title: Meibomian gland dysfunction and hypercholesterolemia.
abstract: OBJECTIVE
  Hypercholesterolemia (total cholesterol ≥ 200 mg/dl) is a significant risk factor for ischemic heart, cerebrovascular, and peripheral vascular disease. Increased cholesterol in the glandular secretion has been postulated to be necessary for the development of meibomian gland dysfunction (MGD), a common form of chronic blepharitis. The purpose of this study was to investigate a possible correlation between MGD and hypercholesterolemia in young and middle-aged patients (aged 18-54 years).
  
  
  METHODS
  Observational, case-control pilot study.
  
  
  METHODS
  Sixty symptomatic patients with MGD with no history of hypercholesterolemia and 63 controls without MGD and with no history of hypercholesterolemia, accrued from January 2011 to June 2012.
  
  
  METHODS
  Body mass index (BMI), fasting blood triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose, and creatinine were measured. Z test or Student t test was used, when appropriate, to calculate differences between groups. Stepwise logistic regression models were used to calculate the estimates of odds ratios (ORs), considering MGD as the dependent variable and including sex, age, BMI, triglycerides, total cholesterol, LDL, HDL, glucose, and creatinine as covariates.
  
  
  METHODS
  Fasting blood levels of total cholesterol, LDL, and HDL (milligrams/deciliter).
  
  
  RESULTS
  Hypercholesterolemia was found in 35 cases (58.3%) and 4 controls (6.3%), a statistically significant difference (P < 0.0001). Mean total cholesterol, LDL, and HDL were 210.8 ± 4.4, 127.6 ± 3.9, and 61.6 ± 1.8 mg/dl, respectively, in cases and 162.9 ± 3.1, 94.2 ± 2.6, and 52.5 ± 1.3 mg/dl, respectively, in controls. All differences were statistically significant (P ≤ 0.0001). Stepwise logistic regression analysis, including sex, BMI, triglycerides, total cholesterol, and glucose as covariates, revealed that MGD was significantly associated with higher blood levels of total cholesterol (OR, 1.07; 95% confidence interval [CI], 1.04-1.09; P < 0.001). Likewise, MGD was found to be significantly associated with increased blood levels of LDL (OR, 1.07; 95% CI, 1.04-1.09; P < 0.001) and HDL (OR, 1.11; 95% CI, 1.06-1.17; P < 0.001).
  
  
  CONCLUSIONS
  The results suggest that young and middle-aged patients with MGD with no history of hypercholesterolemia may have higher blood cholesterol levels than controls of similar age without MGD. If this finding is confirmed by larger studies, MGD may become a marker of previously unknown hypercholesterolemia and ophthalmologists may increase their role in the early detection of an important risk factor for cardiovascular disease.
authors.affiliation: Department of Surgical, Microsurgical, and Medical Sciences, Section of Ophthalmology, University of Sassari, Sassari, Italy. Electronic address: apinna@uniss.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinna
authors.affiliation: Department of Surgical, Microsurgical, and Medical Sciences, Section of Ophthalmology, University of Sassari, Sassari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasetti
authors.affiliation: Department of Biomedical Sciences, Section of Clinical Biochemistry, University of Sassari, Sassari, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Zinellu
authors.affiliation: Department of Biomedical Sciences, Section of Clinical Biochemistry, University of Sassari, Sassari, Italy.
authors.forename: Ciriaco
authors.initials: C
authors.lastname: Carru
authors.affiliation: Department of Biomedical Sciences, Laboratory of Epidemiology and Biostatistics, University of Sassari, Sassari, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Solinas
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D005141:Eyelid Diseases / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications*; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D010865:Pilot Projects; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine