Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan.
Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan.
Sci Rep. 2020 Apr 30;10(1):7388. doi: 10.1038/s41598-020-64489-0.
This nationwide, retrospective, matched cohort study was designed to investigate the risk of corneal ulcer in patients with diabetes mellitus (DM). It included 238,701 patients with DM, recruited between 2003 and 2005 from the Longitudinal Cohort of Diabetes Patients database. The control group included the same number of age- and sex-matched non-DM patients selected from the Taiwan Longitudinal Health Insurance Database, 2000. The data of each patient were collected from the index date until December 2013. The incidence of corneal ulcer was compared between the two groups. In total, 2,549 patients with DM and 1,988 controls developed corneal ulcer during the follow-up period, resulting in an incidence rate for corneal ulcers that was 1.27 times (95% confidence interval [CI] = 1.20-1.35; P < 0.001) higher in patients with DM than in controls. After adjustment for potential confounders, including hyperlipidemia, hypertension, congestive heart failure, coronary artery disease, and chronic renal disease, patients with DM were 1.31 times (95% CI, 1.24-1.40; P < 0.05) more likely than the cohort to develop corneal ulcers. In conclusion, this study shows that DM increases the risk of corneal ulcer. Therefore, close collaboration between ophthalmologists and endocrinologists is important to ensure timely ophthalmology visits.
本全国性、回顾性、匹配队列研究旨在探讨糖尿病（DM）患者发生角膜溃疡的风险。研究纳入了 2003 年至 2005 年期间从糖尿病患者纵向队列数据库中招募的 238701 例 DM 患者。对照组为从台湾纵向健康保险数据库中按年龄和性别匹配的相同数量的非 DM 患者，时间为 2000 年。每位患者的数据均从索引日期收集至 2013 年 12 月。比较两组角膜溃疡的发生率。在随访期间，2549 例 DM 患者和 1988 例对照者发生了角膜溃疡，导致 DM 患者的角膜溃疡发生率是对照组的 1.27 倍（95%置信区间[CI] = 1.20-1.35；P<0.001）。在调整潜在混杂因素（包括高血脂、高血压、充血性心力衰竭、冠心病和慢性肾病）后，DM 患者发生角膜溃疡的风险是对照组的 1.31 倍（95%CI，1.24-1.40；P<0.05）。总之，本研究表明 DM 增加了角膜溃疡的风险。因此，眼科医生和内分泌科医生密切合作以确保及时进行眼科就诊非常重要。
