glaucoma.Results: 1)The level of serum 1,25 dihydroxyvitamin D3 in patients with primary open angle glaucoma was 26.37 ± 5.83 ng / l,and the level of serum 1,25 dihydroxyvitamin D3 in the control group was 30.43 ± 3.91 ng / l.The serum levels of 1,25 dihydroxyvitamin D3 in patients with primary open angle glaucoma were significantly lower than those in the control group(p <0.001).2)The frequencies of Bb and bb genotypes were 25.35% and 74.65% respectively in the primary open angle glaucoma group.The frequency of Bb and bb genotypes in the control group were 5.48% and 94.52%,respectively.The genotype frequencies of the two groups were statistically significant(P = 0.001;?2 = 10.982).The frequency of B allele in primary open angle glaucoma group was 12.68%,the allele frequency of group B was 2.74%,the allele frequency of the two groups was statistically different(p = 0.002;?2 = 10.074;OR = 5.153,95% CI: 1.699 to 15.635).The frequencies of TT and Tt genotypes were 74.65% and 23.35% in the primary open angle glaucoma group respectively.The frequencies of TT and Tt genotypes in the control group were 90.41% and 9.59% respectively.The genotype frequencies of the two groups were statistically significant(P = 0.013;?2 = 6.234).The frequency of t allele in primary open-angle glaucoma group was 12.68%,the allele frequency of control group was 4.79%,the allele frequency of the two groups was statistically different(p = 0.018;?2 = 5.641;OR = 2.882,95% CI: 1.165 to 7.132).There was no significant difference in Cdx-2,Fok I,Apa I and Tru9 I polymorphisms.3)1,25 dihydroxyvitamin D3 reduced the expression of aquaporin 1 in human trabecular cells and increased the expression of vitamin D receptor protein.Conclusion: 1)Low level of 1,25 dihydroxyvitamin D3 is a influence factor for primary open angle glaucoma.2)The Bsm I 'B' allele and the Taq I 't' allele have been regarded as a relevant risk factor in the development of glaucoma.3)1,25 dihydroxyvitamin D3 regulates aquaporin 1 in human trabecular cells,and the vitamin D receptor is also involved.