Britten-Jones Alexis Ceecee, Wu Mengliang, Roberts Leslie J, MacIsaac Richard J, Jiao Haihan, Craig Jennifer P, Chinnery Holly R, Downie Laura E
Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia.
Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, VIC, Australia; Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, Australia.
Ocul Surf. 2024 Oct;34:309-316. doi: 10.1016/j.jtos.2024.08.011. Epub 2024 Aug 15.
To investigate tear neuropeptide Y (NPY) and substance P concentrations in individuals with type 1 diabetes, comparing those with and without both diabetic retinopathy (DR) and peripheral neuropathy.
This cross-sectional study involved 41 participants with type 1 diabetes and none to moderate DR, and 22 healthy controls. Assessments included clinical ocular surface parameters, quantification of corneal nerve attributes (based on in vivo confocal microscopy imaging), DR grading, and evaluation for small and large fibre neuropathy. Concentrations of NPY and substance P in tear samples were measured using enzyme-linked immunosorbent assay.
Mean (± standard deviation) tear NPY concentrations in participants with type 1 diabetes and length-dependent small fibre neuropathy (SFN) was lower than in controls (10.84 ± 4.10 ng/mL vs 14.72 ± 3.12 ng/mL; p=0.004), but not significantly different from type 1 diabetes participants without SFN (13.39 ± 4.66 ng/mL; p=0.11). Tear NPY levels were lower in individuals with type 1 diabetes and mild/moderate non-proliferative DR (10.44 ± 3.46 ng/mL) compared to none/minimal DR (13.79 ± 4.76 ng/mL; p=0.0005) and controls. In separate linear regression models, both the presence of SFN (β = -0.75, p=0.02) and the presence of mild/moderate DR (β = -0.84, p=0.009) were significantly associated with tear NPY levels relative to controls, after adjusting for participant age, sex, and dry eye disease. There were no inter-group differences for tear substance P concentrations.
Tear NPY has potential utility as an indicator of peripheral microvascular complications associated with type 1 diabetes.
研究1型糖尿病患者泪液中神经肽Y（NPY）和P物质的浓度，比较有无糖尿病视网膜病变（DR）和周围神经病变的患者。
这项横断面研究纳入了41例1型糖尿病且无至中度DR的参与者以及22名健康对照者。评估内容包括临床眼表参数、角膜神经属性定量（基于体内共聚焦显微镜成像）、DR分级以及小纤维和大纤维神经病变评估。采用酶联免疫吸附测定法测量泪液样本中NPY和P物质的浓度。
1型糖尿病合并长度依赖性小纤维神经病变（SFN）的参与者泪液NPY平均（±标准差）浓度低于对照组（10.84±4.10 ng/mL对14.72±3.12 ng/mL；p = 0.004），但与无SFN的1型糖尿病参与者相比无显著差异（13.39±4.66 ng/mL；p = 0.11）。与无/轻度DR者（13.79±4.76 ng/mL；p = 0.0005）及对照组相比，1型糖尿病合并轻度/中度非增殖性DR者的泪液NPY水平较低（10.44±3.46 ng/mL）。在单独的线性回归模型中，调整参与者年龄、性别和干眼疾病后，SFN的存在（β = -0.75，p = 0.02）和轻度/中度DR的存在（β = -0.84，p = 0.009）均与相对于对照组的泪液NPY水平显著相关。泪液P物质浓度在组间无差异。
泪液NPY有可能作为1型糖尿病相关周围微血管并发症的指标。
