Dağdeviren Murat, Altay Mustafa, Yildiz Zennure, Şimşek Gülçin, Çitirik Mehmet, Ateş İhsan, Dağdeviren Tanyel Sema, Yildiz Canan, Şahin Tuğba
Department of Endocrinology and Metabolism, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY.
Turk Patoloji Derg. 2019;35(2):119-127. doi: 10.5146/tjpath.2018.01451.
This study was designed to determine whether obesity causes the development of metaplasia in conjunctival epithelial cells.
A total of 61 volunteer participants who had no previous history of illness or drug use were involved in this study. Of those, 20 were obese, and 41 were of normal weight. We measured the glucose and insulin values of all volunteers. We also measured the Body Mass Index (BMI) and Homeostasis Model Assessment for Insulin Resistance (HOMA IR). The impression cytology method was used to analyze the conjunctival epithelium cells, and to classify them between Grades 0 to 3 according to the Nelson criteria.
There was a certain level of loss of goblet cells on the 90% level as well as squamous metaplasia (Grade 2-3) in 80% of the obese participants and impression cytology was found to be normal in only two patients. The expected results were observed in 56.1% of the control group where the squamous metaplasia rate was nearly 17% (p < 0.001). 90.9% of the grade 3 patients were obese. The variables as independent predictors were found to indicate the existence of abnormal cytology in the conjunctiva at various levels; BMI (OR: 1.24; p=0.002) and HOMA IR (OR= 28.6; p= 0.001) in a Model I multivariable regression model, and the existence of obesity (OR: 11.91; p=0.002) and HOMA IR (OR= 15.08; p < 0.001) in a Model II multivariable regression model.
Obesity was found to be a disorder that causes metaplasia in the conjunctival epithelium cells for the first time.
本研究旨在确定肥胖是否会导致结膜上皮细胞化生。
本研究共纳入61名无既往病史或药物使用史的志愿者。其中，20人肥胖，41人体重正常。我们测量了所有志愿者的血糖和胰岛素值。我们还测量了体重指数（BMI）和胰岛素抵抗稳态模型评估（HOMA-IR）。采用印迹细胞学方法分析结膜上皮细胞，并根据纳尔逊标准将其分为0至3级。
在90%的肥胖参与者中，杯状细胞有一定程度的缺失，80%的肥胖参与者存在鳞状化生（2 - 3级），仅2例患者的印迹细胞学检查结果正常。对照组中56.1%观察到预期结果，鳞状化生率接近17%（p < 0.001）。90.9%的3级患者肥胖。在多变量回归模型I中，发现作为独立预测因素的变量在不同水平上表明结膜存在异常细胞学；BMI（OR：1.24；p = 0.002）和HOMA-IR（OR = 28.6；p = 0.001），在多变量回归模型II中，肥胖的存在（OR：11.91；p = 0.002）和HOMA-IR（OR = 15.08；p < 0.001）。
首次发现肥胖是一种导致结膜上皮细胞化生的疾病。
