{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:16:14Z","timestamp":1791598574860,"version":"4.3.4"},"reference-count":79,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education","award":["2019R1F1A1061421"],"award-info":[{"award-number":["2019R1F1A1061421"]}]},{"name":"Ministry of Education","award":["2022R1A2C2006109"],"award-info":[{"award-number":["2022R1A2C2006109"]}]},{"name":"Catholic University Yeouido St. Mary\u2019s Hospital","award":["2019R1F1A1061421"],"award-info":[{"award-number":["2019R1F1A1061421"]}]},{"name":"Catholic University Yeouido St. Mary\u2019s Hospital","award":["2022R1A2C2006109"],"award-info":[{"award-number":["2022R1A2C2006109"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The primary role of meibomian glands (MGs) is to actively synthesize and secret lipids and proteins spread onto the tear film, and the glandular lipids promote tear stability, prevent evaporation, and reduce friction. Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and one of the most common ophthalmic problems worldwide. MGs are densely innervated and regulated by hormones and growth factors. However, since the polar and nonpolar lipids are produced through processes in MGs that are not completely understood, a relevant question has been raised: Would the altered systemic lipids metabolism affect the physiology and structure of MGs? This review introduces the recent update regarding the relationships between serum lipid and MGD in clinical and basic research while providing answers to this question. A causal relationship remains to be established; however, serum lipid level or dyslipidemia may be related to MGD directly or indirectly, or both. Further studies are warranted to establish the role of serum lipid level and meibocyte differentiation\/maturation and lipid synthesis.<\/jats:p>","DOI":"10.3390\/jcm11144010","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T21:57:53Z","timestamp":1657576673000},"page":"4010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Serum Lipid Level with Meibum Biosynthesis and Meibomian Gland Dysfunction: A Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Young-Sik","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Kyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Sik","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Seung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-0742","authenticated-orcid":false,"given":"Reiko","family":"Arita","sequence":"additional","affiliation":[{"name":"Itoh Clinic, Saitama 337-0042, Japan"},{"name":"Department of Ophthalmology, Keio University, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Sun","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1167\/iovs.10-6997c","article-title":"The international workshop on meibomian gland dysfunction: Report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland","volume":"52","author":"Knop","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1167\/iovs.10-6997a","article-title":"The international workshop on meibomian gland dysfunction: Executive summary","volume":"52","author":"Nichols","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jtos.2017.03.006","article-title":"TFOS DEWS II Tear Film Report","volume":"15","author":"Willcox","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"151609","DOI":"10.1016\/j.aanat.2020.151609","article-title":"Characterization of the innervation of the meibomian glands in humans, rats and mice","volume":"233","author":"Garreis","year":"2021","journal-title":"Ann. Anat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/bjo.45.11.718","article-title":"The meibomian glands: An investigation into the secretion and some aspects of the physiology","volume":"45","author":"Linton","year":"1961","journal-title":"Br. J. Ophthalmol."},{"key":"ref_6","first-page":"522","article-title":"Meibomian gland studies: Comparison of steer and human lipids","volume":"20","author":"Nicolaides","year":"1981","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.preteyeres.2009.07.002","article-title":"The Meibomian puzzle: Combining pieces together","volume":"28","author":"Butovich","year":"2009","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jtos.2012.07.004","article-title":"Analysis of meibum and tear lipids","volume":"10","author":"Pucker","year":"2012","journal-title":"Ocul. Surf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.exer.2013.05.010","article-title":"Tear film lipids","volume":"117","author":"Butovich","year":"2013","journal-title":"Exp. Eye Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7417","DOI":"10.1167\/iovs.13-12916","article-title":"A comparison of patient matched meibum and tear lipidomes","volume":"54","author":"Brown","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Butovich, I.A., Wilkerson, A., and Yuksel, S. (2021). Depletion of Cholesteryl Esters Causes Meibomian Gland Dysfunction-Like Symptoms in a Soat1-Null Mouse Model. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22041583"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lam, S.M., Tong, L., Yong, S.S., Li, B., Chaurasia, S.S., Shui, G., and Wenk, M.R. (2011). Meibum lipid composition in Asians with dry eye disease. