Xanthelasma palpebrarum (XP) is associated with elevated serum levels of atherogenic low-density lipoproteins (LDLs) and apolipoprotein B compared with individuals without XP, suggesting that XP confers an increased risk for atherosclerosis, a study in the Journal of the American Academy of Dermatology suggests.

Researchers performed a systematic literature review of studies published before April 15, 2019, that included patients with XP and reported various lipids and markers for atherosclerosis. A total of 15 case-control studies comprising 854 patients with XP and 907 patients without XP were included in the final meta-analysis.

According to the meta-analysis, patients with XP had higher levels of total cholesterol (standard mean difference [SMD], 0.612; 95% CI, 0.376-0.848; P <.001) and LDLs (SMD, 0.587; 95% CI, 0.339-0.836; P <.001) compared with healthy controls. There was no difference between the groups in terms of serum levels of high-density lipoproteins (SMD, –0.135; 95% CI, –0.345 to 0.075; P =.207), very LDLs (SMD, 0.288; 95% CI, –0.010 to 0.585; P =.058), and triglycerides (SMD, 0.259; 95% CI, –0.019 to 0.537; P =.068).

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Serum levels of apolipoprotein B were higher in patients with XP vs healthy controls (SMD, 1.036; 95% CI, 0.361-1.711; P =.003), suggesting that patients with XP have a higher risk for atherosclerosis. Patients with XP also had higher levels of carotid intima-media thickness, another marker of atherosclerosis, than controls (SMD, 1.848; 95% CI, 0.639-3.057; P =.003).

Limitations of the study include the lack of analyses based on patient characteristics as well as the lack of data to estimate the incidence and/or prevalence of stroke or ischemic heart diseases in patients with XP.

Based on their findings, the researchers concluded that “additional careful monitoring and targeted intervention is required for patients with XP beyond cosmetic concerns.”

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Reference

Chang HC, Sung CW, Lin MH. Serum lipids and risk of atherosclerosis in xanthelasma palpebrarum: a systematic review and meta-analysis [published online September 6, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.08.082