Alqudah Noor, Al-Azzam Nosayba, Taani Leen El, Al Qudah Mohammad, Sharayah Abdallah, Al-Rihani Rita A
Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
PLoS One. 2025 Sep 12;20(9):e0331670. doi: 10.1371/journal.pone.0331670. eCollection 2025.
Keratoconus is a progressive corneal disorder characterized by corneal thinning often leading to significant visual impairment. Recent research suggests a potential role of cortisol in the development and progression of keratoconus. However, the relationship between cortisol levels and keratoconus severity remains poorly understood.
To investigate the association between hair cortisol levels and keratoconus severity in a Jordanian population, exploring whether cortisol could serve as a potential biomarker for disease progression or stability.
We conducted a prospective, observational study at King Abdullah University Hospital in Jordan. Sixty participants aged 18-30 years were categorized into three groups: Healthy (n = 20), Progressive Keratoconus (n = 20), and Stable Keratoconus (n = 20). Demographic, clinical, and ocular data were collected, including age, gender, hair cortisol levels, and corneal topography indices (Kmax, Kmean, and thinnest corneal location).
The median cortisol level was significantly higher in the Progressive Keratoconus group (987 pg/mL) compared to the Stable group (300 pg/mL, p-value <0.001). Regression analysis revealed a significant negative association between cortisol levels and stable keratoconus (β = -1.31, p < 0.001). No significant association was observed for progressive keratoconus after adjustment for age and gender. Correlation analysis showed no significant associations between cortisol levels and BMI, Kmax, or Kmean. Cortisol levels also did not vary significantly across keratoconus severity categories in either eye.
Elevated cortisol levels may be associated with keratoconus progression, while lower levels appear linked to disease stability. Cortisol could serve as a potential biomarker for disease monitoring; however, further multicenter studies are needed to validate these findings and clarify cortisol's role in keratoconus pathogenesis.
圆锥角膜是一种进行性角膜疾病，其特征是角膜变薄，常导致严重视力损害。最近的研究表明皮质醇在圆锥角膜的发生和发展中可能起作用。然而，皮质醇水平与圆锥角膜严重程度之间的关系仍知之甚少。
在约旦人群中研究头发皮质醇水平与圆锥角膜严重程度之间的关联，探讨皮质醇是否可作为疾病进展或稳定性的潜在生物标志物。
我们在约旦阿卜杜拉国王大学医院进行了一项前瞻性观察研究。60名年龄在18至30岁之间的参与者被分为三组：健康组（n = 20）、进行性圆锥角膜组（n = 20）和稳定圆锥角膜组（n = 20）。收集了人口统计学、临床和眼部数据，包括年龄、性别、头发皮质醇水平和角膜地形图指数（最大角膜曲率Kmax、平均角膜曲率Kmean和最薄角膜位置）。
进行性圆锥角膜组的皮质醇水平中位数（987 pg/mL）显著高于稳定组（300 pg/mL，p值<0.001）。回归分析显示皮质醇水平与稳定圆锥角膜之间存在显著负相关（β = -1.31，p < 0.001）。在对年龄和性别进行调整后，未观察到进行性圆锥角膜有显著关联。相关性分析显示皮质醇水平与体重指数、Kmax或Kmean之间无显著关联。两只眼中皮质醇水平在圆锥角膜严重程度类别之间也无显著差异。
皮质醇水平升高可能与圆锥角膜进展有关，而较低水平似乎与疾病稳定性有关。皮质醇可作为疾病监测的潜在生物标志物；然而，需要进一步的多中心研究来验证这些发现并阐明皮质醇在圆锥角膜发病机制中的作用。
