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Bi-Gaussian analysis reveals distinct education-related alterations in spherical equivalent and axial length—results from the Gutenberg Health Study

Authors: Alica Hartmann; Stephanie Desirée Grabitz; Felix Mathias Wagner; Philipp Sebastian Wild; Martina Müller-Nurasyid; Karl Johannes Lackner; Manfred Elmar Beutel; +5 Authors

Bi-Gaussian analysis reveals distinct education-related alterations in spherical equivalent and axial length—results from the Gutenberg Health Study

Abstract

Abstract Purpose The aim of this study is to investigate the distribution of spherical equivalent and axial length in the general population and to analyze the influence of education on spherical equivalent with a focus on ocular biometric parameters. Methods The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Participants underwent comprehensive ophthalmologic examinations as part of the 5-year follow-up examination in 2012–2017 including genotyping. The spherical equivalent and axial length distributions were modeled with gaussian mixture models. Regression analysis (on person-individual level) was performed to analyze associations between biometric parameters and educational factors. Mendelian randomization analysis explored the causal effect between spherical equivalent, axial length, and education. Additionally, effect mediation analysis examined the link between spherical equivalent and education. Results A total of 8532 study participants were included (median age: 57 years, 49% female). The distribution of spherical equivalent and axial length follows a bi-Gaussian function, partially explained by the length of education (i.e., < 11 years education vs. 11–20 years). Mendelian randomization indicated an effect of education on refractive error using a genetic risk score of education as an instrument variable (− 0.35 diopters per SD increase in the instrument, 95% CI, − 0.64–0.05, p = 0.02) and an effect of education on axial length (0.63 mm per SD increase in the instrument, 95% CI, 0.22–1.04, p = 0.003). Spherical equivalent, axial length and anterior chamber depth were associated with length of education in regression analyses. Mediation analysis revealed that the association between spherical equivalent and education is mainly driven (70%) by alteration in axial length. Conclusions The distribution of axial length and spherical equivalent is represented by subgroups of the population (bi-Gaussian). This distribution can be partially explained by length of education. The impact of education on spherical equivalent is mainly driven by alteration in axial length.

Country
Germany
Keywords

Male, Adult, Female [MeSH] ; Follow-Up Studies [MeSH] ; Mendelian randomization ; Aged [MeSH] ; Adult [MeSH] ; Educational Status [MeSH] ; Humans [MeSH] ; Myopia ; Middle Aged [MeSH] ; Refraction, Ocular/physiology [MeSH] ; Refractive Errors/genetics [MeSH] ; Biometry ; Germany/epidemiology [MeSH] ; Refractive Errors/diagnosis [MeSH] ; Refractive Errors/physiopathology [MeSH] ; Male [MeSH] ; Axial Length, Eye/pathology [MeSH] ; Gaussian mixture model ; Biometry/methods [MeSH] ; Normal Distribution [MeSH] ; Basic Science ; Refraction, Biometry, 610 Medizin, Normal Distribution, Middle Aged, Refraction, Ocular, Refractive Errors, Axial Length, Eye, Basic Science, 610 Medical sciences, Germany, Humans, Educational Status, Female, Follow-Up Studies, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Average
Top 10%
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