Fernandes Sheldon Ignatius, Nagpal Shubha
Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India.
Oman J Ophthalmol. 2019 Oct 11;12(3):186-190. doi: 10.4103/ojo.OJO_21_2018. eCollection 2019 Sep-Dec.
The aim of this study was to detect the effect of diabetes on the corneal endothelium in patients of Type 1 diabetes in the pediatric age group and to compare them with age-matched controls. Further, it was proposed to establish any correlation between these changes and risk factors of diabetes, viz., age, duration of diabetes, and hemoglobin A1c (HbA1c) values.
This was a prospective cross-sectional study. Fifty children with Type 1 diabetes, between the ages of 7 and 17 years (average, 12.16 ± 2.63 years), and fifty healthy age-matched controls (average 12.28- ±3.00 years) were examined. The central corneal thickness (CCT) and endothelial cell density (CD) were assessed by the Topcon SP-1P specular microscope. The duration of diabetes (average, 3.91 ± 1.65 years) and the HbA1c values (average, 10.92 ± 2.28) were also noted.
The average CCT in the diabetics was 525.16 ± 33.14 μ and in the controls 513.44 ± 29.46 μ. This was significantly higher ( = 0.015). The average endothelial CD in the diabetics was 3039.64 ± 292.84 cells/mm and in the nondiabetics 3360.41 ± 268.04 cells/mm. This was significantly lower ( < 0.001). A significant correlation was found between the endothelial CD and age of the diabetic patients ( = 0.008). However, there was no significant correlation between the endothelial CD and the CCT with either duration of diabetes or HbA1c.
A significant decrease in the endothelial CD and increase in the CCT occurs in children and adolescents with Type 1 diabetes. With the age of the diabetic patients, the endothelial CD significantly reduces. However, duration of diabetes and HbA1c do not affect these values.
本研究的目的是检测糖尿病对儿科年龄组1型糖尿病患者角膜内皮的影响，并将其与年龄匹配的对照组进行比较。此外，还拟确定这些变化与糖尿病危险因素（即年龄、糖尿病病程和糖化血红蛋白（HbA1c）值）之间的相关性。
这是一项前瞻性横断面研究。对50名年龄在7至17岁（平均12.16±2.63岁）的1型糖尿病儿童和50名年龄匹配的健康对照者（平均12.28±3.00岁）进行了检查。使用拓普康SP-1P镜面显微镜评估中央角膜厚度（CCT）和内皮细胞密度（CD）。还记录了糖尿病病程（平均3.91±1.65年）和HbA1c值（平均10.92±2.28）。
糖尿病患者的平均CCT为525.16±33.14μm，对照组为513.44±29.46μm。前者显著更高（P = 0.015）。糖尿病患者的平均内皮CD为3039.64±292.84个细胞/mm²，非糖尿病患者为3360.41±268.04个细胞/mm²。前者显著更低（P < 0.001）。发现糖尿病患者的内皮CD与年龄之间存在显著相关性（P = 0.008）。然而，内皮CD和CCT与糖尿病病程或HbA1c之间均无显著相关性。
1型糖尿病儿童和青少年的内皮CD显著降低，CCT增加。随着糖尿病患者年龄的增长，内皮CD显著降低。然而，糖尿病病程和HbA1c并不影响这些值。
