Ansari Abdus Samad, de Lusignan Simon, Hinton William, Munro Neil, McGovern Andrew
Section of Clinical Medicine and Ageing, Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7PX, UK.
Section of Clinical Medicine and Ageing, Department of Clinical and Experimental Medicine, University of Surrey, Guildford GU2 7PX, UK.
Prim Care Diabetes. 2017 Oct;11(5):421-429. doi: 10.1016/j.pcd.2017.05.009. Epub 2017 Jun 23.
To examine whether diabetes and the degree of glycaemic control is associated with an increased risk of acute eye infection, and prescribing of ocular antimicrobial agents.
A retrospective cohort study was carried out using the Royal College of General Practitioners Research and Surveillance Centre database (RCGP RSC), a large primary care database in the United Kingdom. We compared ocular infection rates in people aged ≥15 years without diabetes to those with diabetes, both type 1 and type 2. We developed logistic regression models to assess the excess risk in diabetes of: conjunctivitis, blepharitis, stye/chalzion, periorbital cellulitis, keratitis/keratoconjunctivitis, lacrimal gland infection, endopthalmitis, and ocular antimicrobial prescriptions over a six-year period (2010-2015). We also analysed the impact of glycaemic control on infection rates in those with diabetes. All models were adjusted for potential confounders.
We analysed infection risk in 889,856 people without diabetes and 48,584 people with diabetes (3273 type 1, and 45,311 type 2). After adjustment for confounders both type 1 and type 2 were associated with increased incidence of conjunctivitis (OR 1.61; 95% CI 1.38-1.88; p<0.0001 and OR 1.11; 95% CI 1.06-1.16; p<0.0001 respectively). No association was found with blepharitis, stye/chalzion, periorbital cellulitis, keratitis/keratoconjunctivitis, lacrimal gland infection, and endopthalmitis in the whole population. In subgroup analyses blepharitis was more common in those with type 1 diabetes under 50 years old and endopthalmitis in those under 50 with type 2 diabetes. Glycaemic control was not found to be associated with any infection. Diabetes was also associated with an increased incidence of antimicrobial prescriptions (Type 1 OR 1.69; 95% CI 1.51-1.88; p<0.0001 and type 2 OR 1.17; 95% CI 1.13-1.20; p<0.0001).
Conjunctivitis is recorded more frequently in people with diabetes. However, no substantial increase in recording of other ocular infections was noted. Infection risk was not found to be associated with the degree of glycaemic control.
研究糖尿病及血糖控制程度是否与急性眼部感染风险增加以及眼部抗菌药物的处方有关。
使用英国一个大型初级保健数据库——皇家全科医师学院研究与监测中心数据库（RCGP RSC）进行了一项回顾性队列研究。我们比较了年龄≥15岁的非糖尿病患者与1型和2型糖尿病患者的眼部感染率。我们建立了逻辑回归模型，以评估在六年期间（2010 - 2015年）糖尿病患者患以下疾病的额外风险：结膜炎、睑缘炎、睑腺炎/睑板腺囊肿、眶周蜂窝织炎、角膜炎/角膜结膜炎、泪腺感染、眼内炎以及眼部抗菌药物处方。我们还分析了血糖控制对糖尿病患者感染率的影响。所有模型均对潜在混杂因素进行了调整。
我们分析了889,856名非糖尿病患者和48,584名糖尿病患者（3273名1型糖尿病患者和45,311名2型糖尿病患者）的感染风险。在对混杂因素进行调整后，1型和2型糖尿病均与结膜炎发病率增加相关（比值比1.61；95%置信区间1.38 - 1.88；p<0.0001和比值比1.11；95%置信区间1.06 - 1.16；p<0.0001）。在整个人口中，未发现与睑缘炎、睑腺炎/睑板腺囊肿、眶周蜂窝织炎、角膜炎/角膜结膜炎、泪腺感染和眼内炎有关联。在亚组分析中，睑缘炎在50岁以下的1型糖尿病患者中更为常见，眼内炎在50岁以下的2型糖尿病患者中更为常见。未发现血糖控制与任何感染有关。糖尿病还与抗菌药物处方的发病率增加有关（1型比值比1.69；95%置信区间1.51 - 1.88；p<0.0001，2型比值比1.17；95%置信区间1.13 - 1.20；p<0.0001）。
糖尿病患者中结膜炎的记录更为频繁。然而，未发现其他眼部感染记录有实质性增加。未发现感染风险与血糖控制程度有关。
