Xanthelasma Palpebrarum Not Linked to Increased Cardiovascular or Dyslipidemia Risk: Study

This study was designed to establish a hypothesis to identify an association between xanthelasma palpebrarum and dyslipidemia, cardiovascular disease, and other systemic conditions within a large population.

Case-control study was carried out at a single tertiary care center in the medical records of 2001 to 2020. Available records were reviewed on the grounds of ophthalmic evaluations, results from blood tests, and diagnoses for systemic conditions. The study group consisted of patients diagnosed with XP in at least one eye, while a control group without XP was established and matched by age and sex at a ratio of 10:1 for the purposes of robust statistical comparisons between the two groups. The main outcome measures were associations of XP with dyslipidemia and cardiovascular disease with an emphasis on comparing lipid profiles and use of medications between the groups.

• The database consisted of 35,452 individuals with an average age of 52.2 ± 12.2 years. Of the total number, 24,287 patients (69%) were males.

• Of these, 203 patients had a diagnosis of XP, while there were 2,030 matched controls included in the study population.

• The prevalence of dyslipidemia was not significantly different between groups, 42% in XP compared with 46% in controls (P = 0.29).

• The use of lipid-lowering agents, that is, statins and fibrates, was nearly the same for both study groups ( P = 0.88).

• Lipid profiles, including total cholesterol, HDL, LDL, and triglyceride levels, were similar in XP patients compared with controls. As an example, median total cholesterol was 192 (XP) vs. 187 (controls) (P = 0.093); LDL was 125 (XP) vs. 120 (controls) (P = 0.17).

• The rates of CVDs were similar between the groups, though 8.9% of XP patients had a history of CVD as compared to 10% controls (P = 0.56).

• Other systemic conditions were also similar between the groups and include hypertension, with 23% of XP and 24% controls. Diabetes mellitus was found in 10% XP as opposed to 14% controls, and cerebrovascular accidents with 1% XP versus 1.3% controls (P>0.05).

XP in itself is not an indicator of an increased incidence of dyslipidemia and cardiovascular disease, as was observed in this large population study. However, based on the present results, the presence of XP should by itself not be used as a marker for heightened cardiovascular or lipid-related risk. This study points out the necessity for further research with respect to systemic relevance and supports a more conservative interpretation of its clinical significance in cardiovascular and lipid health.

Reference:

Lustig-Barzelay, Y., Kapelushnik, N., Goldshtein, I., Leshno, A., Segev, S., Ben-Simon, G. J., & Landau-Prat, D. (2024). Association between xanthelasma palpebrarum with cardiovascular risk and dyslipidemia. Ophthalmology. https://doi.org/10.1016/j.ophtha.2024.07.033