Dyslipidemia Exacerbates Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis

Tomioka, Yasufumi; Kitazawa, Koji; Yamashita, Yohei; Numa, Kohsaku; Inomata, Takenori; Hughes, Jun-Wei B; Soda, Rina; Nakamura, Masahiro; Suzuki, Tomo; Yokoi, Norihiko; Sotozono, Chie

doi:10.3390/jcm12062131

Cited by 7 publications

(5 citation statements)

References 67 publications

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“… 19 , 38 Clinical studies linked hypercholesterolemia and MGD. 51 – 53 Considering that blood Chl can be transported to, and accumulated in, MGs in unaltered form, these observations provide an opportunity for Chl to play a role in inspissation of meibum of certain types of MGD (e.g. its obstructive variant) and patients with DED, and poor stability of their TF.…”

Section: Discussionmentioning

confidence: 99%

Comparative Biophysical Study of Meibomian Lipids of Wild Type and Soat1-Null Mice: Implications to Meibomian Gland Dysfunction and Dry Eye Disease

Wilkerson

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose The biophysical roles of Meibomian lipids (MLs) played in health and meibomian gland dysfunction (MGD) are still unclear. The purpose of this research is to establish the composition-structure-functional correlations of the ML film (MLF) using Soat1 -null mice and comprehensive in vitro biophysical simulations. Methods MLs were extracted from tarsal plates of wild type (WT) and Soat1 knockout (KO) mice. The chemical composition of ML samples was characterized using liquid chromatography – mass spectrometry. Comprehensive biophysical studies of the MLFs, including their dynamic surface activity, interfacial rheology, evaporation resistance, and ultrastructure and topography, were performed with a novel experimental methodology called the constrained drop surfactometry. Results Soat1 inactivation caused multiple alternations in the ML profile. Compared to their WT siblings, the MLs of KO mice were completely devoid of cholesteryl esters (CEs) longer than C 18 to C 20 , but contained 7 times more free cholesterol (Chl). Biophysical assays consistently suggested that the KO-MLF became stiffer than that of WT mice, revealed by reduced film compressibility, increased elastic modulus, and decreased loss tangent, thus causing more energy loss per blinking cycle of the MLF. Moreover, the KO mice showed thinning of their MLF, and reduced evaporation resistance. Conclusions These findings delineated the composition-structure-functional correlations of the MLF and suggested a potential biophysical function of long-chain CEs in optimizing the surface activity, interfacial rheology, and evaporation resistance of the MLF. This study may provide novel implications to pathophysiological and translational understanding of MGD and dry eye disease.

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Section: Discussionmentioning

confidence: 99%

Comparative Biophysical Study of Meibomian Lipids of Wild Type and Soat1-Null Mice: Implications to Meibomian Gland Dysfunction and Dry Eye Disease

Wilkerson

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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“…In a retrospective study, Aldaas et al reviewed 72,931 patients to study the association between DES and dyslipidemia and found that the odds of having a DES diagnosis are increased in patients with dyslipidemia [ 26 ]. In a meta-analysis, Tomoika et al showed that high total cholesterol and high triglycerides were significantly associated with meibomian gland dysfunction and dry eyes, with odds ratios of 5.2 and 3.2, respectively [ 27 ]. Other studies showed similar results, with a higher incidence of DES in patients with dyslipidemia [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Association Between Baseline Serum Lipids and Severity of Dry Eye Symptoms in Acne Patients Treated with Isotretinoin

