# Association of High-Density Lipoprotein Cholesterol with Macular Structure in Nonglaucomatous Individuals

**Authors:** Taiga Inooka, Ryo Tomita, Ayana Suzumura, Shota Fujikawa, Yuki Kimura, Taro Kominami, Tetsuhito Kojima, Shinji Ueno, Yasuki Ito, Koji M. Nishiguchi, Kenya Yuki

PMC · DOI: 10.1016/j.xops.2026.101073 · 2026-01-14

## TL;DR

This study found that higher HDL cholesterol levels are linked to thinner retinal layers in non-glaucoma patients, suggesting a possible early indicator of neurodegeneration.

## Contribution

The study reveals a novel association between HDL-C levels and retinal structure in nonglaucomatous individuals.

## Key findings

- Higher HDL-C levels were significantly associated with thinner ganglion cell complex thickness.
- A nonlinear relationship was observed between HDL-C levels and GCC thickness outside the 60 to 67 mg/dL range.
- Age and axial length were also significant factors affecting GCC thickness.

## Abstract

To investigate the association between serum high-density lipoprotein cholesterol (HDL-C) levels and ganglion cell complex (GCC) thickness in a nonglaucomatous Japanese population.

A retrospective cross-sectional observational study.

We included 588 nonglaucomatous Japanese adults who underwent comprehensive ophthalmic and systemic health screening.

Participants underwent OCT imaging, anthropometric measurements, including brachial–ankle pulse wave velocity, spirometry, and hematologic profiling. Multivariable linear regression models were used to assess the association between HDL-C levels and GCC thickness. Covariates were selected using a stepwise variable selection procedure, with the final model including age and axial length. A piecewise linear regression model further evaluated the association across different HDL-C ranges.

Average GCC thickness.

Older age (P = 0.002), longer axial length (P < 0.001), and higher HDL-C levels (P < 0.001) were significantly associated with thinner GCC thickness. A nonlinear relationship was observed, with GCC thickness inversely associated with HDL-C levels outside the 60 to 67 mg/dL range (P = 0.005).

High-density lipoprotein cholesterol levels are significantly associated with GCC thickness in nonglaucomatous individuals, which suggests a potential role of lipid metabolism in early neuroretinal thinning. High-density lipoprotein cholesterol may serve as a biomarker for neurodegenerative changes, even before glaucomatous alterations become clinically apparent.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

## Linked entities

- **Diseases:** glaucoma (MONDO:0005041)

## Full-text entities

- **Diseases:** glaucomatous alterations (MESH:D004408), neurodegenerative (MESH:D019636), neuroretinal thinning (MESH:D012173)

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12907079/full.md

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Source: https://tomesphere.com/paper/PMC12907079