Aier Eye Hospital Group, Ningbo Aier Guangming Eye Hospital, Ningbo, China.
Aier Eye Hospital Group, Wuhan Aier Eye Hospital, Wuhan, China.
Invest Ophthalmol Vis Sci. 2019 Mar 1;60(4):1028-1043. doi: 10.1167/iovs.18-25845.
Previous studies reported that hyperlipidemia and blood lipid levels were associated with glaucoma, ocular hypertension (OHT), and intraocular pressure (IOP). However, studies aimed at investigating this association have yielded conflicting results. Therefore, to shed light on these inconclusive findings, we performed multiple distinct meta-analyses to clarify the association of hyperlipidemia and blood lipid levels with glaucoma, OHT, and IOP.
A systematic literature search from Embase, Web of Science, and PubMed was performed to identify relevant studies. To assess the association between hyperlipidemia and glaucoma, we used the pooled odds ratio (OR) with 95% confidence interval (CI). When we assessed the association between blood lipid levels and IOP levels, the pooled mean difference in IOP associated with a 10 mg/dL increase in the blood lipid level was estimated. The pooled difference in IOP was also estimated between patients with and without hyperlipidemia. All the papers that assessed the correlation between hyperlipidemia and glaucoma, between blood lipid levels and IOP levels, and between hyperlipidemia and IOP were included in this meta-analysis.
We detected a marked association between hyperlipidemia and glaucoma (OR = 1.37; 95% CI = 1.16-1.61), with significant heterogeneity among studies. However, hyperlipidemia was not significantly associated with glaucoma in our analysis of only cross-sectional studies, studies that reported only on hypercholesterolemia patients, studies that were conducted only in North America and Europe, or studies in which normal-tension glaucoma (NTG) patients were included only in the subgroup analyses. The pooled results showed that an increase of 10 mg/dL in blood triglyceride levels would increase the IOP by 0.016 mm Hg (95% CI = 0.009-0.024), with evident heterogeneity between studies (P < 0.001; I2 = 92.0%). The pooled results showed that the blood total cholesterol and low-density lipoprotein-cholesterol (LDL-c) level both had a significant association with IOP. When compared to the patients with nonhyperlipidemia, those with hyperlipidemia had a significantly higher IOP of 0.51 mm Hg (95% CI = 0.18-0.83) (P = 0.001 for heterogeneity; I2 = 81.6%).
The evidence suggests that hyperlipidemia is significantly associated with an increased risk of glaucoma and that hyperlipidemia and the increased blood lipid levels are associated with increased IOP.
先前的研究报告称，高血脂和血脂水平与青光眼、眼高压（OHT）和眼压（IOP）有关。然而，旨在调查这种关联的研究得出了相互矛盾的结果。因此，为了阐明这些不确定的发现，我们进行了多次不同的荟萃分析，以澄清高血脂和血脂水平与青光眼、OHT 和 IOP 的关系。
从 Embase、Web of Science 和 PubMed 进行系统的文献检索，以确定相关研究。为了评估高血脂与青光眼之间的关联，我们使用了合并的优势比（OR）及其 95%置信区间（CI）。当我们评估血脂水平与 IOP 水平之间的关联时，我们估计了与血脂水平升高 10mg/dL 相关的 IOP 合并平均差异。还估计了高脂血症患者与非高脂血症患者之间的 IOP 差异。所有评估高血脂与青光眼之间相关性、血脂水平与 IOP 水平之间相关性以及高血脂与 IOP 之间相关性的论文都包含在本次荟萃分析中。
我们发现高血脂与青光眼之间存在显著关联（OR=1.37；95%CI=1.16-1.61），但研究之间存在显著异质性。然而，在我们仅对横断面研究、仅报告高胆固醇血症患者的研究、仅在北美和欧洲进行的研究或仅将正常眼压青光眼（NTG）患者纳入亚组分析的研究中，高血脂与青光眼之间无显著相关性。汇总结果显示，血液三酸甘油脂水平升高 10mg/dL 会使 IOP 升高 0.016mmHg（95%CI=0.009-0.024），研究之间存在明显异质性（P<0.001；I2=92.0%）。汇总结果还显示，血液总胆固醇和低密度脂蛋白胆固醇（LDL-c）水平均与 IOP 有显著关联。与非高脂血症患者相比，高脂血症患者的 IOP 显著升高 0.51mmHg（95%CI=0.18-0.83）（P=0.001 用于异质性；I2=81.6%）。
证据表明，高血脂与青光眼风险增加显著相关，高血脂和血脂水平升高与眼压升高相关。
