• Antonio Pinna, Francesco Blasetti, Angelo Zinellu, Ciriaco Carru, and Giuliana Solinas.
• Department of Surgical, Microsurgical, and Medical Sciences, Section of Ophthalmology, University of Sassari, Sassari, Italy. Electronic address: apinna@uniss.it.
• Ophthalmology. 2013 Dec 1; 120 (12): 2385-2389.

ObjectiveHypercholesterolemia (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).DesignObservational, case-control pilot study.Participants And ControlsSixty 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.InterventionsBody 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.Main Outcome MeasuresFasting blood levels of total cholesterol, LDL, and HDL (milligrams/deciliter).ResultsHypercholesterolemia 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).ConclusionsThe 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.Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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