‘Good’ ldl cholesterol could also be linked to an elevated threat of glaucoma in people over 55, whereas, paradoxically, ‘dangerous’ ldl cholesterol could also be related to a decrease threat. These findings problem typical beliefs about components that will assist or hurt eye well being.
Paradoxically, “dangerous” (LDL) ldl cholesterol, usually related to unfavourable well being results, could also be related to a decrease threat of creating 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 liable to glaucoma, are handled, say the researchers.
Understanding Glaucoma and Danger Elements
Glaucoma is projected to have an effect on round 112 million individuals by 2040. Danger components embrace age, ethnicity, the build-up of stress 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, akin to macular degeneration and diabetic retinopathy. Lately printed analysis has additionally implied a hyperlink with glaucoma, however the findings have been inconsistent, and it’s not clear which sort of lipid may 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 Research. 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 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 greater HDL, however decrease LDL, ldl cholesterol, and a better waist-to-hip ratio (indicative of central weight problems).
They have been additionally extra prone to be ex-smokers, and to be taking statins, they usually had a better prevalence of diabetes, hypertension, and heart problems.
These with the very best degree of HDL ldl cholesterol of their bloodstream have been 10% extra prone to develop glaucoma than these with the bottom degree, with each (customary deviation) enhance related to a 5% greater threat.
Equally, members with the very best ranges of LDL ldl cholesterol and triglycerides have been 8% and 14%, respectively, much less prone to develop glaucoma than these with the bottom ranges.
And every (customary deviation) enhance 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 illnesses by combining genetic threat data from throughout the genome.
This confirmed that every further genetic threat was related to 5% greater odds of creating 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 research, 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 additionally 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 ‘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.”
They usually conclude: “HDL ldl cholesterol has been considered the ‘good ldl cholesterol’ for seven many years. Nonetheless, this research demonstrates that top ranges of [it] should not constantly related to a positive prognostic end result. 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 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