Non-Invasive Break-Up Time in the Beijing Adult Dry Eye Cohort Study (ADEC): A Cross-Sectional Baseline Analysis

To analyze the distribution of Non-Invasive Break-Up Time (NIBUT) and its potential associations with demographic characteristics, systemic disease, lifestyle factors, and psychological among adults in Beijing.

We conducted a population-based, cross-sectional analysis using baseline data from the Beijing Adult Dry Eye Cohort (ADEC), collected between July and August 2023. A total of 1,249 adult participants were randomly selected from 15 communities in Beijing, China, and 91.5% responded. Assessments included dry eye clinical signs, the Ocular Surface Disease Index (OSDI), and structured collection of demographic data, systemic diseases, lifestyle factors, and psychological status. Associations between NIBUT and potential correlates were examined using Univariable analyses and blocked multiple linear regression models adjusted for age, sex and other covariates. Results are reported as unstandardized regression coefficients (B) with 95% confidence intervals (CIs).

Data from 1,087 participants (one eye per participant) were included in the final analysis. The mean NIBUT of participants was 11.84 ± 4.39 s. Young adults (aged 18-39 years) had significantly higher NIBUT than both middle-aged (40-59 years) and older adults (≥ 60 years) (both p < 0.001). Female had significantly lower NIBUT values than male (p < 0.001). Blocked multiple linear regression analysis identified several factors that remained independently associated with NIBUT after multivariable adjustment, including female sex (B=-0.966, p = 0.001), older age (B=-0.040, p < 0.001), myopia (B=-0.531, p = 0.023), oral mucosal dryness (B=-1.124, p < 0.001), higher scores on the Hamilton Depression Rating Scale (B=-0.344, p < 0.001), and higher scores on the Hamilton Anxiety Rating Scale (B=-0.212, p < 0.001).

NIBUT is associated with a range of demographic, ocular, and psychological factors. These findings highlight the importance of a comprehensive, multi-factorial approach to the diagnosis and management of dry eye disease in clinical practice.