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0024339"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1167\/iovs.10-6997b","article-title":"The international workshop on meibomian gland dysfunction: Report of the definition and classification subcommittee","volume":"52","author":"Nelson","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3545","DOI":"10.1021\/acs.langmuir.8b04182","article-title":"Investigating the Role of Specific Tear Film Lipids Connected to Dry Eye Syndrome: A Study on O-Acyl-\u03c9-hydroxy Fatty Acids and Diesters","volume":"35","author":"Bland","year":"2019","journal-title":"Langmuir"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.3390\/nu5041218","article-title":"Dyslipidemia in obesity: Mechanisms and potential targets","volume":"5","author":"Klop","year":"2013","journal-title":"Nutrients"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"894","DOI":"10.2174\/1381612822666161006151134","article-title":"PPAR Agonists, Atherogenic Dyslipidemia and Cardiovascular Risk","volume":"23","author":"Nikolic","year":"2017","journal-title":"Curr. Pharm. Des."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref_18","first-page":"1","article-title":"The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","volume":"2","author":"Peterson","year":"2011","journal-title":"Ott. Hosp. Res. Inst."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.4103\/ijo.IJO_1256_17","article-title":"Association of the severity of meibomian gland dysfunction with dyslipidemia in Indian population","volume":"66","author":"Guliani","year":"2018","journal-title":"Indian J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1016\/j.ophtha.2013.05.002","article-title":"Meibomian gland dysfunction and hypercholesterolemia","volume":"120","author":"Pinna","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s10792-015-0149-4","article-title":"Dyslipidemia and its association with meibomian gland dysfunction","volume":"36","author":"Braich","year":"2016","journal-title":"Int. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4935","DOI":"10.1038\/s41598-017-05368-z","article-title":"Asymptomatic Meibomian Gland Dysfunction and Cardiovascular Disease Risk Factors in a Middle-Aged Population in Taiwan\u2014A Cross-sectional Analysis","volume":"7","author":"Chen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3126\/nepjoph.v12i2.27494","article-title":"Association of Lipid Profile with Severity of Meibomian Gland Dysfunction","volume":"12","author":"Irfan","year":"2020","journal-title":"Nepal J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3821","DOI":"10.2147\/OPTH.S322461","article-title":"The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort","volume":"15","author":"Mussi","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"16102","DOI":"10.1038\/s41598-021-95599-y","article-title":"Relationship between serum lipid level and meibomian gland dysfunction subtype in Korea using propensity score matching","volume":"11","author":"Ha","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/IOP.0b013e31827a007d","article-title":"Associations between the grade of meibomian gland dysfunction and dyslipidemia","volume":"29","author":"Bukhari","year":"2013","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3126\/nepjoph.v13i1.30605","article-title":"Risk Factors Associated with Meibomian Gland Dysfunction: A Hospital Based Study","volume":"13","author":"Tulsyan","year":"2021","journal-title":"Nepal J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1657s","DOI":"10.3945\/ajcn.2009.26736S","article-title":"Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: A randomized controlled study","volume":"89","author":"Rajaram","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/jn\/137.2.384","article-title":"Intake of fish oil, oleic acid, folic acid, and vitamins B-6 and E for 1 year decreases plasma C-reactive protein and reduces coronary heart disease risk factors in male patients in a cardiac rehabilitation program","volume":"137","author":"Carrero","year":"2007","journal-title":"J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1093\/ajcn\/84.6.1534","article-title":"Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols","volume":"84","author":"Demonty","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/jn\/138.1.30","article-title":"Docosahexaenoic acid supplementation decreases remnant-like particle-cholesterol and increases the (n-3) index in hypertriglyceridemic men","volume":"138","author":"Kelley","year":"2008","journal-title":"J. Nutr."},{"key":"ref_32","first-page":"336","article-title":"The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis)","volume":"106","author":"Macsai","year":"2008","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1097\/ICO.0b013e318299549c","article-title":"Long-term Supplementation With n-6 and n-3 PUFAs Improves Moderate-to-Severe Keratoconjunctivitis Sicca: A Randomized Double-Blind Clinical Trial","volume":"32","author":"Sheppard","year":"2013","journal-title":"Cornea"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/ICO.0000000000000366","article-title":"Effect of using a combination of lid wipes, eye drops, and omega-3 supplements on meibomian gland functionality in patients with lipid deficient\/evaporative dry eye","volume":"34","author":"Korb","year":"2015","journal-title":"Cornea"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/ICO.0000000000000446","article-title":"Effect of oral omega-3 Fatty Acid supplementation on contrast sensitivity in patients with moderate meibomian gland dysfunction: A prospective placebo-controlled study","volume":"34","author":"Malhotra","year":"2015","journal-title":"Cornea"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/ICO.0b013e318033d79b","article-title":"Effect of oral linoleic and gamma-linolenic acid on meibomian gland dysfunction","volume":"26","author":"Pinna","year":"2007","journal-title":"Cornea"},{"key":"ref_37","first-page":"1133","article-title":"A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction","volume":"8","year":"2013","journal-title":"Clin. Interv. Aging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jtos.2020.04.012","article-title":"Eicosapentaenoic acid (EPA) activates PPAR\u03b3 signaling leading to cell cycle exit, lipid accumulation, and autophagy in human meibomian gland epithelial cells (hMGEC)","volume":"18","author":"Kim","year":"2020","journal-title":"Ocul. Surf."