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

Purpose: To investigate the association between serum high-density lipoprotein cholesterol (HDL-C) levels and ganglion cell complex (GCC) thickness in a nonglaucomatous Japanese population. Design: A retrospective cross-sectional observational study. Participants: We included 588 nonglaucomatous Japanese adults who underwent comprehensive ophthalmic and systemic health screening. Methods: 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. Main Outcome Measures: Average GCC thickness. Results: 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). Conclusions: 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. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.