‘Good’ ldl cholesterol could also be linked to an elevated danger of glaucoma in people over 55, whereas, paradoxically, ‘dangerous’ ldl cholesterol could also be related to a decrease danger. These findings problem standard beliefs about elements that will assist or hurt eye well being.
Paradoxically, “dangerous” (LDL) ldl cholesterol, usually related to destructive well being results, could also be related to a decrease danger of growing this severe eye situation. Glaucoma damages the optic nerve and might result in irreversible imaginative and prescient loss or blindness.
The findings problem obtained knowledge about what might assist and hinder eye well being, and counsel {that a} rethink could also be wanted of how sufferers with excessive blood fat and who’re susceptible to glaucoma, are handled, say the researchers.
Understanding Glaucoma and Threat Elements
Glaucoma is projected to have an effect on round 112 million individuals by 2040. Threat elements embrace age, ethnicity, the build-up of strain inside the eye (IOP), and household historical past, clarify the researchers.
Abnormally excessive ranges of circulating fat (lipids) within the bloodstream have been linked to eye situations, corresponding to macular degeneration and diabetic retinopathy. Not too long ago printed analysis has additionally implied a hyperlink with glaucoma, however the findings have been inconsistent, and it’s not clear which kind of lipid is perhaps most influential, they add.
To strengthen the proof base, the researchers drew on 400,229 contributors aged 40 to 69 within the UK Biobank Examine. They’d all stuffed in a questionnaire, been interviewed, and had undergone a regular panel of blood checks, together with these to measure blood fat.
Their well being was tracked for a mean of 14 years, throughout which period 6868 (almost 2%) of them developed glaucoma.
In contrast with contributors who didn’t develop glaucoma, those that did, tended to be older, and of non-White ethnicity. They’d greater HDL, however decrease LDL, ldl cholesterol, and the next waist-to-hip ratio (indicative of central weight problems).
They had been additionally extra prone to be ex-smokers, and to be taking statins, and so they had the next prevalence of diabetes, hypertension, and heart problems.
These with the best degree of HDL ldl cholesterol of their bloodstream had been 10% extra prone to develop glaucoma than these with the bottom degree, with each (commonplace deviation) improve related to a 5% greater danger.
Equally, contributors with the best ranges of LDL ldl cholesterol and triglycerides had been 8% and 14%, respectively, much less prone to develop glaucoma than these with the bottom ranges.
And every (commonplace deviation) improve in LDL ldl cholesterol, complete ldl cholesterol, and triglycerides lowered the dangers by 4%, 3%, and 4%, respectively.
Age and Different Elements Affect the Findings
However these noticed associations solely persevered amongst these older than 55, with no vital affiliation seen in these aged 40–55; the findings had been additionally influenced by intercourse and kind of glaucoma.
The researchers drew up a polygenic danger rating—a quantity that gives a customized measure of genetic susceptibility to illnesses by combining genetic danger data from throughout the genome.
This confirmed that every further genetic danger was related to 5% greater odds of growing glaucoma. However there have been no vital particular person associations between LDL ldl cholesterol, complete ldl cholesterol, or triglycerides and glaucoma.
That is an observational examine, and as such, no agency conclusions will be drawn about trigger and impact. And the researchers acknowledge numerous limitations to their findings, together with that blood samples weren’t taken after fasting and solely at a single time level.
The findings may also not be relevant to different ethnic teams, as UK Biobank contributors are predominantly of European ancestry.
However they counsel: “These findings problem present paradigms about ‘good’ and ‘dangerous’ ldl cholesterol in relation to eye well being. This might immediate a re-evaluation of lipid administration methods in sufferers in danger for glaucoma.”
And so they conclude: “HDL ldl cholesterol has been thought to be the ‘good ldl cholesterol’ for seven a long time. Nevertheless, this examine demonstrates that prime ranges of [it] aren’t constantly related to a good prognostic final result. Additional research are wanted to research the mechanisms behind these associations.”
Reference: “Associations between serum lipids and glaucoma: a cohort examine of 400 229 UK Biobank contributors” by Yiyuan Ma, Yue Wu, Leyi Hu, Wen Chen, Xinyu Zhang, Danying Zheng, Nathan Congdon, Guangming Jin and Zhenzhen Liu, 4 February 2025, British Journal of Ophthalmology.
DOI: 10.1136/bjo-2024-326062
