‘Good’ ldl cholesterol could also be linked to an elevated threat of glaucoma in people over 55, whereas, paradoxically, ‘unhealthy’ ldl cholesterol could also be related to a decrease threat. These findings problem standard beliefs about elements which will assist or hurt eye well being.
Paradoxically, “unhealthy” (LDL) ldl cholesterol, typically related to adverse well being results, could also be related to a decrease threat of growing this critical eye situation. Glaucoma damages the optic nerve and might result in irreversible imaginative and prescient loss or blindness.
The findings problem acquired knowledge about what could 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 folks by 2040. Threat elements embody age, ethnicity, the build-up of stress throughout 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, akin to macular degeneration and diabetic retinopathy. Lately revealed analysis has additionally implied a hyperlink with glaucoma, however the findings have been inconsistent, and it’s not clear which sort of lipid could be most influential, they add.
To strengthen the proof base, the researchers drew on 400,229 members aged 40 to 69 within the UK Biobank Examine. They’d all stuffed in a questionnaire, been interviewed, and had undergone an ordinary panel of blood exams, together with these to measure blood fat.
Their well being was tracked for a median of 14 years, throughout which era 6868 (almost 2%) of them developed glaucoma.
In contrast with members who didn’t develop glaucoma, those that did, tended to be older, and of non-White ethnicity. They’d larger HDL, however decrease LDL, ldl cholesterol, and a better waist-to-hip ratio (indicative of central weight problems).
They have been additionally extra more likely to be ex-smokers, and to be taking statins, and so they had a better prevalence of diabetes, hypertension, and heart problems.
These with the very best stage of HDL ldl cholesterol of their bloodstream have been 10% extra more likely to develop glaucoma than these with the bottom stage, with each (customary deviation) improve related to a 5% larger threat.
Equally, members with the very best ranges of LDL ldl cholesterol and triglycerides have been 8% and 14%, respectively, much less more likely to develop glaucoma than these with the bottom ranges.
And every (customary 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 endured amongst these older than 55, with no vital affiliation seen in these aged 40–55; the findings have been additionally influenced by intercourse and kind of glaucoma.
The researchers drew up a polygenic threat rating—a quantity that gives a customized measure of genetic susceptibility to ailments by combining genetic threat data from throughout the genome.
This confirmed that every further genetic threat was related to 5% larger 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 could be drawn about trigger and impact. And the researchers acknowledge varied 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 members are predominantly of European ancestry.
However they counsel: “These findings problem current paradigms about ‘good’ and ‘unhealthy’ ldl cholesterol in relation to eye well being. This might immediate a re-evaluation of lipid administration methods in sufferers in danger for glaucoma.”
They usually conclude: “HDL ldl cholesterol has been considered the ‘good ldl cholesterol’ for seven a long time. Nonetheless, this examine demonstrates that top ranges of [it] aren’t persistently related to a good prognostic end result. Additional research are wanted to analyze the mechanisms behind these associations.”
Reference: “Associations between serum lipids and glaucoma: a cohort examine of 400 229 UK Biobank members” 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