Purpose

To determine if meibomian gland architecture in a pediatric population is impacted by body mass index (BMI).

Methods

Prospective evaluation of 175 eyes of 175 pediatric patients from two clinics. Demographic and clinical information were reviewed. Symptoms of dry eye were assessed with the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Meibography was performed and grading of images was performed by a masked rater using a previously validated 5-point meiboscale (0–4) for gland atrophy and a 3-point score (0–2) for gland tortuosity.

Results

175 eyes of 175 participants aged 4–17 years (11.6 ± 3.7 years) were imaged. The mean meiboscore was 0.82 ± 0.94 (range 0–4) and the mean gland tortuosity score was 0.53 ± 0.70 (range 0–2). Ninety-six patients (56%) showed evidence of gland atrophy (meiboscore greater than 0) and the majority of patients (n=50, 29%) had a gland tortuosity score of 1. The mean BMI was 20.5 ± 4.86 kg/m² with 39.4% of patients (n = 69) above the 85th percentile. BMI percentile was not found to be a significant predictor of a meiboscore greater than 0 (odds ratio (OR) 1.004 95% confidence interval (CI) (0.99–1.10, p = 0.41). However, BMI percentile was found to be a significant predictor of gland tortuosity score (OR 1.01 95% CI (1.00–1.02), p = 0.02). Patients with BMI percentiles between 41 and 60 were 3.79 times more likely to have a gland tortuosity score of greater than 0 than patients with BMI percentiles between 0 and 20 (OR 3.789 CI (1.17–12.24)). No significant associations were found between age, race, or sex and meiboscore or tortuosity. There was a trend towards reduction in lipid layer thickness with increasing BMI percentile (p = 0.028, r² = 0.04).

Conclusion

In this pediatric population, there was an association between meibomian gland tortuosity and higher percentiles of BMI. Future studies are needed to elucidate the pathogenesis of meibomian gland tortuosity and atrophy in pediatric patients.

中文翻译：

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儿科人群的睑板腺结构与体重指数的关联。

目的

要确定小儿人群的睑板腺结构是否受到体重指数（BMI）的影响。

方法

对两家诊所的175名小儿患者的175眼进行前瞻性评估。人口统计学和临床​​信息进行了审查。使用标准患者眼干症评估（SPEED）问卷评估干眼症的症状。使用掩盖评分器，使用先前已验证的腺萎缩症的5点meiboscale（0–4）和腺体曲折度的3点评分（0–2），进行了代谢描记和图像分级。

结果

对175位4至17岁（11.6±3.7岁）参与者的175只眼睛进行了成像。平均meiboscore为0.82±0.94（范围0–4），平均腺体曲折度评分为0.53±0.70（范围0–2）。96名患者（56％）表现出腺体萎缩的证据（meiboscore大于0），大多数患者（n = 50，29％）的腺体曲折评分为1。平均BMI为20.5±4.86 kg / m ²39.4％的患者（n = 69）高于第85个百分点。没有发现BMI百分率是meiboscore大于0的重要预测指标（赔率（OR）1.004 95％置信区间（CI）（0.99-1.10，p = 0.41）），但是，发现BMI百分率是显着的体曲折度评分的预测指标（OR 1.01 95％CI（1.00–1.02），p = 0.02）。BMI百分位数在41至60之间的患者比BMI百分位数的患者发生大于0的可能性高3.79倍在0到20之间（或3.789 CI（1.17–12.24））。在年龄，种族或性别与中坚性或曲折性之间未发现显着关联。随着BMI百分位数的增加，脂质层厚度呈减少趋势（p = 0.028） ，r ²  ＝ 0.04）。

结论

在这一儿科人群中，睑板腺曲折度和较高的BMI百分位数之间存在关联。需要进一步的研究来阐明小儿患者睑板腺曲折和萎缩的发病机理。