角膜神经纤维丧失可作为标志物，用以识别糖尿病对帕金森病的影响。

Corneal nerve fibre loss as a marker to identify the impact of diabetes on Parkinson's disease.

机构信息

Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China.

出版信息

Psychogeriatrics. 2024 Nov;24(6):1267-1274. doi: 10.1111/psyg.13187. Epub 2024 Aug 29.

DOI:10.1111/psyg.13187

PMID:39210676

Abstract

BACKGROUND

Patients with Parkinson's disease (PD) suffer from serious quality of life problems. Diabetes has been demonstrated as an independent risk element for PD, aggravating its severity and accelerating its progression. There are currently no suitable biomarkers to reveal the impact of diabetes on PD. The purpose of our research was to study the impact of diabetes on PD using corneal confocal microscopy (CCM), a non-invasive and objective test.

METHODS

Fourteen PD patients with diabetes (PD-DM), 60 PD patients without diabetes (PD-NDM), and 30 healthy controls (HC) were included in the study. The clinical symptoms of patients with PD were assessed using the Unified Parkinson's Disease Rating Scale-3 (UPDRS-3) and the Parkinson's Disease Autonomic Symptom Prognosis Scale (SCOPA-AUT). Participants underwent CCM to quantify the corneal nerve fibres.

RESULTS

Corneal nerve fibre density (CNFD) and corneal nerve fibre length (CNFL) in patients with PD were lower than HC. Furthermore, CNFD in PD-DM was lower than in PD-NDM (P < 0.01). We also assessed the relationship between CCM parameters and clinical scores. CNFL and Hamilton anxiety (HAMA) have a negative correlation (r = -0.261, P = 0.032), but this study did not observe a significant correlation between CCM parameters and SCOPA-AUT. Additionally, CNFD could distinguish PD-DM from PD-NDM, achieving an area under the curve of 75.06% (95% CI, 61.76%-88.36%).

CONCLUSIONS

The CCM could be served as an objective and sensitive biomarker to investigate the impact of diabetes in PD.

摘要

背景

帕金森病（PD）患者存在严重的生活质量问题。糖尿病已被证明是 PD 的独立危险因素，加重其严重程度并加速其进展。目前尚无合适的生物标志物来揭示糖尿病对 PD 的影响。我们的研究目的是使用角膜共焦显微镜（CCM）研究糖尿病对 PD 的影响，CCM 是一种非侵入性和客观的测试。

方法

本研究纳入了 14 名患有糖尿病的 PD 患者（PD-DM）、60 名无糖尿病的 PD 患者（PD-NDM）和 30 名健康对照者（HC）。使用统一帕金森病评定量表第 3 部分（UPDRS-3）和帕金森病自主神经症状预后量表（SCOPA-AUT）评估 PD 患者的临床症状。参与者接受 CCM 以量化角膜神经纤维。

结果

PD 患者的角膜神经纤维密度（CNFD）和角膜神经纤维长度（CNFL）低于 HC。此外，PD-DM 的 CNFD 低于 PD-NDM（P<0.01）。我们还评估了 CCM 参数与临床评分之间的关系。CNFL 与汉密尔顿焦虑量表（HAMA）呈负相关（r=-0.261，P=0.032），但本研究未观察到 CCM 参数与 SCOPA-AUT 之间存在显著相关性。此外，CNFD 可将 PD-DM 与 PD-NDM 区分开来，曲线下面积为 75.06%（95%CI，61.76%-88.36%）。