Correlation Between Androgen Levels And Dry Eye Parameters In Male Patients With Chronic Obstructive Pulmonary Disease

Objective: To investigate the effects of chronic obstructive pulmonary disease (COPD) in the dry eye status in men and to determine whether the hypoandrogenic status has any concomitant impact.Materials and Methods: We enrolled 80 patients with stable COPD and healthy volunteers individually matched on the basis of body mass index (BMI), age, and sex. Ocular surface testing included ocular surface disease index (OSDI) questionnaire, evaluation of meibomian gland dysfunction (MGD), tear fluorescein break-up time (TF-BUT), ocular surface staining with lissamine green (LG), Schirmer test with topical anesthesia, and Sirius meibographic analysis of meibomian gland area (MGA) loss. Bioavailable testosterone and free testosterone were measured using the measured total testosterone (TT), albumin, and sex hormone binding globulin (SHBG) levels.Results: Patients with COPD had lower levels of circulating androgens, decreased TF-BUT, and lower Schirmer score and greater LG staining score, MGD grade, and MG area loss than healthy controls (p<0.01). Forced expiratory volume in 1-second (FEV1), FEV1/forced expiratory vital capacity (FVC), and circulating androgen levels were inversely correlated to the OSDI score, LG staining, MGD grade, and MGA loss and showed positive correlation with TF-BUT and Schirmer score in COPD patients (p<0.01). However, when adjusted for androgen levels, FEV1 and FEV1/FVC ratio were negatively correlated to the Schirmer score (p<0.05).Conclusion: Male COPD patients had worse tear film parameters, and this finding was more notable in patients with lower androgen levels. Hypoandrogenic status in COPD patients attributes to the dry eye status of the patients, irrespective of their FEV1 and FEV1/FVC status.