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A. H. Dao, J. D. Spindle, B. A. Harp, A. T. Jacob, A. Z. Chuang, R. W. Yee; Association of Dyslipidemia in Moderate to Severe Meibomian Gland Dysfunction: A Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6249.
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To examine whether or not there is an association between dyslipidemia and moderate to severe meibomian gland dysfunction, a disease that is a major contributor to dry eye disease.
This is a retrospective study involving 66 patients in our clinic from January 2008 to July 2009 with moderate to severe meibomian gland dysfunction whose serum lipid levels were obtained. Of these, 2 patients were excluded due to rheumatologic disease and 15 patients were excluded from the analysis due to their taking either an omega-3 fatty acid supplement (n=6) or a statin (n=9). Of the 46 remaining patients, 22 were male and 24 were female, the average age was 52.0 years, and the range in age was 27-82. The prevalence of dyslipidemia as defined as total cholesterol >200 mg/dL, low-density lipoprotein (LDL) >130 mg/dL, high-density lipoprotein (HDL), and triglycerides (>150 mg/dL) was compared in these patients to the general population as reported by data from the National Health and Nutrition Examination Survey (NHANES).
Patients with moderate to severe MGD had a higher incidence of dyslipidemia with respect to elevated total cholesterol (>200 mg/dL), 67.4% to 45.1% (p=0.0012) when compared to population controls. There was a smaller number of MGD patients with low HDL, 15.2% when compared to controls, 33.1% (p-value=0.0049).The incidence of increased LDL was not statistically significant (p-value=0.184). There was a statistically smaller number of MGD patients with high triglycerides (TG >150 mg/dL), 15.2% when compared to controls, 33.1% (p-value=0.0049).
Patients with moderate to severe MGD have a higher incidence of dyslipidemia with respect to elevated total cholesterol than the general population. The component of total cholesterol that contributed most to this increase in total cholesterol came from elevated serum HDL levels. To our knowledge, elevated HDL has not been associated with any pathological state. Patients with MGD had a statistically significant lower incidence of hypoalphalipoproteinemia (low HDL) than the general population. The potential to screen for dyslipidemia on physical exam at the slit lamp is an exciting finding.
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