‘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 typical beliefs about components which will assist or hurt eye well being.
Paradoxically, “unhealthy” (LDL) ldl cholesterol, typically related to unfavorable well being results, could also be related to a decrease threat of creating this critical eye situation. Glaucoma damages the optic nerve and may result in irreversible imaginative and prescient loss or blindness.
The findings problem acquired 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 Danger Elements
Glaucoma is projected to have an effect on round 112 million folks by 2040. Danger components embody 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 circumstances, corresponding to macular degeneration and diabetic retinopathy. Not too long ago revealed analysis has additionally implied a hyperlink with glaucoma, however the findings have been inconsistent, and it’s not clear which sort of lipid is likely to be most influential, they add.
To strengthen the proof base, the researchers drew on 400,229 contributors aged 40 to 69 within the UK Biobank Research. They’d all stuffed in a questionnaire, been interviewed, and had undergone an ordinary panel of blood checks, together with these to measure blood fat.
Their well being was tracked for a mean of 14 years, throughout which era 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 larger 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, they usually had the next prevalence of diabetes, hypertension, and heart problems.
These with the very best stage of HDL ldl cholesterol of their bloodstream had been 10% extra prone to develop glaucoma than these with the bottom stage, with each (normal deviation) improve related to a 5% larger threat.
Equally, contributors with the very 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 (normal deviation) improve in LDL ldl cholesterol, whole 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 continued amongst these older than 55, with no important 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 threat rating—a quantity that gives a personalised measure of genetic susceptibility to illnesses by combining genetic threat info from throughout the genome.
This confirmed that every further genetic threat was related to 5% larger odds of creating glaucoma. However there have been no important particular person associations between LDL ldl cholesterol, whole ldl cholesterol, or triglycerides and glaucoma.
That is an observational research, and as such, no agency conclusions may 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 contributors 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 thought to be the ‘good ldl cholesterol’ for seven a long time. Nevertheless, this research demonstrates that top ranges of [it] aren’t persistently related to a good prognostic consequence. Additional research are wanted to research the mechanisms behind these associations.”
Reference: “Associations between serum lipids and glaucoma: a cohort research 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