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Butovich, I.A., Bhat, N., and Wojtowicz, J.C. (2019). Comparative Transcriptomic and Lipidomic Analyses of Human Male and Female Meibomian Glands Reveal Common Signature Genes of Meibogenesis. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20184539"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.ajo.2020.06.029","article-title":"Effect of 3-Hydroxy-3-Methyl-Glutaryl-Coenzyme A Reductase Inhibitors on the Meibomian Gland Morphology in Patients with Dyslipidemia","volume":"219","author":"Wu","year":"2020","journal-title":"Am. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/ceo.13388","article-title":"Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study","volume":"47","author":"Ooi","year":"2019","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_42","first-page":"214","article-title":"Culture of rabbit meibomian gland using collagen gel","volume":"32","author":"Maskin","year":"1991","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_43","first-page":"3150","article-title":"Development of a defined, serum-free culture system for the maintenance of epithelial cells from the mouse meibomian gland","volume":"43","author":"Richards","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.jtos.2016.08.001","article-title":"PPAR\u03b3 Regulates Mouse Meibocyte Differentiation and Lipid Synthesis","volume":"14","author":"Jester","year":"2016","journal-title":"Ocul. Surf."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3993","DOI":"10.1167\/iovs.09-5108","article-title":"Culture, immortalization, and characterization of human meibomian gland epithelial cells","volume":"51","author":"Liu","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jtos.2018.07.004","article-title":"PPAR\u03b3 regulates meibocyte differentiation and lipid synthesis of cultured human meibomian gland epithelial cells (hMGEC)","volume":"16","author":"Kim","year":"2018","journal-title":"Ocul. Surf."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1001\/jamaophthalmol.2013.6030","article-title":"Effect of azithromycin on lipid accumulation in immortalized human meibomian gland epithelial cells","volume":"132","author":"Liu","year":"2014","journal-title":"JAMA Ophthalmol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.exer.2018.02.009","article-title":"Effect of brimonidine, an \u03b12 adrenergic agonist, on human meibomian gland epithelial cells","volume":"170","author":"Han","year":"2018","journal-title":"Exp. Eye Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.exer.2015.08.024","article-title":"In vitro effects of docosahexaenoic and eicosapentaenoic acid on human meibomian gland epithelial cells","volume":"140","author":"Hampel","year":"2015","journal-title":"Exp. Eye Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tox.2014.02.014","article-title":"One man\u2019s poison is another man\u2019s meat: Using azithromycin-induced phospholipidosis to promote ocular surface health","volume":"320","author":"Liu","year":"2014","journal-title":"Toxicology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jtos.2020.11.011","article-title":"Saturation of cholesteryl esters produced by human meibomian gland epithelial cells after treatment with rosiglitazone","volume":"20","author":"Ziemanski","year":"2020","journal-title":"Ocul. Surf."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3866","DOI":"10.1167\/iovs.13-13407","article-title":"Serum-induced differentiation of human meibomian gland epithelial cells","volume":"55","author":"Sullivan","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1097\/ICO.0000000000000874","article-title":"Influence of Omega 3 and 6 Fatty Acids on Human Meibomian Gland Epithelial Cells","volume":"35","author":"Liu","year":"2016","journal-title":"Cornea"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1167\/iovs.17-23266","article-title":"Differentiation Patterns of Immortalized Human Meibomian Gland Epithelial Cells in Three-Dimensional Culture","volume":"59","author":"Asano","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.exer.2017.06.020","article-title":"Meibomian glands, meibum, and meibogenesis","volume":"163","author":"Butovich","year":"2017","journal-title":"Exp. Eye Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1096\/fj.201700947R","article-title":"Very long-chain tear film lipids produced by fatty acid elongase ELOVL1 prevent dry eye disease in mice","volume":"32","author":"Sassa","year":"2018","journal-title":"FASEB J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"10034","DOI":"10.1096\/fj.201900725R","article-title":"On the pivotal role of Elovl3\/ELOVL3 in meibogenesis and ocular physiology of mice","volume":"33","author":"Butovich","year":"2019","journal-title":"FASEB J."