Di Benedetto A, Aragona P, Romano G, Romeo G, Di Cesare E, Spinella R, Ferreri G, Cucinotta D
Department of Internal Medicine, University of Messina, Italy.
J Diabetes Complications. 1999 May-Jun;13(3):159-62. doi: 10.1016/s1056-8727(98)00023-3.
Cataract is a frequent ocular complication in diabetic patients, but few data are available concerning early modifications occurring in the lens of these patients and their relationship with metabolic control and other clinical parameters. We measured lens opacity in 73 type I, insulin-dependent diabetic patients aging 50 years or less and without clinical evidence of cataract, and in 46 healthy volunteers of similar age. We used a quick, simple, and reliable instrument, the Lensmeter 701, which is based on a back-light scattering quantification system and is able to quantify lens transparency along the nuclear axis. Mean lens opacity was significantly (p = 0.0001) higher in diabetic patients than in the control group, and multiple regression analysis showed that it correlated with age (p = 0.0001) and HbA1c levels (p = 0.009). Moreover in the younger group of patients (age < or =20 years) the only observed correlation was that with Hba1c (p = 0.03), whereas in the older ones (age 21-30 and >30 years) lens opacity correlated with age (p = 0.02 and p = 0.01). These data indicate that early opacifications of the lens occur in type I, insulin-dependent diabetic patients and are influenced by the degree of the metabolic control in the younger ones, whereas the well-known role of aging on lens transparency became prevalent in the older patients. Only longitudinal studies, however, can demonstrate whether these alterations represent any early stage of cataractagenesis and the role of good metabolic control in preventing this ocular complication.
白内障是糖尿病患者常见的眼部并发症，但关于这些患者晶状体早期变化及其与代谢控制和其他临床参数之间关系的数据却很少。我们测量了73名年龄在50岁及以下、无白内障临床证据的I型胰岛素依赖型糖尿病患者以及46名年龄相仿的健康志愿者的晶状体混浊度。我们使用了一种快速、简单且可靠的仪器——701型焦度计，它基于背向光散射定量系统，能够沿晶状体核轴量化晶状体透明度。糖尿病患者的平均晶状体混浊度显著高于对照组（p = 0.0001），多元回归分析表明，它与年龄（p = 0.0001）和糖化血红蛋白水平（p = 0.009）相关。此外，在较年轻的患者组（年龄≤20岁）中，唯一观察到的相关性是与糖化血红蛋白的相关性（p = 0.03），而在年龄较大的患者组（年龄21 - 30岁及>30岁）中，晶状体混浊度与年龄相关（p = 0.02和p = 0.01）。这些数据表明，I型胰岛素依赖型糖尿病患者会出现晶状体早期混浊，且在较年轻患者中受代谢控制程度的影响，而在年龄较大的患者中，衰老对晶状体透明度的影响更为显著。然而，只有纵向研究才能证明这些改变是否代表白内障发生的任何早期阶段，以及良好的代谢控制在预防这种眼部并发症中的作用。
