Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Ophthalmology, Kyoto City Hospital Organization, Kyoto, Japan.
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Ocul Surf. 2022 Oct;26:310-317. doi: 10.1016/j.jtos.2021.10.003. Epub 2021 Oct 16.
To investigate the alteration in lipid composition of meibum, objective clinical signs, and subjective symptoms associated with aging and meibomian gland (MG) dysfunction (MGD).
In 10 MGD patients [4 males/6 females, mean age: 65.6 ± 7.9 years (range: 50-79 years)] and 24 healthy volunteer subjects [young subjects: 6 males/6 females, mean age: 25.7 ± 3.8 years (range: 20-35 years), elderly subjects: 6 males/6 females, mean age: 58.4 ± 7.5 years (range: 50-79 years)], three objective clinical signs were evaluated: MG orifice obstruction, meibum score, and tear film lipid layer interference pattern. Subjective symptoms were analyzed via a 15-item questionnaire. After careful collection of meibum samples, comprehensive lipid analysis was performed via liquid chromatography-mass spectrometry. Data was analyzed via JMP® ver. 13 (SAS Institute, Inc., Cary, NC) statistical analysis software.
In the MGD patients and elderly subjects, there was a significant decrease in non-polar lipids such as cholesterol esters (ChEs), while a significant increase in polar lipids [cholesterol (Ch), (O-acyl)-ω-hydroxy fatty acid (OAHFA), and free fatty acid (FA)] in total lipids (Tukey-Kramer test: p < 0.05). Triglyceride was significantly increased only in MGD patients (p < 0.05). Symptom scores representative of vision quality (i.e., blurred vision/haziness) were significantly negatively-correlated with the ratio of the non-polar lipid ChE, while significantly positively correlated with the polar lipids Ch, OAHFA, and FA (Spearman's rank correlation coefficient: p < 0.05).
Our findings revealed that both MGD and aging affect the composition ratio of major meibum lipids, resulting in the appearance of subjective symptoms.
研究与年龄和睑板腺（MG）功能障碍（MGD）相关的类脂组成变化、客观临床体征和主观症状。
在 10 例 MGD 患者[4 男/6 女，平均年龄：65.6±7.9 岁（范围：50-79 岁）]和 24 名健康志愿者受试者[年轻受试者：6 男/6 女，平均年龄：25.7±3.8 岁（范围：20-35 岁），老年受试者：6 男/6 女，平均年龄：58.4±7.5 岁（范围：50-79 岁）]中，评估了 3 项客观临床体征：MG 口阻塞、类脂评分和泪膜脂质层干扰模式。通过 15 项问卷分析主观症状。在仔细收集类脂样本后，通过液相色谱-质谱法进行综合类脂分析。使用 JMP®ver.13（SAS Institute，Inc.，Cary，NC）统计分析软件进行数据分析。
在 MGD 患者和老年受试者中，非极性脂质（如胆固醇酯（ChE））显著减少，而总脂质中的极性脂质[胆固醇（Ch）、（O-酰基）-ω-羟基脂肪酸（OAHFA）和游离脂肪酸（FA）]显著增加（Tukey-Kramer 检验：p<0.05）。仅在 MGD 患者中甘油三酯显著增加（p<0.05）。代表视觉质量的症状评分（即视力模糊/朦胧）与非极性脂质 ChE 的比例呈显著负相关，而与极性脂质 Ch、OAHFA 和 FA 呈显著正相关（Spearman 秩相关系数：p<0.05）。
我们的发现表明，MGD 和衰老都会影响主要类脂的组成比例，从而导致出现主观症状。
