Association of Statin Use and High Serum Cholesterol Levels With Risk of Primary Open-Angle Glaucoma

Abstract

The use of statins (hydroxymethylglutaryl coenzyme A inhibitors) has been associated with a lower risk of primary open-angle glaucoma (POAG); however, results have been conflicting, and little is known about the association between high cholesterol levels and POAG. OBJECTIVE To assess the association of elevated cholesterol levels and statin use with incident POAG. DESIGN, SETTING, AND PARTICIPANTS This study used data collected biennially from participants aged 40 years or older who were free of glaucoma and reported eye examinations, within 3 population-based cohorts: the Nurses' Health Study (N = 50 710; followed up from 2000 to 2014), the Nurses' Health Study 2 (N = 62 992; 1999-2015), and the Health Professionals Follow-up Study (N = 23 081; 2000-2014). Incident cases of POAG were confirmed by medical record review. The analyses were performed in January and November 2019. EXPOSURES Biennially updated self-reported information on elevated cholesterol level status, serum cholesterol levels, and duration of statin use. MAIN OUTCOMES AND MEASURES Multivariable-adjusted relative risks (RRs) and 95% CIs were estimated using Cox proportional hazards regression models on pooled data, with stratification by cohort. RESULTS Among the 136 783 participants in the 3 cohorts (113 702 women and 23 081 men), 887 incident cases of POAG were identified. A 20-mg/dL increase in total serum cholesterol was not associated with risk of POAG (RR, 1.02 [95% CI, 0.98-1.07]; P = .32). Any self-reported history of elevated cholesterol was not associated with risk of POAG (RR, 1.11 [95% CI, 0.94-1.31]). A history of any statin use was not associated with risk of POAG (RR, 0.93 [95% CI, 0.80-1.10]). Use of statins for 5 or more years vs never use of statins was not associated with risk of POAG (RR, 0.93 [95% CI, 0.75-1.15]; P = .49 for linear trend). CONCLUSIONS AND RELEVANCE Among adults aged 40 years or older, higher self-reported total serum cholesterol levels and statin use compared with never use of statins were not associated with risk of POAG.

AIBP protects retinal ganglion cells against neuroinflammation and mitochondrial dysfunction in glaucomatous neurodegeneration

“…AIBP has been known to accelerate cholesterol efflux from endothelial cells and macrophages [ 4 , [7] , [8] , [9] , 23 , 41 ]. Accumulating evidence indicates that cholesterol is considered as a risk factor for POAG [ [53] , [54] , [55] , [56] , [57] ]. Indeed, epidemiological studies indicate that POAG is linked to single-nucleotide polymorphisms of ABCA1 [ [53] , [54] , [55] ].…”

Dietary Patterns, Carbohydrates, and Age-Related Eye Diseases

“…Information surrounding statin use and cataracts is also inconclusive: of three meta-analyses of observational and randomized controlled trials for statins and cataracts, one reported reduced risk for cataract, one reported a mild increased risk, and the third was inconclusive [ 106 , 107 , 108 ]. Similarly, a recent retraction of a study analyzing glaucoma and statin use revealed that there was no decreased risk of primary open-angle glaucoma with statin use over 5 years (OR = 0.93 (95% CI: 0.75–1.15); P trend = 0.49) [ 109 , 110 ].…”

Systemic therapy a risk factor for glaucoma development and progression

“…В исследовании J. Kang et al (2019) повышение уровня общего холестерина в сыворотке крови пациентов старше 40 лет на 20 мг/дл сопровождалось повышением риска развития ПОУГ на 7%. Лечение статинами менее 5 лет снижало риск развития ПОУГ на 15%, в течение 5 лет и болеена 21%, а более 10 лет -на 40% в сравнении с теми, кто никогда не употреблял препараты данной группы [44].…”

“…Kang et al (2019) повышение уровня общего холестерина в сыворотке крови пациентов старше 40 лет на 20 мг/дл сопровождалось повышением риска развития ПОУГ на 7%. Лечение статинами менее 5 лет снижало риск развития ПОУГ на 15%, в течение 5 лет и болеена 21%, а более 10 лет -на 40% в сравнении с теми, кто никогда не употреблял препараты данной группы [44]. В проспективном исследовании D. Leung et al (2010) отмечена корреляция между приемом статинов и стабилизацией периметрических изменений в течение более чем 3 лет у пациентов с глаукомой нормального давления [45].…”