Differences in meibomian fatty acid composition in patients with meibomian gland dysfunction and aqueous-deficient dry eye
Differences in meibomian fatty acid composition in patients with meibomian gland dysfunction and aqueous-deficient dry eye
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DOI：
10.1136/bjo.2007.126144
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发表时间：
2008-01-01
影响因子：
4.1
通讯作者：
Creuzot-Garcher, C.
中科院分区：
文献类型：
--
作者：
Joffre, C.;Souchier, M.;Creuzot-Garcher, C.
目的：评价健康人与睑板腺功能障碍或缺水性干眼患者睑板脂肪酸组成的差异。方法：采用无菌Schirmer纸采集健康人（20例）、干眼症（缺水）患者（32例）和睑板腺功能障碍（MGD）患者（25例）眼睑边缘轻柔按摩后的睑板油。用气相色谱（GC）和气相质谱（GC - mass spectrometry）分析了黑棉脂肪酸的直接转甲基化。结果：梅博脂脂肪酸在健康个体和干眼患者中相似，但在MGD患者中存在差异，MGD患者的支链脂肪酸水平明显较高（29.8% vs 20.2%） （p < 0.0001），饱和脂肪酸水平较低（9.3 vs 24.6%） （p < 0.0001），特别是棕榈酸（C16）和硬脂酸（C18）水平较低。结论：支链脂肪酸的增加可能反映了睑板腺分泌物中蜡、胆固醇酯和甘油三酯含量的增加。由于蜡和胆固醇酯是脂肪的主要脂质，这些差异可能对泪膜脂层的流动性和稳定性产生物理影响。睑板脂肪酸组成，特别是支链的增加可能是睑板腺功能障碍的标志。
Aims: To evaluate the differences in meibomian fatty acid composition in healthy subjects and in patients suffering from meibomian gland dysfunction or aqueous-deficient dry eye.Methods: We collected meibomian oil using a sterile Schirmer paper in healthy individuals (n= 20), dry eye patients (aqueous-deficient) (n= 32) and meibomian gland dysfunction (MGD) patients (n= 25) after gentle massage of the lid margin. Meibomian fatty acids were directly transmethylated and analysed using gas chromatography (GC) and GC mass spectrometry.Results: Meibomian fatty acids were similar in healthy individuals and in dry eye patients but were different in MGD patients, who showed significantly higher levels of branched-chain fatty acids (29.8% vs 20.2%) (p < 0.0001) and lower levels of saturated fatty acids (9.3 vs 24.6%) (p < 0.0001), in particular lower levels of palmitic (C16) and stearic (C18) acids.Conclusion: The increase in branched-chain fatty acids may reflect greater quantities of wax and cholesterol esters and triglycerides in meibomian gland excreta. Since wax and cholesterol esters are the main lipids of meibum, these differences may have physical consequences for tear-film lipid-layer fluidity and stability. Meibomian fatty acid composition and particularly the increase in branched chains could be a marker for meibomian gland dysfunction.