系统 ω-3 多不饱和脂肪酸水平与角膜神经结构和功能的关系。
Association between systemic omega-3 polyunsaturated fatty acid levels, and corneal nerve structure and function.
机构信息
Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.
Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
出版信息
Eye (Lond). 2023 Jun;37(9):1866-1873. doi: 10.1038/s41433-022-02259-0. Epub 2022 Sep 26.
BACKGROUND
Omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have anti-inflammatory and neuroprotective properties. This study sought to determine the relationship between corneal parameters and systemic omega-3 fatty acid levels.
METHODS
Forty-seven participants with no/mild peripheral neuropathy (26 with diabetes and 21 without) underwent comprehensive ocular surface and systemic PUFA assessments. Corneal anatomical parameters were assessed using in vivo confocal microscopy. Corneal sensitivity was measured using non-contact esthesiometry. Relationships between systemic PUFA levels and corneal parameters were evaluated with multiple linear regression, adjusted for age, sex, neuropathy symptom score, and presence of diabetes and dry eye disease. The relationship between corneal nerve fibre length (CNFL) and corneal sensitivity threshold was evaluated.
RESULTS
The median Omega-3 Index, a measure of erythrocyte EPA and DHA, was 5.21% (interquartile range: 4.44-5.94%) in the study population. Mean ( ± SD) CNFL was 13.53 ± 3.37 mm/mm. Multiple linear regression showed that Omega-3 Index (β = 0.33; p = 0.02), age (β = -0.46; p = 0.001) and diabetes (β = -0.30; p = 0.03) were independently associated with CNFL (R = 0.39, p = 0.002). In a separate model, DHA (β = 0.32; p = 0.027) and age (β = -0.41; p = 0.003) were associated with CNFL (R = 0.37, p = 0.003). Neither systemic EPA nor omega-6 fatty acid levels correlated with CNFL. There was no association between PUFA levels and corneal sensitivity or corneal immune cell density. A negative correlation was found between CNFL and corneal sensation thresholds to a cooled stimulus in diabetes participants, in the central (ρ = -0.50; p = 0.009) and peripheral (ρ = -0.50; p = 0.01) cornea.
CONCLUSIONS
A positive relationship between the systemic Omega-3 Index and corneal nerve parameters suggests omega-3 PUFA intake may influence corneal nerve architecture.
背景
ω-3 多不饱和脂肪酸（PUFA），二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）具有抗炎和神经保护作用。本研究旨在确定角膜参数与系统 ω-3 脂肪酸水平之间的关系。
方法
47 名无/轻度周围神经病变的参与者（糖尿病 26 名，非糖尿病 21 名）接受了全面的眼表和系统 PUFA 评估。使用活体共焦显微镜评估角膜解剖参数。使用非接触式触觉计测量角膜敏感性。使用多元线性回归评估系统 PUFA 水平与角膜参数之间的关系，调整年龄、性别、神经病症状评分以及糖尿病和干眼症的存在。评估角膜神经纤维长度（CNFL）与角膜感觉阈值之间的关系。
结果
研究人群的红细胞 EPA 和 DHA 测量的ω-3 指数中位数为 5.21%（四分位距：4.44-5.94%）。平均（ ± 标准差）CNFL 为 13.53 ± 3.37 mm/mm。多元线性回归显示，ω-3 指数（β = 0.33；p = 0.02）、年龄（β = -0.46；p = 0.001）和糖尿病（β = -0.30；p = 0.03）与 CNFL 独立相关（R = 0.39，p = 0.002）。在另一个模型中，DHA（β = 0.32；p = 0.027）和年龄（β = -0.41；p = 0.003）与 CNFL 相关（R = 0.37，p = 0.003）。系统 EPA 或 ω-6 脂肪酸水平与 CNFL 均无相关性。PUFA 水平与角膜敏感性或角膜免疫细胞密度之间无关联。在糖尿病参与者中，CNFL 与冷刺激角膜感觉阈值之间存在负相关，在中央（ρ = -0.50；p = 0.009）和周边（ρ = -0.50；p = 0.01）角膜。
结论
系统 ω-3 指数与角膜神经参数之间的正相关关系表明 ω-3 PUFA 摄入可能影响角膜神经结构。
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