Udom G J, Oritsemuelebi B, Frazzoli C, Bocca B, Ruggieri F, Orisakwe O E
Kampala International University, Ishaka, Uganda.
Federal University Oye-Ekiti, Oye-Ekiti, Nigeria.
Vestn Oftalmol. 2025;141(2):89-100. doi: 10.17116/oftalma202514102189.
To uncover the negative impacts of heavy metals on carbohydrate metabolism, their mechanisms and contributory factors, as well as their role on the etiopathogenesis, pathophysiology, and progression of eye diseases.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), various databases were searched (e.g., Scopus, PubMed, etc.) to collect evidence on the link and role of heavy metals in carbohydrate metabolism and pathogenesis of eye diseases. Included studies were appraised for quality using the Critical Appraisal Skills Programme checklists and extracted data were analyzed using the narrative synthesis method.
Of the 128 papers retrieved, 24 papers met the inclusion criteria. Heavy metals are associated with the onset and progression of diabetes and eye diseases secondary to diabetes (age-related macular degeneration, cataract, and diabetic retinopathy) majorly via toxic interference (induction, inhibition and/or deactivation) of glucose metabolizing enzymes and oxidative stress. The etiology of DR is intricate and includes the simultaneous disruption of several metabolic and signaling mechanisms within the retinal neurovascular unit. The retina is more susceptible to metal-induced toxicities due to the high affinity of heavy metals to melanin content of the retinal epithelium.
This study emphasizes the harmful effects of chronic and intermittent exposure to heavy metals, suggesting no safe exposure levels. To prevent eye diseases secondary to heavy metals-induced altered carbohydrate metabolism, metal chelators, low glycemic diets, and lifestyle modifications should be exploited among vulnerable populations.
揭示重金属对碳水化合物代谢的负面影响、其机制和促成因素，以及它们在眼部疾病的病因学、病理生理学和进展中的作用。
按照系统评价和荟萃分析的首选报告项目（PRISMA），检索了各种数据库（如Scopus、PubMed等），以收集关于重金属在碳水化合物代谢和眼部疾病发病机制中的联系和作用的证据。使用批判性评估技能计划清单对纳入的研究进行质量评估，并使用叙述性综合方法对提取的数据进行分析。
在检索到的128篇论文中，24篇符合纳入标准。重金属主要通过对葡萄糖代谢酶的毒性干扰（诱导、抑制和/或失活）和氧化应激，与糖尿病及糖尿病继发的眼部疾病（年龄相关性黄斑变性、白内障和糖尿病视网膜病变）的发生和进展相关。糖尿病视网膜病变的病因复杂，包括视网膜神经血管单元内几种代谢和信号传导机制的同时破坏。由于重金属对视网膜上皮黑色素含量的高亲和力，视网膜更容易受到金属诱导的毒性影响。
本研究强调了长期和间歇性接触重金属的有害影响，表明不存在安全接触水平。为预防重金属诱导的碳水化合物代谢改变继发的眼部疾病，应在易感人群中采用金属螯合剂、低血糖饮食和生活方式改变等措施。
