To determine whether body mass index (BMI) affects meibomian gland architecture in children, researchers prospectively evaluated 175 eyes of 175 pediatric patients between the ages of four and 17. They assessed dry eye symptoms with a questionnaire and performed meibography.

They found the mean meiboscore was 0.82±0.94 on a five-point meiboscale for gland atrophy and the mean gland tortuosity score was 0.53 ±0.70 on a three-point scale. Ninety-six patients (56%) showed evidence of gland atrophy (a meiboscore greater than zero) and a majority of patients had a gland tortuosity score of 1.

Mean BMI was 20.5 ±4.86kg/m², and almost 40% of the patients were above the 85^th percentile. The researchers noted that BMI percentile wasn’t a significant predictor of a meiboscore greater than zero, but it was a significant predictor of gland tortuosity score. Those with a BMI percentile between 41 and 60 were found to be 3.79 times more likely to have a gland tortuosity score greater than zero, compared with patients with a BMI percentile between 0 and 20. There were no significant associations between age, race or sex and meiboscore or tortuosity. The researchers also noted a trend toward reduction in lipid layer thickness as BMI percentile increased.

Meibomian gland tortuosity was associated with higher BMI percentiles in this particular population. The researchers concluded that “further studies are needed to elucidate the pathogenesis of meibomian gland tortuosity and atrophy in pediatric patients.”