Alajaji

2024

Cureus

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Background: Isotretinoin is a commonly prescribed medication for moderate-to-severe acne. Elevated triglycerides and total cholesterol, as well as eye dryness, are frequent side effects of isotretinoin.Objective: This study aims to examine the association between serum baseline levels of triglycerides and total cholesterol with regards to the severity of dry eye symptoms in acne patients treated with isotretinoin.Method: The study was a retrospective review of acne patients treated with isotretinoin for at least four months at the dermatology clinics of Qassim University Medical City, Saudi Arabia. Thirty patients were included in the study as they met the inclusion criteria. Baseline levels of triglycerides and total cholesterol were reviewed for these patients. The Ocular Surface Disease Index (OSDI) questionnaire was sent and filled out by the study participants to assess the severity of eye dryness.Result: 30 patients were included in the study, with 16 (53.3%) females and 14 (46.7%) males. The average age of participants was 22.1 years. The duration of treatment was between 120 and 140 days in 13 (43.3%) participants and 140 and 180 days in 17 (56.7%) participants. The mean ± 1 standard deviation (SD) was reported for each of the three variables, with an Ocular Surface Disease Index (OSDI) score of 27.6 ± 19.2, a baseline total cholesterol of 4.4 ± 0.9 mmol/L, and a baseline triglyceride level of 0.83 ± 0.4 mmol/L. Using a multiple linear regression model, baseline triglycerides and total cholesterol were used as predictors of the OSDI score. There was a significant dependent interaction between baseline total cholesterol and triglycerides and their effect on the OSDI score, with a higher OSDI score at higher levels of both triglycerides and cholesterol and a lower OSDI score at lower levels of both triglycerides and cholesterol. The study result showed that, in acne patients treated with isotretinoin for at least four months, a higher baseline level of both triglycerides and total cholesterol is associated with worse dry eye symptoms compared to those with lower baseline levels. Conclusion:The study concluded that baseline levels of triglycerides and total cholesterol are both significant predictors of the severity of dry eye symptoms in acne patients treated with isotretinoin. Despite study limitations due to the small sample size, we hope that, based on our findings, this will open the door to future studies with a larger sample size to further confirm our findings generalize the result, and apply it to clinical practice so that clinicians may identify those at higher risk of severe eye dryness before starting isotretinoin and subsequently be able to recommend specific measures to minimize symptoms of eye dryness.

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“…Conversely, PE is also an important phospholipid in the cell membranes of mammals and is required for the stability of lipoproteins. 55 Dyslipidemia is one of the significant risk factors for MGD. 56 The proportions of PE (4.6 ± 3.2 vs. 16.7 ± 4%, P < 0.05) and SM (7.2 ± 4.8 vs. 14.0 ± 8.1%, P < 0.05) in patients with chronic blepharitis-keratoconjunctivitis sicca (CB-KCS) were significantly reduced compared with normal controls, respectively.…”

Section: Discussionmentioning

confidence: 99%

Meibomian Gland Shortening Is Associated With Altered Meibum Composition

Iqbal,

Stapleton,

Masoudi

et al. 2024

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to investigate differences in the composition of meibum extracted from human meibomian glands displaying different morphological characteristics. Methods Adult participants with evidence of meibomian gland shortening were enrolled. Glands were observed using infrared meibography, and meibum was collected from one short and one long gland from the lower eyelid of the same eye. Total protein concentration was evaluated using the detergent compatible ( DC ) protein assay and lipid analysis was performed using liquid chromatography mass spectrometry. Results Fifteen participants (8 women and 7 men) completed the study (mean age = 34.7 ± 7.7 years). The average volume of meibum collected from the short and long glands was 0.02 ± 0.01 and 0.05 ± 0.03 µL, respectively ( P = 0.01). Average protein concentration in the short glands was significantly higher compared to the long glands (0.10 ± 0.03 vs. 0.08 ± 0.02 mg/mL, P = 0.01). Among the non-polar lipids, the mole percent of cholesterol esters (CEs; P = 0.02), triacylglycerols (TAGs; P = 0.04), and ceramide (Cer; P = 0.03) was significantly lower in short glands compared with long glands. Among the polar lipids, the mole percent of (O-acyl)-ω-hydroxy fatty acid (OAHFA; P = 0.01) was significantly lower in short glands, whereas phosphatidylcholine (PC; P = 0.02) and sphingomyelin (SM; P = 0.01) were significantly higher in short glands than long glands. Conclusions Meibum composition differed between short and long glands. The lower mole percent of CE, TAG, OAHFA, and Cer and a higher mole percent of PC and SM among short glands may indicate disease activity. This information may clarify the natural history of meibomian gland dysfunction and future targets for therapy.

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Dyslipidemia Exacerbates Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis

Cited by 7 publications

References 67 publications

Comparative Biophysical Study of Meibomian Lipids of Wild Type and Soat1-Null Mice: Implications to Meibomian Gland Dysfunction and Dry Eye Disease

Comparative Biophysical Study of Meibomian Lipids of Wild Type and Soat1-Null Mice: Implications to Meibomian Gland Dysfunction and Dry Eye Disease

Association Between Baseline Serum Lipids and Severity of Dry Eye Symptoms in Acne Patients Treated with Isotretinoin

Meibomian Gland Shortening Is Associated With Altered Meibum Composition

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