Kato S, Shiokawa A, Fukushima H, Numaga J, Kitano S, Hori S, Kaiya T, Oshika T
Department of Ophthalmology, School of Medicine, University of Tokyo, 3-28-5 Mejirodai, Bunkyo-ku, Tokyo, 112-8688 Japan.
Am J Ophthalmol. 2001 Mar;131(3):301-4. doi: 10.1016/s0002-9394(00)00804-7.
To assess quantitatively the cumulative effect of hyperglycemia on lens transparency in patients with juvenile type 1 diabetes mellitus.
Subjects were 30 patients (30 eyes) with type 1 diabetes mellitus who had well-documented records on the duration of diabetes mellitus and condition of glycemic control from the onset. They were 35 years of age or younger (mean, 26.0 years), had a history of type 1 diabetes mellitus at least 5 years (mean, 8.4 years), had corrected visual acuity of 20/20 or better, and showed no clinically apparent cataract on slit-lamp examination. Twenty-one eyes of 21 subjects served as age-matched normal controls. They were 35 years of age or younger (mean, 25.7 years), had no diabetes mellitus, had corrected visual acuity of 20/20 or better, and showed no signs of cataract on slit-lamp examination. The degree of lens opacity was quantified using the anterior eye segment analysis system based on the Scheimpflug principle. An index was created to represent the cumulative effect of long-term glycemic control (hyperglycemic accumulation) by multiplying the average hemoglobin A(1c) value and the number of months from the onset.
The patients with diabetes mellitus exhibited significantly greater degree of lens opacity than the normal controls (P =.017, Mann-Whitney U-test). Among the patients with diabetes mellitus, the lens opacity was greater in eyes with retinopathy than those without retinopathy (P =.011). Multiple regression analysis revealed that only the index of hyperglycemic accumulation significantly correlated with the degree of lens opacity (P =.042).
Accumulated effect of hyperglycemia is related to the lens transparency in patients with diabetes.
定量评估高血糖对青少年1型糖尿病患者晶状体透明度的累积影响。
研究对象为30例1型糖尿病患者（30只眼），这些患者自发病起就有关于糖尿病病程和血糖控制情况的详细记录。他们年龄在35岁及以下（平均26.0岁），1型糖尿病病史至少5年（平均8.4年），矫正视力为20/20或更好，裂隙灯检查未发现明显的临床白内障。21名受试者的21只眼作为年龄匹配的正常对照。他们年龄在35岁及以下（平均25.7岁），无糖尿病，矫正视力为20/20或更好，裂隙灯检查未发现白内障迹象。使用基于Scheimpflug原理的眼前节分析系统对晶状体混浊程度进行量化。通过将平均糖化血红蛋白A1c值与发病后的月数相乘，创建了一个指数来表示长期血糖控制（高血糖累积）的累积影响。
糖尿病患者的晶状体混浊程度明显高于正常对照组（P = 0.017，Mann-Whitney U检验）。在糖尿病患者中，有视网膜病变的眼的晶状体混浊程度高于无视网膜病变的眼（P = 0.011）。多元回归分析显示，只有高血糖累积指数与晶状体混浊程度显著相关（P = 0.042）。
高血糖的累积效应与糖尿病患者的晶状体透明度有关。
