胆固醇水平与正常眼压性青光眼严重程度的关系。
The Association between Cholesterol Levels and Severity of Normal Tension Glaucoma.
机构信息
Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
出版信息
Mol Vis. 2023 Sep 20;29:153-159. eCollection 2023.
PURPOSE
To evaluate the serum lipid levels, including total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) of patients with normal tension glaucoma (NTG) and to investigate the relationship between serum HDL levels and the severity of NTG.
METHODS
In this cross-sectional, case-control study, 282 NTG subjects and 202 control subjects were enrolled from the outpatient clinic of the Department of Ophthalmology at Taichung Veterans General Hospital in central Taiwan from 2015 to 2021. Fasting cholesterol, HDL, and LDL levels were evaluated using a biochemical analyzer (ARCHITECT c16000). Glaucoma severity was classified by visual field test as mild (mean deviation [MD] ≥ -6.0dB), moderate (-12dB ≤ MD < -6 dB), and severe (MD < -12dB), based on the mean deviation.
RESULTS
HDL levels were significantly lower in the NTG group compared with the control subjects (47 ± 18mg/dl versus 53 ± 18mg/dl; p = 0.03). There were no statistically significant differences in total cholesterol or LDL levels between the NTG and control subjects (total cholesterol levels: 194 ± 39mg/dl versus 190 ± 32mg/dl; p > 0.05; LDL levels: 113 ± 30mg/dl versus 110 ± 29mg/dl; p > 0.05). The mean serum HDL levels were lowest in the severe group (41 ± 11mg/dl) followed by the moderate (45 ± 16mg/dl) and mild (50 ± 15mg/dl) groups, with significant differences among the three groups (p = 0.02). The multivariate regression analysis revealed a statistically significant negative correlation between HDL and vertical cup-to-disc ratio (VCDR; B =-0.16, p = 0.03) among all NTG patients and a positive correlation between HDL and retinal nerve fiber layer (RNFL; r = 0.34, p = 0.03) among all NTG patients.
CONCLUSIONS
A significantly lower serum HDL concentration was found in the NTG patients, which was negatively associated with disease severity. The findings warrant further study to elucidate the role of these phenomena in the pathogenesis of glaucoma.
目的
评估正常眼压性青光眼（NTG）患者的血清脂质水平，包括总胆固醇、高密度脂蛋白（HDL）和低密度脂蛋白（LDL），并探讨血清 HDL 水平与 NTG 严重程度之间的关系。
方法
本研究采用病例对照的横断面研究设计，于 2015 年至 2021 年期间从中国台湾省台中荣民总医院眼科门诊招募了 282 名 NTG 患者和 202 名对照者。使用生化分析仪（ARCHITECT c16000）评估空腹胆固醇、HDL 和 LDL 水平。根据平均偏差，将青光眼严重程度通过视野测试分为轻度（平均偏差[MD]≥-6.0dB）、中度（-12dB≤MD<-6dB）和重度（MD<-12dB）。
结果
与对照组相比，NTG 组的 HDL 水平显著降低（47±18mg/dl 与 53±18mg/dl；p=0.03）。NTG 组和对照组之间的总胆固醇或 LDL 水平没有统计学差异（总胆固醇水平：194±39mg/dl 与 190±32mg/dl；p>0.05；LDL 水平：113±30mg/dl 与 110±29mg/dl；p>0.05）。重度组的平均血清 HDL 水平最低（41±11mg/dl），其次是中度组（45±16mg/dl）和轻度组（50±15mg/dl），三组间差异有统计学意义（p=0.02）。多元回归分析显示，在所有 NTG 患者中，HDL 与垂直杯盘比（VCDR；B=-0.16，p=0.03）之间存在统计学显著的负相关，在所有 NTG 患者中，HDL 与视网膜神经纤维层（RNFL；r=0.34，p=0.03）之间存在统计学显著的正相关。
结论
NTG 患者的血清 HDL 浓度显著降低，且与疾病严重程度呈负相关。这些发现需要进一步研究，以阐明这些现象在青光眼发病机制中的作用。
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