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Study of meibomian gland dysfunction and hypercholesterolemia

Background: Hypercholesterolemia is a risk factor for ischemic heart disease and cerebrovascular disease. Increased cholesterol in the meibomian gland secretion has been considered necessary for development of meibomian gland dysfunction (MGD). Aim: To study the association of MGD with hypercholesterolemia in adults aged 20-60 years age. Setting and Design: Observational case-control study. Methods and Materials: We studied one hundred and twenty individuals aged 20-60 years divided into two groups; sixty cases of MGD and no known hypercholesterolemia; sixty controls with neither MGD nor hypercholesterolemia. Examination included anterior segment examination, tear film break-up time (TBUT), Schirmer's test and assessment of meibomian gland function. MGD was graded based on quality of meibum secretion and meibomian gland function (expressibility). Other investigations included lipid profile, random blood sugar, serum creatinine and body mass index (BMI). Statistical Analysis: We calculated proportion, mean, standard deviation, 95% confidence interval (CI), Z- test, and paired t-test for comparison between groups. Results: Hypercholesterolemia (i.e. serum cholesterol ≥ 200 mg/dl) was found in 39 (65%) and 31 (51.67%) among cases and control respectively. Hypercholesterolemia was found in 17 (44.7%) cases with grade 2 meibomian gland function (i.e. expressibility) (p=0.038) and 26 (68.4%) cases with grade 2 meibomian gland secretion (p = 0.037), these associations were statistically significant. Conclusions: Moderate MGD (i.e. grade 2 expressibility and secretion) is associated with elevated level of total cholesterol (i.e. serum cholesterol level ≥ 200 mg/dl).