Blepharitis as an early sign of metabolic syndrome: a nationwide population-based study

Lee, Chia-Yi; Chen, Hung-Chi; Lin, Hui-Wen; Huang, Jing‐Yang; Chao, Shih-Chun; Yeh, Chao‐Bin; Lin, Hung‐Yu; Yang, Shun‐Fa

doi:10.1136/bjophthalmol-2017-310975

Cited by 10 publications

(7 citation statements)

References 24 publications

(19 reference statements)

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“…In our study, blepharitis was observed in 23.7% of patients, whereas MGD was observed in 53.75% of patients. Lee et al [ 30 ] stated that blepharitis is significantly related to metabolic syndromes such as DM, and can serve as an early sign of DM. Hom et al [ 31 ] and Ansari et al [ 32 ] observed similar results in their studies.…”

Section: Discussionmentioning

confidence: 99%

Ocular Surface Diseases in Patients With Diabetes

Naik¹,

Magdum²,

Ahuja³

et al. 2022

Cureus

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Purpose Diabetes is a major cause of ocular morbidity as multiple mechanisms play a role in inducing inflammatory changes in the eye. Diabetic retinopathy is the most common complication and is well-documented. However, in the era of modern medicine, attention is also being focused on ocular surface changes in diabetes. Therefore, this study aimed to determine the association between diabetes and ocular surface diseases. Materials and Methods This is a cross-sectional study examining 320 eyes of 160 patients with diabetes who were grouped according to their duration of diabetes. The symptoms were evaluated using the ocular surface disease index (OSDI) questionnaire. Their recent hemoglobin (Hb) A1c value was recorded. Their external or internal hordeolum, blepharitis, meibomian gland dysfunction, and corneal sensitivity were also evaluated. The tear film was examined using tests, such as Schirmer's test, tear film breakup time (TBUT), tear film meniscus height (TFMH), fluorescein stain, and rose bengal stain. The results were correlated with the duration and control of diabetes. Results The mean age of the study population was 56.60 years comprising 56% (n=89) females and 44% (n=71) males. The mean OSDI scores were 7.9 ± 3.55 and 57 ± 19.22 in patients without dry eye and with severe dry eye, respectively. The study observed OSDI scores were consistently high with diabetes severity. About 67% (n=24) of patients with HbA1c of >8% had dry eyes. Dry eye was found in 68% (n=59) of patients with the duration of diabetes being >10 years. About 23.7% (n=38) had blepharitis, whereas only 4% (n=7) had external or internal hordeolum and 44% (n=86) had different grades of meibomian gland dysfunction. Corneal sensitivity was abnormal in only 12% (n=12) of patients. About 55% (n=86) of patients had varying degrees of dry eye. A statistically significant correlation was found between the severity of dry eye and TBUT, TFMH values, and grades of corneal staining (P < 0.0001). Conclusion This study observed that the incidence of dry eyes was found to be higher when patients had uncontrolled diabetes and diabetes for a longer period. The OSDI scoring system is an important diagnostic tool while examining patients with dry eye. In an ophthalmology clinic, patients with diabetes should always be evaluated for any ocular surface changes when being screened for diabetic retinopathy, and proper guidelines should be implemented to detect changes in the ocular surface system as early as possible so that any long-term complications such as infectious or neurotrophic keratitis may be avoided at an early stage.

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Section: Discussionmentioning

confidence: 99%

Ocular Surface Diseases in Patients With Diabetes

Naik¹,

Magdum²,

Ahuja³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…V indikaci diet se dnes zdá, že nejlepší dietou na metabolický syndrom je konzumace vlákniny [8]. A to, že metabolický syndrom má vazbu na jakékoli zánětlivé onemocnění, ukazují dnes 2 práce o blefaritidě [9,10]. I tak malý zánět z hlediska celotělového, jako jsou záněty oka, mají k metabolickému syndromu vztah.…”

Section: Další Pohledy Na Metabolický Syndromunclassified

Current views on metabolic syndrome

Svačina¹

2018

Vnitř Lék

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Klíčová slova: definice metabolického syndromu -inzulinová rezistence -myokiny -systémový zánět -zánět tukové tkáně Current views on metabolic syndrome SummaryThe theory of metabolic syndrome originated 30 years ago. Several definitions try to explain the frequent common incidence of the risk factors for atherosclerosis. At first the syndrome of insulin resistance was involved. It was only later that the relation of the metabolic syndrome was described to what is known as systemic inflammation arising in adipose tissue and inflammatory diseases such as chronic bronchitis or psoriasis, or to degenerative diseases such as Alzheimer's disease. The views on the metabolic syndrome are thus constantly changing.

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“…Patients with posterior blepharitis have inflammation of the posterior lid margin involving the meibomian gland, and this form is often associated with several systemic diseases ( 1 , 3 ). An observational study published in 2013 revealed that MGD was significantly associated with increased systemic total cholesterol and low-density lipoprotein (LDL) levels, and another population-based study reported an aHR of 1.145 for an increased risk of developing metabolic syndrome in patients with blepharitis ( 15 , 16 ). Meibomian secretions of meibum are composed of a mixture of lipids, including wax esters, cholesteryl esters, cholesteryl esters of (O-acyl)-ω-hydroxy fatty acids, triacylglycerols, free fatty acids, cholesterol and small amounts of polar and non-polar lipids ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the use of statin was able to decrease the risk of blepharitis in patients with DM (aHR:0.757, p = 0.001). In a population study assessing blepharitis as a potential indicator for metabolic syndrome, hypertension and DM were not correlated with blepharitis ( 16 ). However, a study by Nemet et al and another population-based study reported a significant association of cardiovascular disease, including hypertension and coronary heart disease, with blepharitis ( 22 , 25 ), which is consistent with our results.…”

Section: Discussionmentioning

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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Blepharitis as an early sign of metabolic syndrome: a nationwide population-based study

Abstract: Blepharitis is significantly related to MetS and can serve as an early sign of MetS. Additional studies should examine the relationship between blepharitis and MetS in terms of severity.

Cited by 10 publications

References 24 publications

Ocular Surface Diseases in Patients With Diabetes

Ocular Surface Diseases in Patients With Diabetes

Current views on metabolic syndrome

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

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