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Hung-Chi Chen, Chien-Ting Chen, Hung-Ta Chen, Yih-Shiou Hwang, Hsin-Chiung Lin, David Ma; Relationships of meibomian gland dysfunction and cardiovascular disease risk factors in a middle-aged population. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5431. doi: https://doi.org/.
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To determine the prevalence of meibomian gland dysfunction (MGD) and its association with cardiovascular disease (CVD) risk factors in middle-aged population.
This cross-sectional, retrospective study randomly enrolled 89 participants with MGD and 199 participants without MGD, aging between 30 to 60 years old, from a community-based, Taiwanese Han population (N = 1329). Participants underwent standardized questionnaires and physical examinations, as well as laboratory investigations. Identification and grading of MGD were completed by one ophthalmologist using slit-lamp biomicroscopy examination on the eyelid margins, meibomian gland orifices and meibomian gland secretions. CVD risk factor parameters were measured by standardized techniques. Dyslipidemia was defined as serum levels of total cholesterol ≥ 240 mg/dL, low-density lipoprotein cholesterol (LDL-C) ≥ 160 mg/dL, high-density lipoprotein cholesterol (HDL-C) ≥ 40 mg/dL, non-HDL-C ≥ 190 mg/dL, and fasting triglyceride (TG) ≥ 150 mg/dL respectively.
The prevalence of MGD among our community-based, middle-aged participants was 89/1329 (6.7%). Most participants with MGD were men (86.5%). After adjusted for age and sex, participants having elevated total cholesterol, LDL-C, fasting TG (P < 0.01), uric acid, decreased HDL-C levels as well as having fatty liver (P < 0.05) were significantly associated with MGD. No significant correlations were detected between MGD and parameters such as waist circumference, body mass index (BMI), systolic blood pressure (BP), diastolic BP, fasting glucose, postprandial (PC) glucose, and high sensitivity C-reactive protein (hs-CRP). Using stepwise logistic regression analysis, we found that both LDL-C (OR: 1.03, 95% CI: 1.02-1.04) and fasting TG (OR: 1.01 95% CI: 1.00-1.01) levels were risk factors for having MGD (P < 0.001). Additionally, participants with moderate-to-severe MGD had significantly higher risk of having elevated total cholesterol (OR: 7.91 vs. OR: 2.08), LDL-C (OR: 5.82 vs. OR: 2.68), and fasting TG (OR: 5.46 vs. OR: 2.70) than those with only mild MGD (P < 0.001).
Serum levels of total cholesterol, LDL-C, and fasting TG are significantly correlated to MGD. Presence of MGD in middle-aged men may be an indicator for dyslipidemia, and we speculate that the relationship between MGD and CVD may be dependent of dyslipidemia.
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