Yu Tao, Han Xu-Guang, Gao Yang, Song Ai-Ping, Dang Guang-Fu
Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China.
Jinan Aier Ophthalmology Hospital, Aier Eye Hospital Group, Jinan 250014, Shandong Province, China.
Int J Ophthalmol. 2019 Sep 18;12(9):1415-1419. doi: 10.18240/ijo.2019.09.07. eCollection 2019.
To observe the changes of microcellular structure of meibomian glands (MGs) in type 2 diabetes mellitus (DM), and to explore its correlation with the duration of diabetes.
The study assessed 132 eyes of 132 patients with type 2 diabetes mellitus (DM group) and 100 eyes of 100 non-diabetic participants (NDM group). All patients underwent the examination of the Keratograph 5M system to obtain the meibography which were used to evaluate the structure dropout of the MGs. And then laser scanning confocal microscopy (LSCM) was performed for observing the acinar cells and ducts of the MGs to obtain the following parameters: the MG acinar unit density (MGAUD), MG acinar longest diameter (MGALD) and MG acinar shortest diameter (MGASD). The examination results of the right eye were selected for analysis.
Compared with that in NDM group, the meiboscore was significantly higher (=-4.057, <0.001), and there were more MGs dropout in DM group. With the prolongation of the course of diabetes, the absence of MGs aggravated and the MGs dropout score increased (=0.596; <0.001). LSCM showed that there were various cytological alterations in acinar cells of MGs with the progress of diabetes duration, such as expansion, atrophy or fibrosis of MG acinar units, decreased density of MG acinar units, deposition of lipid substances, infiltration of inflammatory cells, proliferation of fibrous tissues, . And the opening of the glandular duct changed from smooth at the beginning to narrow, blocked, fibrotic and so on. Compared with that in NDM group, the MGAUD in DM group was significantly lower (=-9.713; <0.001), the MGALD and MGASD were significantly larger (=-9.751, -6.416; <0.001). With the duration of diabetes, the MGAUD reduced, the MGASD increased (=0.860, 0.364, <0.001); but the MGALD had no correlation with diabetic duration (=0.133, =0.151).
With the progress of diabetes, the meibomian glandular acinar cells of diabetic patients show various manifestations. Those changes may result in the dysfuction of the MGs, tear film instability and dry eye symptoms in patients with type 2 DM.
观察2型糖尿病患者睑板腺的微观细胞结构变化，并探讨其与糖尿病病程的相关性。
本研究评估了132例2型糖尿病患者的132只眼（糖尿病组）和100例非糖尿病参与者的100只眼（非糖尿病组）。所有患者均接受了角膜地形图5M系统检查以获取睑板腺图像，用于评估睑板腺的结构缺失情况。然后进行激光扫描共聚焦显微镜（LSCM）检查，观察睑板腺的腺泡细胞和导管，以获得以下参数：睑板腺腺泡单位密度（MGAUD）、睑板腺腺泡最长直径（MGALD）和睑板腺腺泡最短直径（MGASD）。选取右眼的检查结果进行分析。
与非糖尿病组相比，糖尿病组的睑板腺评分显著更高（=-4.057，<0.001），且睑板腺缺失更多。随着糖尿病病程的延长，睑板腺缺失加重，睑板腺缺失评分增加（=0.596；<0.001）。LSCM显示，随着糖尿病病程的进展，睑板腺腺泡细胞出现多种细胞学改变，如睑板腺腺泡单位扩张、萎缩或纤维化，睑板腺腺泡单位密度降低，脂质物质沉积，炎性细胞浸润，纤维组织增生等。并且腺管开口从最初的光滑逐渐变为狭窄、阻塞、纤维化等。与非糖尿病组相比，糖尿病组的MGAUD显著更低（=-9.713；<0.001），MGALD和MGASD显著更大（=-9.751，-6.416；<0.001）。随着糖尿病病程的延长，MGAUD降低，MGASD增加（=0.860，0.364，<0.001）；但MGALD与糖尿病病程无关（=0.133，=0.151）。
随着糖尿病的进展，糖尿病患者的睑板腺腺泡细胞出现多种表现。这些变化可能导致2型糖尿病患者睑板腺功能障碍、泪膜不稳定和干眼症状。
