Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Pituitary Tumour Center of Excellence, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Transl Vis Sci Technol. 2024 Jul 1;13(7):20. doi: 10.1167/tvst.13.7.20.
To examine the effects of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) on choroidal structures with different blood glucose levels in patients with diabetes mellitus (DM) with acromegaly without diabetic retinopathy.
Eighty-eight eyes of 44 patients with acromegaly were divided into a nondiabetic group (23 patients, 46 eyes) and a diabetic group (21 patients, 42 eyes). Forty-four age- and sex-matched healthy controls and 21 patients with type 2 DM without diabetic retinopathy were also included. Linear regression models with a simple slope analysis were used to identify the correlation and interaction between endocrine parameters and choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascular index (CVI).
Our study revealed significant increases in the ChT, LA, SA, and TCA in patients with acromegaly compared with healthy controls, with no difference in the CVI. Comparatively, patients with DM with acromegaly had greater ChT than matched patients with type 2 DM, with no significant differences in other choroidal parameters. The enhancement of SA, LA and TCA caused by an acromegalic status disappeared in patients with diabetic status, whereas ChT and CVI were not affected by the interaction. In the diabetic acromegaly, higher IGF-1 (P = 0.006) and GH levels (P = 0.049), longer DM duration (P = 0.007), lower blood glucose (P = 0.001), and the interaction between GH and blood glucose were associated independently with thicker ChT. Higher GH levels (P = 0.016, 0.004 and 0.007), longer DM duration (P = 0.022, 0.013 and 0.013), lower blood glucose (P = 0.034, 0.011 and 0.01), and the interaction of IGF-1 and blood glucose were associated independently with larger SA, LA, and TCA. As blood glucose levels increased, the positive correlation between serum GH level and ChT diminished, and became insignificant when blood glucose was more than 7.35 mM/L. The associations between serum IGF-1 levels and LA, SA, and TCA became increasingly negative, with LA, becoming significantly and negatively associated to the GH levels only when blood glucose levels were more than 8.59 mM/L.
Acromegaly-related choroidal enhancements diminish in the presence of DM. In diabetic acromegaly, blood glucose levels are linked negatively with changes in choroidal metrics and their association with GH and IGF-1.
We revealed the potential beneficial impacts of IGF-1 and GH on structural measures of the choroid in patients with DM at relatively well-controlled blood glucose level, which could provide a potential treatment target for diabetic retinopathy.
研究肢端肥大症伴糖尿病患者血清生长激素（GH）和胰岛素样生长因子-1（IGF-1）水平对不同血糖水平下脉络膜结构的影响。
将 44 例肢端肥大症患者的 88 只眼分为非糖尿病组（23 例，46 只眼）和糖尿病组（21 例，42 只眼）。另纳入 44 名年龄和性别匹配的健康对照者和 21 例无糖尿病视网膜病变的 2 型糖尿病患者。采用简单斜率分析的线性回归模型，确定内分泌参数与脉络膜厚度（ChT）、总脉络膜面积（TCA）、管腔面积（LA）、基质面积（SA）和脉络膜血管指数（CVI）之间的相关性和交互作用。
与健康对照组相比，肢端肥大症患者的 ChT、LA、SA 和 TCA 均显著增加，而 CVI 无差异。相比之下，糖尿病合并肢端肥大症患者的 ChT 高于匹配的 2 型糖尿病患者，但其他脉络膜参数无显著差异。肢端肥大症状态下引起的 SA、LA 和 TCA 增加在糖尿病状态下消失，而 ChT 和 CVI 不受相互作用的影响。在糖尿病合并肢端肥大症中，较高的 IGF-1（P = 0.006）和 GH 水平（P = 0.049）、较长的糖尿病病程（P = 0.007）、较低的血糖（P = 0.001）以及 GH 和血糖之间的相互作用与较厚的 ChT 独立相关。较高的 GH 水平（P = 0.016、0.004 和 0.007）、较长的糖尿病病程（P = 0.022、0.013 和 0.013）、较低的血糖（P = 0.034、0.011 和 0.01）以及 IGF-1 和血糖的相互作用与较大的 SA、LA 和 TCA 独立相关。随着血糖水平的升高，血清 GH 水平与 ChT 之间的正相关减弱，当血糖超过 7.35 mM/L 时，相关性变得无统计学意义。血清 IGF-1 水平与 LA、SA 和 TCA 之间的相关性变得越来越负，只有当血糖水平超过 8.59 mM/L 时，LA 才与 GH 水平呈显著负相关。
肢端肥大症相关脉络膜增强在糖尿病存在时减弱。在糖尿病合并肢端肥大症中，血糖水平与脉络膜指标的变化呈负相关，与 GH 和 IGF-1 相关。
研究肢端肥大症伴糖尿病患者血清生长激素（GH）和胰岛素样生长因子-1（IGF-1）水平对不同血糖水平下脉络膜结构的影响。
将 44 例肢端肥大症患者的 88 只眼分为非糖尿病组（23 例，46 只眼）和糖尿病组（21 例，42 只眼）。另纳入 44 名年龄和性别匹配的健康对照者和 21 例无糖尿病视网膜病变的 2 型糖尿病患者。采用简单斜率分析的线性回归模型，确定内分泌参数与脉络膜厚度（ChT）、总脉络膜面积（TCA）、管腔面积（LA）、基质面积（SA）和脉络膜血管指数（CVI）之间的相关性和交互作用。
与健康对照组相比，肢端肥大症患者的 ChT、LA、SA 和 TCA 均显著增加，而 CVI 无差异。相比之下，糖尿病合并肢端肥大症患者的 ChT 高于匹配的 2 型糖尿病患者，但其他脉络膜参数无显著差异。肢端肥大症状态下引起的 SA、LA 和 TCA 增加在糖尿病状态下消失，而 ChT 和 CVI 不受相互作用的影响。在糖尿病合并肢端肥大症中，较高的 IGF-1（P = 0.006）和 GH 水平（P = 0.049）、较长的糖尿病病程（P = 0.007）、较低的血糖（P = 0.001）以及 GH 和血糖之间的相互作用与较厚的 ChT 独立相关。较高的 GH 水平（P = 0.016、0.004 和 0.007）、较长的糖尿病病程（P = 0.022、0.013 和 0.013）、较低的血糖（P = 0.034、0.011 和 0.01）以及 IGF-1 和血糖的相互作用与较大的 SA、LA 和 TCA 独立相关。随着血糖水平的升高，血清 GH 水平与 ChT 之间的正相关减弱，当血糖超过 7.35 mM/L 时，相关性变得无统计学意义。血清 IGF-1 水平与 LA、SA 和 TCA 之间的相关性变得越来越负，只有当血糖水平超过 8.59 mM/L 时，LA 才与 GH 水平呈显著负相关。
肢端肥大症相关脉络膜增强在糖尿病存在时减弱。在糖尿病合并肢端肥大症中，血糖水平与脉络膜指标的变化呈负相关，与 GH 和 IGF-1 相关。
