Association between human peripheral blood lipid levels and inflammatory indicators in patients with primary open angle glaucoma

Objective

To investigate the association between serum lipid levels and inflammatory indicators in patients with primary open angle glaucoma (POAG).

Methods

A case-control study was conducted.A total of 86 POAG subjects were collected as a POAG group at Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong from January 2016 to March 2022.Meanwhile, 86 with age-related cataract only, matched at age, sex and body mass index were collected as a control group.The intraocular pressure (IOP) and the mean defect of visual field (MD) were measured by Goldmann tonometer and Humphrey field analyzer, respectively.Human peripheral blood samples collected from subjects for serum lipid levels, including total cholesterol, total triglycerides, high density lipoprotein (HDL), and low density lipoprotein (LDL), were analyzed using an automated hematology analyzer and inflammatory markers including C-reactive protein, white blood cells (WBC), neutrophils, lymphocytes, monocytes, were analyzed using an automated biochemical analyzer.Indicators with statistically significant differences between the two groups were selected as independent variables, and multiple logistic regression analysis was used to determine the risk factors for POAG.Correlations between risk factors and ocular parameters (IOP and MD) were assessed using Pearson correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong (No.EC20210313[2]-P03). Written informed consent was obtained from each patient before any medical examination.

Results

The HDL was (1.59±0.42)mmol/L in the POAG group, which was significantly lower than (1.76±0.50)mmol/L in the control group (t=2.435, P=0.016). The LDL was (3.34±0.66)mmol/L in the POAG group, which was significantly higher than (3.08±0.71)mmol/L in the control group (t=2.520, P=0.013). The WBC was (6.91±1.60)×10⁹/L in the POAG group, which was significantly higher than (6.11±1.29)×10⁹/L in the control group (t=3.619, P<0.001). Multiple logistic regression analysis showed that high serum LDL level (P=0.039, OR=2.354, 95% CI: 1.105-5.303) and high WBC level (P=0.044, OR=1.310, 95% CI: 1.007-1.703) were risk factors for POAG.Pearson correlation analysis showed that the serum LDL and WBC levels of POAG patients were moderately positively associated with IOP (r=0.610, P<0.001; r=0.358, P=0.001). LDL level was moderately negatively associated with MD (r=-0.496, P<0.001). WBC level was weakly negatively associated with MD (r=-0.235, P=0.030).

Conclusions

The elevated peripheral blood LDL and WBC levels are risk factors for POAG onset.The elevated LDL and WBC levels are positively correlated with IOP and negatively correlated with MD in POAG patients.

Primary open-angle glaucoma; Lipoproteins; Serum lipid level; Inflammatory indicators; Intraocular pressure; Mean defect of visual field