Corneal arcus and cardiovascular risk factors in middle-aged subjects in taiwan

BACKGROUND: To delineate the association between corneal arcus and potential cardiovascular risk factors in middle-aged population. METHODS: This cross-sectional study randomly enrolled 119 subjects with corneal arcus and 119 subjects without arcus, aged between 30 and 60 years, from community-based East Asian population. Corneal arcus identification was completed by a single ophthalmologist using slit-lamp biomicroscopy examination. Cardiovascular risk factor parameters were measured by standardized techniques. RESULTS: Subjects with higher levels of total-cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and total/HDL cholesterol ratio had increased risk of having corneal arcus, whereas subjects with higher systolic blood pressure (SBP) and diastolic blood pressure had decreased risk. Using stepwise logistic regression analysis, we found that male gender was a strong independent risk factor for arcus formation [odds ratio (OR): 2.87; 95% confidence interval (CI): 1.59-5.17; P < 0.001]. Higher non-HDL-C level also had significant but mildly increased risk (OR: 1.02; 95% CI: 1.01-1.02; P 0.008) of having arcus, whereas higher SBP had significant but mildly decreased risk (OR: 0.98; 95% CI: 0.96-0.99; P < 0.001). Besides, subjects who had circumferential arcus had significantly higher risk of having LDL-C ≥160 mg/dL than those who had only partial arcus (OR: 5.79 versus OR: 4.60; P < 0.001). CONCLUSIONS: In addition to serum LDL-C, male gender and serum non-HDL-C level are significantly correlated to corneal arcus. Conversely, SBP is negatively correlated to corneal arcus. Presence of corneal arcus in middle-aged men may be an indicator for dyslipidemia, and we speculate that the relationship between arcus and coronary heart disease may be dependent of dyslipidemia.