Meibomian Gland Dysfunction and Hypercholesterolemia

High cholesterol is a known risk factor for ischemic heart, cerebrovascular, and peripheral vascular disease. Previous studies have postulated that hypercholesterolemia (defined as total cholesterol of at least 200 mg/dL) also plays a role in the development of meibomian gland dysfunction (MGD). In this observational, case-control study, Pinna et al. investigated the correlation between MGD and hypercholesterolemia and found that patients with MGD had a significantly higher rate of hypercholesterolemia than age-matched controls who didn’t have the disease. This study included 60 symptomatic MGD patients and 63 healthy controls, all of whom had no history of hypercholesterolemia and were between the ages of 18 and 54 years. The authors measured body mass index, fasting blood triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose, and creatinine. Main outcome measures included fasting blood levels of total cholesterol, LDL, and HDL. Hypercholesterolemia was found in 35 patients with MGD (58.3 percent) and four controls (6.3 percent). In MGD patients, mean total cholesterol, LDL, and HDL were 210.8, 127.6, and 61.6 mg/dL, respectively. In controls, these levels were 162.9, 94.2, and 52.5 mg/dL, respectively. All differences were statistically significant. Logistic regression analysis showed that MGD was indeed significantly associated with higher blood levels of total cholesterol, LDL, and HDL. Because of the study’s relatively small sample size, the authors called for larger investigations into the relationship between MGD and increased blood cholesterol. At this stage, it is premature to advocate serum cholesterol screening for all MGD patients, they noted. However, if these findings are confirmed, MGD may become a marker of previously unknown hypercholesterolemia, and ophthalmologists may find themselves playing a larger role in the early detection of cardiovascular disease.