原发性开角型青光眼患者血清脂质和脂蛋白谱及其与眼压的关系：中国人的观察性横断面研究。

Serum lipid and lipoprotein profiles and their association with intraocular pressure in primary open-angle glaucoma: an observational cross-sectional study in the Chinese population.

机构信息

Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.

Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China.

出版信息

Lipids Health Dis. 2024 Sep 30;23(1):323. doi: 10.1186/s12944-024-02316-5.

DOI:10.1186/s12944-024-02316-5

PMID:39350087

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11441088/

Abstract

BACKGROUND

Glaucoma is a leading cause of vision impairment and permanent blindness. Primary open-angle glaucoma (POAG) is a prominent type of primary glaucoma; however, its cause is difficult to determine. This study aimed to analyze the serum lipid profile of Chinese POAG patients and assess its correlation with intraocular pressure (IOP).

METHODS

The study included 1,139, 1,248, and 356 Chinese individuals with POAG, primary angle closure glaucoma (PACG), and controls, respectively. Peripheral whole blood samples were collected at the time of diagnosis. Enzymatic colorimetry was used to determine serum levels of different lipids: high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides, cholesterol, and very low-density lipoproteins (VLDL). Additionally, immunoturbidimetry was used to quantify serum levels of apolipoproteins A (APOA), B (APOB), E (APOE), and lipoprotein A [Lp(a)], while intraocular pressure (IOP) was measured in all patients with POAG.

RESULTS

After adjusting for age and sex, patients with POAG exhibited elevated serum levels of VLDL, APOA, and APOE but mitigated cholesterol levels compared with the control participants. Significantly lower serum triglyceride, VLDL, and Lp(a) levels were found in patients with PACG than in control participants. Serum cholesterol (P = 0.019; β = -0.75, 95% confidence interval [CI]: -1.38 - -0.12) and HDL levels (P < 0.001; β = -2.91, 95% CI: -4.58 - -1.25) were inversely linked to IOP in patients with POAG, after adjusting for age, sex, and ocular metrics. In addition, serum Lp(a) levels were correlated with the average IOP (P = 0.023; β = -0.0039, 95% CI: -0.0073 - -0.006) and night peak (P = 0.027; β = -0.0061, 95% CI: -0.0113 - -0.0008) in patients with POAG.

CONCLUSIONS

Significantly different serum lipid and lipoprotein profiles were observed in POAG and PACG patients. This study highlighted the differences in serum lipid and lipoprotein levels among Chinese POAG patients and their relationship with IOP and IOP fluctuation. Serum lipid and lipoprotein profiles should be considered while evaluating glaucoma risk.

摘要

背景

青光眼是导致视力损害和永久性失明的主要原因之一。原发性开角型青光眼（POAG）是一种主要的原发性青光眼，但其病因难以确定。本研究旨在分析中国 POAG 患者的血清脂质谱，并评估其与眼内压（IOP）的相关性。

方法

本研究纳入了 1139 名、1248 名和 356 名中国 POAG、原发性闭角型青光眼（PACG）和对照组患者。在诊断时采集外周全血样本。采用酶比色法测定高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、胆固醇和极低密度脂蛋白（VLDL）等不同脂质的血清水平。此外，采用免疫比浊法测定载脂蛋白 A（APOA）、B（APOB）、E（APOE）和脂蛋白 A[Lp(a)]的血清水平，同时测量所有 POAG 患者的眼内压（IOP）。

结果

调整年龄和性别后，与对照组相比，POAG 患者的血清 VLDL、APOA 和 APOE 水平升高，但胆固醇水平降低。与对照组相比，PACG 患者的血清甘油三酯、VLDL 和 Lp(a)水平显著降低。调整年龄、性别和眼部指标后，POAG 患者的血清胆固醇（P=0.019；β=-0.75，95%置信区间[CI]：-1.38- -0.12）和 HDL 水平（P<0.001；β=-2.91，95%CI：-4.58- -1.25）与 IOP 呈负相关。此外，血清 Lp(a)水平与 POAG 患者的平均 IOP（P=0.023；β=-0.0039，95%CI：-0.0073- -0.006）和夜间峰值（P=0.027；β=-0.0061，95%CI：-0.0113- -0.0008）相关。