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Clinical science
Blepharitis as an early sign of metabolic syndrome: a nationwide population-based study
  1. Chia-Yi Lee1,
  2. Hung-Chi Chen2,3,4,
  3. Hui-Wen Lin5,6,
  4. Jing-Yang Huang7,
  5. Shih-Chun Chao1,8,9,
  6. Chao-Bin Yeh10,11,
  7. Hung-Yu Lin1,12,13,14,
  8. Shun-Fa Yang7,12
  1. 1 Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
  2. 2 Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
  3. 3 Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
  4. 4 Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
  5. 5 Department of Optometry, Asia University, Taichung, Taiwan
  6. 6 Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
  7. 7 Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
  8. 8 Department of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
  9. 9 Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan
  10. 10 Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  11. 11 Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
  12. 12 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
  13. 13 Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
  14. 14 Department of Optometry, Yuanpei University of Medical Technology, Hsinchu, Taiwan
  1. Correspondence to Dr Hung-Yu Lin, Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan; anthonyhungyulin{at}hotmail.com and Professor Shun-Fa Yang, Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; ysf{at}csmu.edu.tw

Abstract

Background To investigate the relationship between blepharitis and metabolic syndrome (MetS) by using the Longitudinal Health Insurance Database (LHID) of Taiwan.

Methods This retrospective cohort study was conducted using data collected from the LHID for the period from 2009 to 2013. This study enrolled patients who received a diagnosis of blepharitis according to the International Classification of Diseases, Ninth Revision, diagnostic code. The exclusion criteria were legal blindness, eyeball removal, ocular tumours prior to the diagnosis of blepharitis, and patients diagnosed with blepharitis and initiated antibiotic treatment concurrently. An age-matched, gender-matched and disease-matched population without blepharitis served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyse the data.

Results In this study, a total of 10 093 patients with blepharitis were included in the study group, and another 40 372 participants without blepharitis were included in the control group. Conditional logistic regression revealed a higher cumulative probability of hyperlipidaemia and coronary arterial disease. After adjustment, patients with blepharitis had a higher probability of developing new MetS than controls. According to subgroup analysis, hyperlipidaemia and coronary artery diseases were significantly correlated with the prior development of blepharitis. However, hypertension and diabetes mellitus and insulin resistance showed no correlation with blepharitis.

Conclusion Blepharitis is significantly related to MetS and can serve as an early sign of MetS. Additional studies should examine the relationship between blepharitis and MetS in terms of severity.

  • blepharitis
  • metabolic syndrome
  • cardiovascular
  • hyperlipidemia
  • population-based

https://doi.org/10.1136/bjophthalmol-2017-310975

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    Footnotes

    • C-YL and H-CC contributed equally and share the first authorship

    • Contributors Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data for the work: C-YL, H-CC, H-WL, J-YH, S-CC, C-BY, H-YL, S-FY. Drafting the work or revising it critically for important intellectual content: C-YL, H-CC, H-WL, J-YH, S-CC, C-BY, H-YL, S-FY. Final approval of the version to be published: C-YL, H-CC, H-WL, J-YH, S-CC, C-BY, H-YL, S-FY. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: C-YL, H-CC, H-WL, J-YH, S-CC, C-BY, H-YL, S-FY.

    • Competing interests None declared.

    • Ethics approval This retrospective population-based cohort study was approved by the National Health Insurance Administration and the Institutional Review Board of Chung Shan Medical University Hospital (registration number: CSMUH CS2-15061).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice This article has been corrected since it published Online First. The equal contributorship statement has been added in.

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