Purpose

To investigate the alteration in lipid composition of meibum, objective clinical signs, and subjective symptoms associated with aging and meibomian gland (MG) dysfunction (MGD).

Methods

In 10 MGD patients [4 males/6 females, mean age: 65.6 ± 7.9 years (range: 50–79 years)] and 24 healthy volunteer subjects [young subjects: 6 males/6 females, mean age: 25.7 ± 3.8 years (range: 20–35 years), elderly subjects: 6 males/6 females, mean age: 58.4 ± 7.5 years (range: 50–79 years)], three objective clinical signs were evaluated: MG orifice obstruction, meibum score, and tear film lipid layer interference pattern. Subjective symptoms were analyzed via a 15-item questionnaire. After careful collection of meibum samples, comprehensive lipid analysis was performed via liquid chromatography-mass spectrometry. Data was analyzed via JMP® ver. 13 (SAS Institute, Inc., Cary, NC) statistical analysis software.

Results

In the MGD patients and elderly subjects, there was a significant decrease in non-polar lipids such as cholesterol esters (ChEs), while a significant increase in polar lipids [cholesterol (Ch), (O-acyl)-ω-hydroxy fatty acid (OAHFA), and free fatty acid (FA)] in total lipids (Tukey-Kramer test: p < 0.05). Triglyceride was significantly increased only in MGD patients (p < 0.05). Symptom scores representative of vision quality (i.e., blurred vision/haziness) were significantly negatively-correlated with the ratio of the non-polar lipid ChE, while significantly positively correlated with the polar lipids Ch, OAHFA, and FA (Spearman's rank correlation coefficient: p < 0.05).

Conclusions

Our findings revealed that both MGD and aging affect the composition ratio of major meibum lipids, resulting in the appearance of subjective symptoms.

中文翻译：

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由于衰老和睑板腺功能障碍引起的睑脂成分和主观症状的改变

目的

研究与衰老和睑板腺 (MG) 功能障碍 (MGD) 相关的睑脂脂质成分、客观临床体征和主观症状的变化。

方法

在 10 名 MGD 患者 [4 名男性/6 名女性，平均年龄：65.6 ± 7.9 岁（范围：50-79 岁）] 和 24 名健康志愿者受试者 [年轻受试者：6 名男性/6 名女性，平均年龄：25.7 ± 3.8 岁（范围：20-35 岁），老年受试者：6 名男性/6 名女性，平均年龄：58.4 ± 7.5 岁（范围：50-79 岁）]，评估了三个客观临床体征：MG 孔阻塞、睑脂评分和撕裂膜脂层干涉图案。主观症状通过 15 项问卷进行分析。仔细收集睑脂样本后，通过液相色谱-质谱法进行全面的脂质分析。通过 JMP® ver. 分析数据。13 (SAS Institute, Inc., Cary, NC) 统计分析软件。

结果

在 MGD 患者和老年受试者中，胆固醇酯 (ChEs) 等非极性脂质显着减少，而极性脂质[胆固醇 (Ch)、( O-酰基)-ω-羟基脂肪酸显着增加(OAHFA) 和游离脂肪酸 (FA)] 在总脂质中（Tukey-Kramer 检验：p < 0.05）。甘油三酯仅在 MGD 患者中显着增加 (p < 0.05)。代表视觉质量的症状评分（即视力模糊/混浊）与非极性脂质 ChE 的比率显着负相关，而与极性脂质 Ch、OAHFA 和 FA 显着正相关（Spearman 等级相关系数： p < 0.05）。

结论

我们的研究结果表明，MGD 和衰老都会影响主要睑脂的组成比例，从而导致主观症状的出现。