普通老年人群中的原发性开角型青光眼、眼压与糖尿病。鹿特丹研究。

Primary open-angle glaucoma, intraocular pressure, and diabetes mellitus in the general elderly population. The Rotterdam Study.

作者信息

Dielemans I, de Jong P T, Stolk R, Vingerling J R, Grobbee D E, Hofman A

机构信息

Institute of Ophthalmology, Erasmus University Medical School, Rotterdam, The Netherlands.

出版信息

Ophthalmology. 1996 Aug;103(8):1271-5. doi: 10.1016/s0161-6420(96)30511-3.

DOI:10.1016/s0161-6420(96)30511-3

PMID:8764798

Abstract

PURPOSE

To investigate the association of primary open-angle glaucoma and intraocular pressure (IOP) with newly diagnosed diabetes mellitus.

METHODS

Subjects participating in the Rotterdam Study (n = 4178; ages, 55 years and older) were examined according to standard protocols, including a medical history interview, perimetry, applanation tonometry, funduscopy, and a nonfasting glucose tolerance test. Glaucoma was defined by the presence of a glaucomatous visual field defect. A distinction was made between high-tension glaucoma and normal-tension glaucoma. The relation of glaucoma and IOP with newly diagnosed diabetes mellitus and blood glucose was analyzed using regression analysis.

RESULTS

The presence of diabetes mellitus was associated with an overall rise in mean IOP of both eyes of 0.31 mmHg (95% confidence interval, 0.12-0.50), and with a threefold increased presence of high-tension glaucoma (odds ratio, 3.11; 95% confidence interval, 1.12-8.66). A 10-mmol/l higher random serum glucose level was borderline significantly associated with a mean IOP that was, on average, 0.41 mmHg (95% confidence interval, -0.02-0.84) higher and with an odds ratio of 2.82 (95% confidence interval, 0.92-8.58) for high-tension glaucoma. A 10-mmol/l rise in serum glucose on a glucose tolerance test was associated with an overall rise of mean IOP of 0.59 mmHg (95% confidence interval, 0.26-0.92) and with an odds ratio of 1.88 (95% confidence interval, 0.81-4.32) for high-tension glaucoma.

CONCLUSION

Newly diagnosed diabetes mellitus and high levels of blood glucose are associated with elevated IOP and high-tension glaucoma.

摘要

目的

研究原发性开角型青光眼及眼压（IOP）与新诊断糖尿病之间的关联。

方法

按照标准方案对参与鹿特丹研究的受试者（n = 4178；年龄≥55岁）进行检查，包括病史访谈、视野检查、压平眼压测量、眼底镜检查以及非空腹葡萄糖耐量试验。青光眼通过青光眼性视野缺损来定义。区分了高眼压性青光眼和正常眼压性青光眼。使用回归分析来分析青光眼和眼压与新诊断糖尿病及血糖的关系。

结果

糖尿病的存在与双眼平均眼压总体升高0.31 mmHg（95%置信区间，0.12 - 0.50）相关，且与高眼压性青光眼的发生率增加三倍相关（比值比，3.11；95%置信区间，1.12 - 8.66）。随机血清葡萄糖水平每升高10 mmol/l与平均眼压平均升高0.41 mmHg（95%置信区间， - 0.02 - 0.84）及高眼压性青光眼的比值比为2.82（95%置信区间，0.92 - 8.58）临界显著相关。葡萄糖耐量试验中血清葡萄糖水平每升高10 mmol/l与平均眼压总体升高0.59 mmHg（95%置信区间，0.26 - 0.92）及高眼压性青光眼的比值比为1.88（95%置信区间，0.81 - 4.32）相关。