title: Dyslipidaemia and age-related involutional blepharoptosis.
abstract: BACKGROUND
  The aetiology of age-related involutional blepharoptosis may be multifactorial. Dyslipidaemia may be involved in the pathogenesis of this disease, as dyslipidaemia, which is often related to ageing, is a risk factor for many disorders. The relationship between lipid profiles and age-related involutional blepharoptosis was evaluated to investigate this hypothesis. There are no known reference data in the literature examining the statistical association between dyslipidaemia and age-related involutional blepharoptosis.
  
  
  METHODS
  The study population was 251 consecutive Japanese patients aged 60 years or older who had at least one of the most common age-related changes of the eyelid and eyebrow, and who underwent surgical intervention. Blepharoptosis was defined as a marginal reflex distance of <2mm. Using strict exclusion criteria applied to all the patients regardless of eyelid position, 101 patients were finally enrolled. The selected demographic and clinical characteristics, as well as biochemical parameters including plasma lipids, were statistically compared between the patients who developed pure age-related involutional blepharoptosis and those who did not.
  
  
  RESULTS
  Dyslipidaemia was observed to be associated with the presence of age-related involutional blepharoptosis (odds ratio: 4.008, 95% confidence interval: 1.586-10.131, p=0.002). Univariate analysis revealed that triglycerides and non-high-density lipoprotein cholesterol were significantly higher in patients with age-related involutional blepharoptosis compared with those without blepharoptosis. With multivariate analysis, non-high-density lipoprotein cholesterol (p=0.003) and high-density lipoprotein cholesterol (p=0.044) were both significantly and independently associated with the presence of age-related involutional blepharoptosis, but in opposite directions (positive and inverse, respectively), whereas triglycerides were no longer significant.
  
  
  CONCLUSIONS
  Dyslipidaemia, specifically atherogenic dyslipidaemia, should be considered as a possible determinant of age-related involutional blepharoptosis. Further studies are required to clarify the causal relationship between dyslipidaemia and age-related involutional blepharoptosis.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Metropolitan Bokutoh Hospital, 4-23-15 Koutoubashi Sumida-ku, Tokyo 130-8575, Japan. prsbk1@yahoo.co.jp
authors.forename: Motothugu
authors.initials: M
authors.lastname: Shirado
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000704:Analysis of Variance; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D050171:Dyslipidemias / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome