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糖尿病病程和糖化血红蛋白水平对角膜内皮形态的影响。

Effects of diabetes duration and HgA1C level on corneal endothelial morphology.

机构信息

Ministry of Health, Osmaniye Government Hospital, Osmaniye, Turkey.

Ministry of Health, Ulucanlar Eye Research and Education Hospital, Ankara, Turkey.

出版信息

Eur J Ophthalmol. 2021 May;31(3):967-975. doi: 10.1177/1120672120914812. Epub 2020 Apr 22.

Abstract

OBJECTIVE

The aim of this study is to investigate the effects of the HbA1c level and the duration of diabetes mellitus on the corneal endothelium morphology and to compare between healthy individuals and diabetes mellitus patients with non-proliferative diabetic retinopathy and proliferative diabetic retinopathy.

MATERIAL AND METHODS

Ninety patients who applied to the Health Sciences University Ulucanlar Eye Training and Research Hospital between January 2016 and January 2017 were included in this prospective randomized study. In the study, 45 diabetes mellitus patients and 45 healthy individuals were evaluated. The diabetes patients were compared in terms of HbA1c level, diabetes mellitus duration, corneal endothelial cell density, coefficient of variation, standard deviation, and hexagonality with healthy control group.

RESULTS

A statistically significant difference was found in the endothelial cell densitometer, coefficient of variation, and standard deviation measurements between the diabetes mellitus patients and the control (healthy) group. But, there was no statistically significant difference between 6A (hexagonality) and central corneal thickness measurements. There was a negative correlation between HbA1c levels and diabetes mellitus times and endothelial cell densitometer values in the patients with diabetes mellitus diagnosis and standard deviation values in the positive direction. There was a statistically significant difference between diabetes mellitus patients with the diagnosis of non-proliferative diabetic retinopathy and proliferative diabetic retinopathy in the endothelial cell densitometer and standard deviation values. But there was not any statistically significant difference between coefficient of variation, 6A, and central corneal thickness values.

CONCLUSION

The endothelial cell densitometer in diabetes mellitus patients with retinopathy is lower than that in healthy individuals. There is a negative correlation between retinopathy severity and corneal endothelial cell density. Diabetes affects negatively not only vascular tissues but also avascular cornea.

摘要

目的

本研究旨在探讨糖化血红蛋白(HbA1c)水平和糖尿病病程对角膜内皮形态的影响,并比较非增殖性糖尿病视网膜病变和增殖性糖尿病视网膜病变患者与健康个体之间的差异。

材料与方法

本前瞻性随机研究纳入了 2016 年 1 月至 2017 年 1 月期间向健康科学大学乌鲁卡尔眼科培训与研究医院就诊的 90 例患者。在该研究中,将 45 例糖尿病患者与 45 例健康个体进行了比较。比较了糖尿病患者的糖化血红蛋白(HbA1c)水平、糖尿病病程、角膜内皮细胞密度、变异系数、标准差和六边形性,并与健康对照组进行了比较。

结果

糖尿病患者与对照组(健康个体)之间的内皮细胞密度计、变异系数和标准差测量值存在统计学显著差异。但是,六边形性和中央角膜厚度测量值之间无统计学显著差异。在糖尿病患者中,HbA1c 水平与糖尿病病程呈负相关,与内皮细胞密度计值呈负相关,与标准差值呈正相关。在诊断为非增殖性糖尿病视网膜病变和增殖性糖尿病视网膜病变的糖尿病患者中,内皮细胞密度计和标准差值存在统计学显著差异。但是,变异系数、六边形性和中央角膜厚度值之间无统计学显著差异。

结论

患有视网膜病变的糖尿病患者的内皮细胞密度计值低于健康个体。视网膜病变的严重程度与角膜内皮细胞密度呈负相关。糖尿病不仅会对血管组织产生负面影响,还会对无血管的角膜产生影响。

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