The Association between Serum Lipids and Intraocular Pressure in 2 Large United Kingdom Cohorts

Modifiable Risk Factors for Glaucoma Collaboration and the UK Biobank Eye and Vision Consortium

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Purpose: Serum lipids are modifiable, routinely collected blood test features associated with cardiovascular health. We examined the association of commonly collected serum lipid measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) with intraocular pressure (IOP). Design: Cross-sectional study in the UK Biobank and European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohorts. Participants: We included 94 323 participants from the UK Biobank (mean age, 57 years) and 6230 participants from the EPIC-Norfolk (mean age, 68 years) cohorts with data on TC, HDL-C, LDL-C, and triglycerides collected between 2006 and 2009. Methods: Multivariate linear regression adjusting for demographic, lifestyle, anthropometric, medical, and ophthalmic covariables was used to examine the associations of serum lipids with corneal-compensated IOP (IOPcc). Main Outcome Measures: Corneal-compensated IOP. Results: Higher levels of TC, HDL-C, and LDL-C were associated independently with higher IOPcc in both cohorts after adjustment for key demographic, medical, and lifestyle factors. For each 1-standard deviation increase in TC, HDL-C, and LDL-C, IOPcc was higher by 0.09 mmHg (95% confidence interval [CI], 0.06–0.11 mmHg; P < 0.001), 0.11 mmHg (95% CI, 0.08–0.13 mmHg; P < 0.001), and 0.07 mmHg (95% CI, 0.05–0.09 mmHg; P < 0.001), respectively, in the UK Biobank cohort. In the EPIC-Norfolk cohort, each 1-standard deviation increase in TC, HDL-C, and LDL-C was associated with a higher IOPcc by 0.19 mmHg (95% CI, 0.07–0.31 mmHg; P = 0.001), 0.14 mmHg (95% CI, 0.03–0.25 mmHg; P = 0.016), and 0.17 mmHg (95% CI, 0.06–0.29 mmHg; P = 0.003). An inverse association between triglyceride levels and IOP in the UK Biobank (–0.05 mmHg; 95% CI, –0.08 to –0.03; P < 0.001) was not replicated in the EPIC-Norfolk cohort (P = 0.30). Conclusions: Our findings suggest that serum TC, HDL-C, and LDL-C are associated positively with IOP in 2 United Kingdom cohorts and that triglyceride levels may be associated negatively. Future research is required to assess whether these associations are causal in nature.

    Original languageEnglish
    JournalOphthalmology
    DOIs
    Publication statusAccepted/In press - 2022

    Bibliographical note

    Funding Information:
    Supported by UCL Overseas Research Scholarship (K.V.S.); Fight for Sight, London, United Kingdom (grant no.: 1956A [K.V.S.]); The Desmond Foundation (K.V.S.); the Wellcome Trust (grant no.: 220558/Z/20/Z [A.W.]); Alcon (P.J.F.); United Kingdom Research and Innovation Future Leaders Fellowship (A.P.K.); Moorfields Eye Charity (Springboard Award [R.N.L.] and Career Development Fellowship [A.P.K.]); the National Eye Institute, National Institutes of Health, Bethesda, Maryland (grant nos.: EY015473 [L.R.P.], EY032559 [L.R.P.], [J.L.W.]); Research to Prevent Blindness, Inc., New York, New York (Challenge Grant [L.R.P., J.L.W.]); The Glaucoma Foundation, New York, New York (L.R.P.); Astra Zeneca (N.S.); Boehringer Ingelheim (N.S.); Novartis (N.S.); Roche Diagnostics (N.S.); Association for Research in Vision and Ophthalmology Foundation (David Epstein Award [J.L.W.]); and UK Research and Innovation Future Leaders Fellowship (Medical Research Council grant no.: MR/T040912/1 [A.P.K.]). The authors acknowledge a proportion of their financial support from the United Kingdom Department of Health through an award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Biomedical Research Centre for Ophthalmology. This research used data from the UK Biobank Resource under data access request nos. 2112 and 36741. The UK Biobank Eye and Vision Consortium is supported by grants from Moorfields Eye Charity, The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, the Alcon Research Institute, and the International Glaucoma Association (United Kingdom). The EPIC-Norfolk study was supported by the Medical Research Council, United Kingdom (grant nos.: SP2024/0201 and MR/N003284/1), and Cancer Research United Kingdom (grant nos.: G9502233 and C864/A8257). No funders had a direct role in the collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication. Obtained funding: N/A; Study was performed as part of the authors' regular employment duties. No additional funding was provided.

    Funding Information:
    Supported by UCL Overseas Research Scholarship (K.V.S.); Fight for Sight , London, United Kingdom (grant no.: 1956A [K.V.S.]); The Desmond Foundation (K.V.S.); the Wellcome Trust (grant no.: 220558/Z/20/Z [A.W.]); Alcon (P.J.F.); United Kingdom Research and Innovation Future Leaders Fellowship (A.P.K.); Moorfields Eye Charity (Springboard Award [R.N.L.] and Career Development Fellowship [A.P.K.]); the National Eye Institute, National Institutes of Health , Bethesda, Maryland (grant nos.: EY015473 [L.R.P.], EY032559 [L.R.P.], [J.L.W.]); Research to Prevent Blindness , Inc., New York, New York (Challenge Grant [L.R.P., J.L.W.]); The Glaucoma Foundation , New York, New York (L.R.P.); Astra Zeneca (N.S.); Boehringer Ingelheim (N.S.); Novartis (N.S.); Roche Diagnostics (N.S.); Association for Research in Vision and Ophthalmology Foundation (David Epstein Award [J.L.W.]); and UK Research and Innovation Future Leaders Fellowship ( Medical Research Council grant no.: MR/T040912/1 [A.P.K.]). The authors acknowledge a proportion of their financial support from the United Kingdom Department of Health through an award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Biomedical Research Centre for Ophthalmology. This research used data from the UK Biobank Resource under data access request nos. 2112 and 36741. The UK Biobank Eye and Vision Consortium is supported by grants from Moorfields Eye Charity, The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, the Alcon Research Institute , and the International Glaucoma Association (United Kingdom). The EPIC-Norfolk study was supported by the Medical Research Council , United Kingdom (grant nos.: SP2024/0201 and MR/N003284/1 ), and Cancer Research United Kingdom (grant nos.: G9502233 and C864/A8257 ). No funders had a direct role in the collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

    Publisher Copyright:
    © 2022 American Academy of Ophthalmology

    Keywords

    • Cholesterol
    • Glaucoma
    • Intraocular pressure
    • Lipids

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