ArticleBMC ophthalmology2026
Elevated serum high-density lipoprotein is positively associated with incident glaucoma among middle-aged and older adults: a national cohort in China.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeEmerging evidence challenges the traditional view of high-density lipoprotein (HDL) as uniformly protective in ocular health. This study aimed to evaluate the association between serum HDL levels and glaucoma in a middle-aged and older Chinese population.
methodsWe conducted a retrospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,510 participants aged over 45 years without baseline glaucoma were included. Serum HDL was measured at baseline (2011), and incident glaucoma was ascertained via self-report during follow-up (2013-2018). Cox proportional hazards models and restricted cubic spline (RCS) analyses were used to assess the association, with adjustment for demographic and clinical covariates.
resultsOver a 7 years' follow-up, 224 participants (2.98%) developed glaucoma. After multivariable adjustment, each 1 mmol/L increase in HDL was associated with a 57% higher risk of glaucoma (HR = 1.57; 95% CI: 1.10-2.26; p = 0.014). Participants with low HDL level (< 1.0 mmol/L) had a significantly lower glaucoma risk compared to those with normal HDL level (HR = 0.63; 95% CI: 0.38-0.89; p = 0.012). RCS analysis indicated a steeper increase in risk at serum HDL ≤ 1.501 mmol/L. Subgroup analyses revealed consistency across most strata, with a stronger association observed in participants with liver disease (p for interaction = 0.035).
conclusionElevated serum HDL levels were associated with an increased risk of glaucoma in Chinese middle-aged and older adults, particularly at lower HDL concentrations. These findings challenge the conventional "good cholesterol" paradigm in glaucoma and underscore the need for further research into lipid-related pathways in its pathogenesis.
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