Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome

Sam Young Yoon; Seok Hyun Bae; Young Joo Shin; Shin Goo Park; Sang-Hee Hwang; Joon Young Hyon; Won Ryang Wee

doi:10.1371/journal.pone.0147847

Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome

PLoS One. 2016 Jan 25;11(1):e0147847. doi: 10.1371/journal.pone.0147847. eCollection 2016.

Authors

Sam Young Yoon¹, Seok Hyun Bae¹, Young Joo Shin¹, Shin Goo Park², Sang-Hee Hwang³, Joon Young Hyon^{4

5}, Won Ryang Wee⁴

Affiliations

¹ Department of Ophthalmology, Hallym University College of Medicine, Seoul, Republic of Korea.
² Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
³ Department of Dentistry, Keimyung University School of Medicine, Daegu, Republic of Korea.
⁴ Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
⁵ Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.

Abstract

Background: Dry eye syndrome (DES) is a common tear film and ocular surface disease that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Systemic diseases associated with DES include diabetes mellitus, rheumatoid arthritis, depression, anxiety, thyroid disease, allergic diseases, irritable bowel syndrome, chronic pain syndrome, and hyperlipidemia. Interestingly, it has been found that most of these are associated with low levels of serum 25-hydroxyvitamin D (25(OH)D) or inadequate sunlight exposure.

Methods: In this cross-sectional data analysis, noninstitutionalized adults aged ≥19 years (N = 17,542) who participated in Korean National Health and Nutrition Examination Survey 2010-2012 were included. Information regarding duration of sunlight exposure was collected from the survey participants. Serum 25(OH)D and zinc levels were measured. The confounding variables were age, gender, sunlight exposure time, region of residence, obesity, serum 25(OH)D level, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and walking exercise.

Results: Mean serum 25(OH)D levels of subjects with and without DES were 16.90 ± 6.0 and 17.52 ± 6.07 (p<0.001). Inadequate sunlight exposure time (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.307-1.848), urban residence (OR, 1.669; 95% CI, 1.456-1.913), indoor occupation (OR, 1.578; 95% CI, 1.389-1.814), and low serum 25(OH)D level (OR, 1.158; 95% CI, 1.026-1.308) were the risk factors for DES. After adjusting for age, sex, obesity, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and occupation, low serum 25(OH)D level (OR, 1.178; 95% CI, 1.010-1.372) and deficient sunlight exposure time (OR, 1.383; 95% CI, 1.094-1.749) were the risk factors for diagnosed DES.

Conclusion: Low serum 25(OH)D levels and inadequate sunlight exposure are associated with DES in Korean adults. These results suggest that sufficient sunlight exposure or vitamin D supplementation may be useful in DES treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Dry Eye Syndromes / blood*
Female
Health Surveys
Humans
Male
Middle Aged
Risk Factors
Sunlight*
Vitamin D / analogs & derivatives*
Vitamin D / blood
Young Adult

Substances

Vitamin D
25-hydroxyvitamin D

Grants and funding

This study was supported by the National Research Foundation (NRF) grant (NRF-2015R1D1A1A09058505) funded by the Korean government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.