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A groundbreaking study published in the British Journal of Ophthalmology suggests that the commonly-held belief that “good” (HDL) cholesterol protects health may not extend to eye health, particularly when it comes to glaucoma risk in individuals aged 55 and older. The research highlights an unexpected paradox: while high levels of HDL cholesterol, traditionally seen as beneficial, could increase the likelihood of developing glaucoma, higher levels of “bad” (LDL) cholesterol may actually reduce the risk.
Glaucoma, a condition that damages the optic nerve and can lead to irreversible blindness, is set to affect an estimated 112 million people by 2040. Current risk factors include age, ethnicity, eye pressure, and family history. While abnormally high lipid levels have been linked to eye conditions like macular degeneration and diabetic retinopathy, the connection to glaucoma has been less clear—until now.
The study, based on the UK Biobank dataset, analyzed 400,229 participants aged 40 to 69 over an average of 14 years. Among the participants, 6,868 developed glaucoma. The results revealed a complex relationship between cholesterol types and glaucoma risk.
Those with higher HDL cholesterol levels had a 10% greater likelihood of developing glaucoma compared to individuals with the lowest HDL levels. In contrast, participants with the highest levels of LDL cholesterol and triglycerides were 8% and 14% less likely to develop glaucoma, respectively.
This association was notably present only in participants over the age of 55, with no significant connection observed in those younger than 55. Additionally, the study found that participants with a higher waist-to-hip ratio, a history of smoking, and pre-existing conditions such as diabetes, high blood pressure, and cardiovascular disease were more likely to develop glaucoma.
The researchers used a polygenic risk score to account for genetic factors, which showed that genetic susceptibility also played a role in glaucoma risk, but did not alter the overall findings related to cholesterol levels.
While the results are intriguing, the researchers emphasize that the study’s observational nature means no definitive conclusions can be drawn about cause and effect. The study’s limitations include the fact that blood samples were not taken after fasting, and participants were predominantly of European ancestry, which may limit the applicability of the findings to other ethnic groups.
Despite these limitations, the study calls into question the long-standing notion of HDL as the “good cholesterol” and suggests a reevaluation of lipid management strategies in individuals at risk for glaucoma.
Disclaimer: The findings of this study are based on an observational analysis, and further research is required to confirm the causal relationship between cholesterol levels and glaucoma. The results should not be interpreted as medical advice, and individuals concerned about their eye health should consult with a healthcare professional.
