糖尿病性白内障患者白内障超声乳化术后氧化应激水平与角膜内皮细胞丢失的关系

Relationship Between Postoperative Oxidative Stress Levels and Corneal Endothelial Cell Loss After Phacoemulsification in Diabetic Patients with Cataract.

作者信息

Gao Yuan, Yang Ning, Wei LiJuan, Yan YiJie, Li Lei

机构信息

Department of Ophthalmology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou City, Hainan Province, 570311, People's Republic of China.

出版信息

Clin Ophthalmol. 2024 Dec 25;18:3957-3965. doi: 10.2147/OPTH.S497133. eCollection 2024.

DOI:10.2147/OPTH.S497133

PMID:39734598

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11682677/

Abstract

OBJECTIVE

To investigate the relationship between postoperative oxidative stress and corneal endothelial cell loss in diabetic patients with cataract.

METHODS

One hundred and twenty patients who underwent phacoemulsification were selected, including 80 diabetic patients with cataract and 40 patients with ordinary cataracts. Corneal endothelial cell loss was recorded, and the endothelial cell density (ECD), the proportion of hexagonal cells, and the corneal thickness within the central corneal area were compared. According to the severity of endothelial cell loss, the diabetic patients with cataract were divided into a general loss group (n = 37) and a serious loss group (n = 43), and the postoperative serum superoxide dismutase (SOD), malonaldehyde (MDA), and glutathione peroxidase (GSH-Px) were measured. The relationship between oxidative stress factors and corneal endothelial cell loss in diabetic patients with cataract was analyzed, and the predictive value of MDA, SOD, and GSH-Px was investigated by using receiver operating characteristic (ROC) curve.

RESULTS

Diabetic patients with cataract had higher serum MDA and lower SOD and GSH-px, and higher fasting blood glucose concentration, glycosylated hemoglobin level, and low-density lipoprotein cholesterol ( < 0.05). The mean change in ECD in diabetic patients with cataract was 10.95%, which was greater than the 6.11% in non-diabetic patients with cataract ( < 0.05), and the proportion of hexagonal cells decreased and corneal thickness increased. MDA levels was negatively correlated with corneal endothelial cell loss in diabetic patients with cataract ( = 0.509), and SOD and GSH-px were negatively correlated ( = -0.361, = -0.482). The area under the ROC curve of MDA, SOD, and GSH-px in corneal endothelial cell loss was 0.719, 0.773, and 0.752, respectively.

CONCLUSION

The degree of postoperative corneal endothelial cell loss in diabetic patients with cataract was greater and positively correlated with MDA, and negatively correlated with SOD and GSH-px.

摘要

目的

探讨糖尿病性白内障患者术后氧化应激与角膜内皮细胞丢失之间的关系。

方法

选取120例行超声乳化白内障吸除术的患者，其中糖尿病性白内障患者80例，普通白内障患者40例。记录角膜内皮细胞丢失情况，比较两组患者的内皮细胞密度（ECD）、六角形细胞比例及中央角膜区角膜厚度。根据角膜内皮细胞丢失的严重程度，将糖尿病性白内障患者分为一般丢失组（n = 37）和严重丢失组（n = 43），检测术后血清超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽过氧化物酶（GSH-Px）水平。分析糖尿病性白内障患者氧化应激因子与角膜内皮细胞丢失的关系，并采用受试者工作特征（ROC）曲线研究MDA、SOD和GSH-Px的预测价值。

结果

糖尿病性白内障患者血清MDA水平较高，SOD和GSH-px水平较低，空腹血糖浓度、糖化血红蛋白水平及低密度脂蛋白胆固醇水平也较高（P < 0.05）。糖尿病性白内障患者ECD的平均变化为10.95%，大于非糖尿病性白内障患者的6.11%（P < 0.05），六角形细胞比例降低，角膜厚度增加。糖尿病性白内障患者MDA水平与角膜内皮细胞丢失呈负相关（r = 0.509），SOD和GSH-px与角膜内皮细胞丢失呈负相关（r = -0.361，r = -0.482）。MDA、SOD和GSH-px在角膜内皮细胞丢失中的ROC曲线下面积分别为0.719、0.773和0.752。