Meibomian Gland Dysfunction: Endocrine Aspects

Abstract

Purpose. To compare the hormone levels of patients with seborrheic meibomian gland dysfunction with controls. Procedures. This is a retrospective case-control study involving 50 patients and 50 controls. Blood workup for hormones was studied in both groups by using macroELISA (enzyme-linked immunosorbent assay). Statistical evaluation was done by using SPSS 15.0 independent samples t-test. Results. There were statistically significant differences of serum testosterone and dehydroepiandrosterone sulphate levels between patients and controls (P = 0.000). Female gender showed statistically significant differences of serum thyroid-stimulating hormone and prolactin levels between patients and controls (P = 0.014 and P = 0.043), in addition to serum testosterone and dehydroepiandrosterone sulphate levels (P = 0.000 and P = 0.001). However, male gender showed statistically significant differences of only serum testosterone and dehydroepiandrosterone sulphate levels between patients and controls. (P = 0.003 and P = 0.003 resp.). Conclusions. Increased serum levels of testosterone and dehydroepiandrosterone sulphate in both genders should be considered as diagnostic markers for seborrheic meibomian gland dysfunction.

Prolactin Inducible Protein, but Not Prolactin, Is Present in Human Tears, Is Involved in Tear Film Quality, and Influences Evaporative Dry Eye Disease

“…In contrast, PRL blood serum concentration has been shown to correlate negatively with tear quality in women on hormone replacement therapy (18). In another study, women, but not men, with seborrheic MGD revealed significantly higher PRL levels in blood serum compared to controls (45). Both studies did not include PRL concentration or other hormonal factors in the donor tears.…”

TFOS DEWS II Sex, Gender, and Hormones Report

“…With regard to the meibomian gland, investigators have found that women, but not men, with seborrheic MGD have significantly elevated serum levels of prolactin [772]. The reason for this linkage is unknown.…”

“…These receptors are thought to be the target for autoantibodies in thyroid-associated ophthalmopathy, and, possibly through aberrant signal transduction, contribute to the reduced aqueous tear secretion and ocular surface damage in this disorder [793]. TSH levels in the serum of women, but not men, are also increased in seborrheic MGD [772]. The basis for this correlation is not known.…”

Association Between Serum Levels of Testosterone and Estradiol With Meibomian Gland Assessments in Postmenopausal Women

“… 23 , 24 Furthermore, testosterone deficiency has been shown to promote meibomian gland dysfunction especially in patients taking antiandrogen therapy. 18 , 25 These patients showed changes in the appearance of the meibomian glands as well as a reduced quality of meibum secretion. 19 Ocular surface effects of estrogens on the meibomian glands are more controversial, although it is thought that a high level of serum estradiol is a risk factor for dry eye 26 through its suppression of lipid synthesis and promotion of lipid catabolism in the meibomian glands.…”