Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study

Ooi, Kenneth G.-J.; Lee, Ming‐Han H.; Burlutsky, George; Gopinath, Bamini; Mitchell, Paul; Watson, Stephanie

doi:10.1111/ceo.13388

Cited by 19 publications

(16 citation statements)

References 24 publications

(41 reference statements)

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“…In contrast, the Australian Blue Mountains Eye Study III (BMES III) cohort study [ 41 ], a large population-based retrospective analysis consisting predominantly of Caucasian Australians aged over 59 years, showed that hypercholesterolemia—as well as serum LDL and HDL levels—had no significant association with DED symptoms, such as dryness, grittiness, itchiness, discomfort, or watering. However, oral statin therapy was associated with an increased risk of one or more moderate to severe symptoms of DED.…”

Section: Research Results From Previous Studiesmentioning

confidence: 99%

Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review

Yoo

Park

Hwang

et al. 2022

JCM

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The primary role of meibomian glands (MGs) is to actively synthesize and secret lipids and proteins spread onto the tear film, and the glandular lipids promote tear stability, prevent evaporation, and reduce friction. Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and one of the most common ophthalmic problems worldwide. MGs are densely innervated and regulated by hormones and growth factors. However, since the polar and nonpolar lipids are produced through processes in MGs that are not completely understood, a relevant question has been raised: Would the altered systemic lipids metabolism affect the physiology and structure of MGs? This review introduces the recent update regarding the relationships between serum lipid and MGD in clinical and basic research while providing answers to this question. A causal relationship remains to be established; however, serum lipid level or dyslipidemia may be related to MGD directly or indirectly, or both. Further studies are warranted to establish the role of serum lipid level and meibocyte differentiation/maturation and lipid synthesis.

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Section: Research Results From Previous Studiesmentioning

confidence: 99%

Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review

Yoo

Park

Hwang

et al. 2022

JCM

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“…This could be related to the small sample size and the limited follow-up duration. A cross-sectional study from the Blue Mountains Eye study found that usage of statins was correlated with one or more symptoms of dry eye disease ( 12 ). However, this result is limited, as the study looked at symptoms of dry eye and lacked clinical examination results.…”

Section: Discussionmentioning

confidence: 99%

“…This raises the possibility that statins are able to directly affect lipid production in the eyelid and may decrease blepharitis risk. However, a prospective study in Taiwan found that statin use was unable to reverse lid margin meiboscores and meibum quality in patients with blepharitis, and the Blue Mountains Eye Study III showed the presence of dry eye symptoms with statin usage ( 12 , 13 ). However, a large, clinical study evaluating the role of statins in the prevention of blepharitis is lacking.…”

Section: Introductionmentioning

confidence: 99%

Statin Use Is Associated With a Lower Risk of Blepharitis: A Population-Based Study

et al. 2022

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BackgroundBlepharitis is a common eye disorder that may be overlooked by patients and clinical practitioners. The symptoms of blepharitis often manifest as irritation, a burning sensation, grittiness, and itchiness and may decrease visual acuity if not treated promptly. Meibomian gland dysfunction (MGD), a common cause of blepharitis, is believed to be associated with increased inflammatory marker levels that may disrupt the composition of lipids produced by the sebaceous glands in the eyelids and ultimately cause tear film instability.MethodsThis is a retrospective, population-based study using National Health Insurance Research Database (NHIRD) data from a 14-year period (2000–2015). Pearson chi-squared and Student's t-tests were used to assess the differences in categorical and continuous variables, respectively, between statin users and non-statin users. Univariate and multivariate Cox regression analyses were performed to calculate the hazard ratios (HRs) after adjusting for confounders. Kaplan-Meier analysis was used to assess the cumulative risk of blepharitis between the two cohorts.ResultsA total of 67,014 patients who used statins were enrolled as the study cohort, and 268,056 patients who did not use statins were enrolled as the comparison cohort. The incidence of blepharitis was 3.04% with statin treatment and 3.72% without statin treatment (p < 0.001). Patients who used statins had a lower risk of developing blepharitis [adjusted hazard ratio (aHR): 0.746, p < 0.001] than those who did not. In addition, diabetes mellitus (DM), hypertension, coronary heart disease (CHD), stroke, chalazion, rosacea, Sjogren syndrome, psoriasis and atopy were found to be possible risk factors for blepharitis.ConclusionStatin use can decrease the risk of developing blepharitis. However, further prospective studies are needed to evaluate statin treatment for various subtypes of blepharitis and to identify the associated mechanism.

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“…Dyslipidemia has been suggested to induce MGD, a major cause of DED [5,32]. However, oral statin therapy, not hypercholesterolemia, were recently reported to be associated with the symptoms of DED [33]. Interestingly, sterols have been reported to reduce cataract severity [34,35], and cholesterol metabolism might be linked to cataract formation [36].…”

Section: New Factors In Dry Eye Disease Modelmentioning

confidence: 99%

Explanatory Model of Dry Eye Disease Using Health and Nutrition Examinations: Machine Learning and Network-Based Factor Analysis From a National Survey

et al. 2020

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Background Dry eye disease (DED) is a complex disease of the ocular surface, and its associated factors are important for understanding and effectively treating DED. Objective This study aimed to provide an integrative and personalized model of DED by making an explanatory model of DED using as many factors as possible from the Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods Using KNHANES data for 2012 (4391 sample cases), a point-based scoring system was created for ranking factors associated with DED and assessing patient-specific DED risk. First, decision trees and lasso were used to classify continuous factors and to select important factors, respectively. Next, a survey-weighted multiple logistic regression was trained using these factors, and points were assigned using the regression coefficients. Finally, network graphs of partial correlations between factors were utilized to study the interrelatedness of DED-associated factors. Results The point-based model achieved an area under the curve of 0.70 (95% CI 0.61-0.78), and 13 of 78 factors considered were chosen. Important factors included sex (+9 points for women), corneal refractive surgery (+9 points), current depression (+7 points), cataract surgery (+7 points), stress (+6 points), age (54-66 years; +4 points), rhinitis (+4 points), lipid-lowering medication (+4 points), and intake of omega-3 (0.43%-0.65% kcal/day; −4 points). Among these, the age group 54 to 66 years had high centrality in the network, whereas omega-3 had low centrality. Conclusions Integrative understanding of DED was possible using the machine learning–based model and network-based factor analysis. This method for finding important risk factors and identifying patient-specific risk could be applied to other multifactorial diseases.

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Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study

Abstract: The association between oral statin use and presence of moderate to severe DED symptomatology is a novel finding that deserves further mechanistic and clinical correlation in order to determine its potential, or lack thereof, for the management of dry eye.

Cited by 19 publications

References 24 publications

Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review

Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review

Statin Use Is Associated With a Lower Risk of Blepharitis: A Population-Based Study

Explanatory Model of Dry Eye Disease Using Health and Nutrition Examinations: Machine Learning and Network-Based Factor Analysis From a National Survey

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