Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Program in Molecular Medicine, National Yang Ming University, Taipei, Taiwan.
Acta Diabetol. 2021 Jun;58(6):779-786. doi: 10.1007/s00592-020-01631-4. Epub 2021 Feb 15.
To compare the annual axial length (AL) changes in myopic children with type 1 diabetes mellitus (T1DM) and those without diabetes.
There are two groups of myopic children in this retrospective cohort study. Group 1 consisted of myopic children with T1DM (44 eyes of 22 patients). Group 2 comprised age-matched myopic children without diabetes (44 eyes of 22 children). These two groups were compared with regard to their baseline clinical characteristics. A generalized estimating equations (GEE) model was also used to determine the most likely factor that contributed to the results.
The average ages of group 1 and group 2 were 14.8 and 14.6 years, respectively. Children in group 1 had significantly slower annual AL changes (0.051 mm/year vs 0.103 mm/year; 50.5% slower, P = 0.011) and shorter baseline AL (23.97 vs 25.19 mm, P < 0.001) than those in group 2. GEE also showed that serum glycated hemoglobin (HbA1c) level (B = -0.023, P = 0.039) was the most important factor in reducing AL elongation in group 1 myopic children.
Long-term higher HbA1c level may reduce AL elongation. A strict blood sugar control strategy in clinical practice is warranted to axial myopia progression in T1DM children.
比较 1 型糖尿病(T1DM)和非糖尿病近视儿童的年度眼轴(AL)变化。
本回顾性队列研究纳入两组近视儿童。第 1 组为 T1DM 伴近视儿童(22 例患者 44 只眼),第 2 组为年龄匹配的非糖尿病伴近视儿童(22 例儿童 44 只眼)。比较两组的基线临床特征。还使用广义估计方程(GEE)模型来确定导致结果的最可能因素。
第 1 组和第 2 组的平均年龄分别为 14.8 岁和 14.6 岁。第 1 组儿童的年 AL 变化明显较慢(0.051mm/年比 0.103mm/年;慢 50.5%,P=0.011),基线 AL 较短(23.97mm 比 25.19mm,P<0.001)。GEE 还显示,血清糖化血红蛋白(HbA1c)水平(B=-0.023,P=0.039)是第 1 组近视儿童 AL 伸长减少的最重要因素。
长期较高的 HbA1c 水平可能会减缓 AL 伸长。在临床实践中,需要严格控制血糖的策略,以防止 T1DM 儿童的轴性近视进展。