Association between daily dietary antioxidant component intake and glaucoma: a cross-sectional study based on the National Health and Nutrition Examination Survey

Objective  To investigate the correlation between the daily intake of dietary antioxidant components and the risk of glaucoma development, and to analyze the potential influencing factors.

Methods  A cross-sectional study was conducted using data from the 2005—2008 cycles of the National Health and Nutrition Examination Survey, with a total of 3 550 participants enrolled. The daily intake of 14 dietary antioxidant components was defined as the exposure factor, and glaucoma diagnosis was the outcome variable. Covariates included age, sex, race, educational level, poverty-income ratio, smoking status, drinking status, diabetes, and hypertension. Weighted multivariate logistic regression analysis was used to explore the association between the daily intake of each dietary antioxidant component and glaucoma risk. Weighted restricted cubic splines were applied to analyze the dose-response relationship. Spearman correlation analysis was performed to examine the correlations among the intakes of the 14 antioxidant components. Taking riboflavin as an example, subgroup analysis was conducted to explore the differential characteristics and interaction of the association between riboflavin intake and glaucoma risk across different subgroups.

Results  After adjusting for confounding factors (age, sex, race, educational level, poverty-income ratio, smoking status, drinking status, diabetes, and hypertension), the daily intakes of riboflavin (odds ratio [ OR]=0.65, 95% confidence interval [ CI]: 0.47-0.91, P=0.006), folate ( OR=0.10, 95% CI: 0.02-0.58, P=0.005), vitamin B12 ( OR=0.88, 95% CI: 0.81-0.96, P=0.002), vitamin E ( OR=0.94, 95% CI: 0.89-0.99, P=0.04), selenium ( OR=0.99, 95% CI: 0.98-0.99, P<0.001), niacin ( OR=0.97, 95% CI: 0.94-0.99, P=0.04), calcium ( OR=0.99, 95% CI: 0.99-0.99, P<0.001), and magnesium ( OR=0.99, 95% CI: 0.99-0.99, P=0.04) were identified as influencing factors for glaucoma. The daily intakes of riboflavin, folate, selenium, niacin, calcium, and magnesium were negatively correlated with glaucoma risk, and the associations showed a linear trend in the dose-response analysis (nonlinear P>0.05). Spearman correlation analysis revealed that positive correlations among the intakes of the 14 antioxidant components were significantly more common than negative correlations. Subgroup analysis indicated that the correlation between daily riboflavin intake and glaucoma risk varied across subgroups of age, sex, smoking status, drinking status, diabetes, and hypertension (all P<0.05). Interaction analysis showed that the age subgroup had a significant interaction effect on the association between riboflavin intake and glaucoma risk (interaction P<0.01).

Conclusions  The daily intakes of multiple dietary antioxidant components are negatively correlated with the risk of glaucoma. The correlation of riboflavin and risk of glaucoma varies across different subgroups, and there are synergistic and antagonistic effects among various dietary antioxidant components.