{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:47:23Z","timestamp":1785577643674,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Existing research on the relationship between body mass index (BMI) and astigmatism yields inconsistent results. This study analyses this association in a nationally representative sample of adolescents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, cross\u2010sectional study included Israeli adolescents who underwent medical assessments before mandatory military service between 2011 and 2022. BMI was categorised based on the US age\u2010 and sex\u2010matched percentiles. Astigmatism was categorised by magnitude [low\u2010moderate: 0.75 to &lt;3.00 diopters (D), high: \u22653.00 D], and axis orientation [with\u2010the\u2010rule (WTR), against\u2010the\u2010rule (ATR), or oblique (OBL)]. Sex\u2010stratified regression models adjusted for sociodemographic variables were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 935\u2009989 adolescents evaluated, 887\u2009325 were included [511\u2009465 (57.6%) males, mean age 17.2\u2009years]. Astigmatism was diagnosed in 123\u2009675 (13.9%) adolescents, of whom 117\u2009081 (13.2%) had low\u2010moderate and 6594 (0.7%) had high astigmatism. WTR astigmatism was the most prevalent (8.2%), followed by ATR (4.1%) and OBL (1.6%) types. Compared with low\u2010normal BMI (5th to 50th percentile), the adjusted ORs for total astigmatism increased with increasing BMI, peaking at 1.65 (1.57\u20131.74) in males and 1.74 (1.64\u20131.86) in females with severe obesity. ORs were accentuated for high astigmatism, reaching 3.51 (3.01\u20134.09) in males, and 3.45 (2.83\u20134.22) in females with severe obesity. WTR astigmatism demonstrated the strongest association with BMI, with ORs reaching 2.26 (2.13\u20132.40) in males and 2.04 (1.90\u20132.20) in females with severe obesity. The results persisted in a series of subgroup analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obesity is associated with higher odds of astigmatism in adolescence. Further investigation into the role of weight management in astigmatism development is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.14406","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T05:58:20Z","timestamp":1716875900000},"page":"616-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Body mass index and astigmatism: A nationwide study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6925-5157","authenticated-orcid":false,"given":"Itay","family":"Nitzan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Hadassah\u2010Hebrew University Medical Center  Jerusalem Israel"},{"name":"Department of Military Medicine, Faculty of Medicine Hebrew University of Jerusalem  Israel"},{"name":"Israel Defense Forces Medical Corps, Tel Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbal","family":"Akavian","sequence":"additional","affiliation":[{"name":"Department of Military Medicine, Faculty of Medicine Hebrew University of Jerusalem  Israel"},{"name":"Israel Defense Forces Medical Corps, Tel Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3718-2664","authenticated-orcid":false,"given":"Or","family":"Shmueli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Hadassah\u2010Hebrew University Medical Center  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Erdinest","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Hadassah\u2010Hebrew University Medical Center  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Hanina","sequence":"additional","affiliation":[{"name":"Israel Defense Forces Medical Corps, Tel Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilad","family":"Twig","sequence":"additional","affiliation":[{"name":"Department of Military Medicine, Faculty of Medicine Hebrew University of Jerusalem  Israel"},{"name":"Israel Defense Forces Medical Corps, Tel Hashomer  Ramat Gan Israel"},{"name":"Division of Endocrinology, Diabetes and Metabolism Sheba Medical Center, Tel Hashomer  Ramat Gan Israel"},{"name":"Department of Preventive Medicine, School of Public Health, Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"The Gertner Institute for Epidemiology &amp; 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