糖尿病患者的临床眼表面特征和 MUC5AC 的表达：一项基于人群的研究。
Clinical ocular surface characteristics and expression of MUC5AC in diabetics: a population-based study.
机构信息
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
出版信息
Eye (Lond). 2024 Nov;38(16):3145-3152. doi: 10.1038/s41433-024-03252-5. Epub 2024 Jul 28.
OBJECTIVES
To investigate the clinical characteristics and the expression of mucin 5AC (MUC5AC) in in diabetic and non-diabetic subjects with or without dry eye disease.
METHODS
A total of 399 participants (796 eyes) aged 50-80 years were enrolled in this study. Participants were divided into 4 groups: non-diabetic without dry eye group (normal group), non-diabetic with dry eye group, diabetic without dry eye group and diabetic with dry eye group. Demographic information, fasting plasma glucose (FBG), and glycated haemoglobin A1C (HbA1C) data were collected. Additionally, ocular surface disease index (OSDI) questionnaire, signs of dry eye, tear osmolarity, and meibomian glands were evaluated. Tear MUC5AC expression and conjunctival goblet cells density (GCD) were tested.
RESULTS
Compared with non-diabetic with dry eye group, diabetic with dry eye group showed significantly lower tear film osmolarity (TFO), but higher corneal fluorescein and conjunctival lissamine green staining scores. In comparison with diabetic without dry eye group, diabetic with dry eye group showed significantly higher TFO, corneal fluorescein and conjunctival lissamine green staining scorers. The MUC5AC concentration and GCD of diabetic with dry eye group was significantly lower than those of the non-diabetic with dry eye group. Diabetic subjects with higher HbA1c levels (≥7.8%) showed higher TFO and shorter fluorescein tear break time.
CONCLUSION
Diabetics with dry eye exhibited notably higher corneal fluorescein and conjunctival lissamine green staining scores. Conjunctival goblet cells and MUC5AC were significantly reduced in diabetics. Higher TFO was associated with the duration of diabetes and HbA1c levels.
目的
研究糖尿病和非糖尿病患者中伴有和不伴有干眼的临床特征以及黏蛋白 5AC（MUC5AC）的表达。
方法
本研究共纳入 399 名 50-80 岁的参与者（796 只眼）。参与者分为 4 组：非糖尿病无干眼组（正常组）、非糖尿病干眼组、糖尿病无干眼组和糖尿病干眼组。收集人口统计学信息、空腹血糖（FBG）和糖化血红蛋白 A1C（HbA1C）数据。此外，评估眼表疾病指数（OSDI）问卷、干眼体征、泪液渗透压和睑板腺。测试泪液 MUC5AC 表达和结膜杯状细胞密度（GCD）。
结果
与非糖尿病干眼组相比，糖尿病干眼组的泪膜渗透压（TFO）明显降低，但角膜荧光素和结膜丽丝胺绿染色评分较高。与糖尿病无干眼组相比，糖尿病干眼组的 TFO、角膜荧光素和结膜丽丝胺绿染色评分明显较高。糖尿病干眼组的 MUC5AC 浓度和 GCD 明显低于非糖尿病干眼组。HbA1c 水平较高（≥7.8%）的糖尿病患者的 TFO 更高，泪膜破裂时间更短。
结论
糖尿病合并干眼患者的角膜荧光素和结膜丽丝胺绿染色评分明显升高。糖尿病患者的结膜杯状细胞和 MUC5AC 明显减少。较高的 TFO与糖尿病病程和 HbA1c 水平有关。
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