The Correlation Between Adiponectin and Endothelin-1 Systemic Levels with Normal-Tension Glaucoma in Metabolic Syndrome Patients

Background: The pathomechanism in Normo-tension glaucoma (NTG) is a dysregulation in the optic nerve head, which also occurs in Metabolic syndrome (MetS). Current therapies such as lowering intraocular pressure (IOP) have failed to inhibit the progression of NTG. This encourages various studies to evaluate the role of MetS. Objective: This study aims to evaluate the possible role of ET-1, TBARS, FRAP, hsCRP, Adiponectin, and Leptin systemic levels in the pathogenesis of NTG in MetS patients. Methods: This is a cross-sectional study conducted at the National Cardiac Center, Harapan Kita Hospital, Indonesia, with 29 patients divided into two groups, namely, with NTG (n=15) and without NTG (n=14). MetS was diagnosed based on the 2006 IDF criteria, while NTG was determined based on the presence of IOP, MD of the visual field, RNFL, and cupping of the disc as assessed by OCT. Furthermore, plasma ET-1, hsCRP, Leptin, and Adiponectin were assayed by ELISA, FRAP and TBARS were measured by colorimetric assay, while comparative and correlative tests were also performed. Results: There was a positive significant correlation between ET-1 and MD in NTG group (p = 0.025 ; r = 0.416 ; CI 95%= 1.85±0.89) as well as adiponectin and RNFL thickness (p = 0.035 ; r = 0.392 ; CI 95% = 2.71±8.27), however, a negative correlation was found between Adiponectin and MD (p = 0.012 ; r = -0.459 ; CI 95% = 5.53±18.68). Furthermore, there were no statistical differences in TBARS, FRAP, hsCRP, and leptin levels between the 2 groups. Conclusion: Based on the results, Adiponectin and ET-1 have potential involvement in the pathogenesis of NTG in MetS patients.