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Miyamoto, M., Sassa, T., Sawai, M., and Kihara, A. (2020). Lipid polarity gradient formed by \u03c9-hydroxy lipids in tear film prevents dry eye disease. eLife, 9.","DOI":"10.7554\/eLife.53582"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"13792","DOI":"10.1096\/fj.202001191R","article-title":"Deficiency in Acyl-CoA:Wax Alcohol Acyltransferase 2 causes evaporative dry eye disease by abolishing biosynthesis of wax esters","volume":"34","author":"Silvaroli","year":"2020","journal-title":"FASEB J."},{"key":"ref_60","first-page":"2632","article-title":"Inactivation of Awat2 in mice causes loss of wax ester lipids from meibum","volume":"61","author":"McMahon","year":"2020","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Sun, M., Moreno, I.Y., Dang, M., and Coulson-Thomas, V.J. (2020). Meibomian Gland Dysfunction: What Have Animal Models Taught Us?. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21228822"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00041433-200002000-00004","article-title":"The value of apolipoprotein E knockout mice for studying the effects of dietary fat and cholesterol on atherogenesis","volume":"11","author":"Osada","year":"2000","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.jtos.2019.06.002","article-title":"Hyperlipidemia induces meibomian gland dysfunction","volume":"17","author":"Bu","year":"2019","journal-title":"Ocul. Surf."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3268","DOI":"10.1167\/iovs.16-19227","article-title":"Meibomian Gland Dysfunction Model in Hairless Mice Fed a Special Diet with Limited Lipid Content","volume":"57","author":"Miyake","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jtos.2020.02.009","article-title":"High-fat diet induces dry eye-like ocular surface damages in murine","volume":"18","author":"Wu","year":"2020","journal-title":"Ocul. Surf."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Osae, E.A., Steven, P., Redfern, R., Hanlon, S., Smith, C.W., Rumbaut, R.E., and Burns, A.R. (2019). Dyslipidemia and Meibomian Gland Dysfunction: Utility of Lipidomics and Experimental Prospects with a Diet-Induced Obesity Mouse Model. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20143505"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Hargrave, A., Courson, J.A., Pham, V., Landry, P., Magadi, S., Shankar, P., Hanlon, S., Das, A., Rumbaut, R.E., and Smith, C.W. (2020). Corneal dysfunction precedes the onset of hyperglycemia in a mouse model of diet-induced obesity. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0238750"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Osae, E.A., Bullock, T., Chintapalati, M., Brodesser, S., Hanlon, S., Redfern, R., Steven, P., Smith, C.W., Rumbaut, R.E., and Burns, A.R. (2020). Obese Mice with Dyslipidemia Exhibit Meibomian Gland Hypertrophy and Alterations in Meibum Composition and Aqueous Tear Production. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21228772"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1073\/pnas.0334211100","article-title":"Differential effects of prostaglandin derived from omega-6 and omega-3 polyunsaturated fatty acids on COX-2 expression and IL-6 secretion","volume":"100","author":"Bagga","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.clnu.2004.08.004","article-title":"Dyslipidemia and inflammation: An evolutionary conserved mechanism","volume":"24","author":"Esteve","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/ICO.0000000000000173","article-title":"Association of dry eye and inflammatory systemic diseases in a tertiary care-based sample","volume":"33","author":"Henrich","year":"2014","journal-title":"Cornea"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1136\/bjophthalmol-2012-301767","article-title":"Prevalence and predictors of Sjogren\u2019s syndrome in a prospective cohort of patients with aqueous-deficient dry eye","volume":"96","author":"Liew","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1159\/000487487","article-title":"Meibomian Gland Dysfunction in Primary and Secondary Sj\u00f6gren Syndrome","volume":"59","author":"Sullivan","year":"2018","journal-title":"Ophthalmic Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jtos.2013.08.002","article-title":"Effect of desiccating stress on mouse meibomian gland function","volume":"12","author":"Suhalim","year":"2014","journal-title":"Ocul. Surf."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Botta, M., Audano, M., Sahebkar, A., Sirtori, C.R., Mitro, N., and Ruscica, M. (2018). PPAR Agonists and Metabolic Syndrome: An Established Role?. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19041197"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1001\/archophthalmol.2011.69","article-title":"Effects of age and dysfunction on human meibomian glands","volume":"129","author":"Nien","year":"2011","journal-title":"Arch. Ophthalmol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/j.1472-8206.2009.00741.x","article-title":"Chicago, periscope and PROactive: CV risk modification in diabetes with pioglitazone","volume":"23","author":"Betteridge","year":"2009","journal-title":"Fundam. Clin. Pharmacol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/ICO.0000000000000815","article-title":"Epidemiology of Meibomian Gland Dysfunction in an Elderly Population","volume":"35","author":"Alghamdi","year":"2016","journal-title":"Cornea"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.jtos.2012.07.001","article-title":"Wakayama Symposium: Peroxisome proliferator-activated receptor-gamma (PPAR\u03b3) and meibomian gland dysfunction","volume":"10","author":"Jester","year":"2012","journal-title":"Ocul. 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