Koefoed Theil P, Hansen T, Larsen M, Pedersen O, Lund-Andersen H
Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Denmark.
Diabetologia. 1996 Dec;39(12):1524-7. doi: 10.1007/s001250050608.
Lens and cornea autofluorescence has been shown to be increased in patients with insulin-dependent diabetes mellitus and to be positively correlated to glycaemic control and duration of diabetes. We have studied lens and cornea autofluorescence at the clinical onset of non-insulin-dependent diabetes mellitus (NIDDM), in comparison with age-matched subjects with normal glucose tolerance. Fourteen subjects with NIDDM diagnosed less than 6 months prior to the examination were characterised by ocular fluorometry, glycosylated hemoglobin A1c, plasma lipid status, arterial blood pressure, and an oral glucose tolerance test (OGTT). Eleven age- and gender-matched healthy subjects without a family history of diabetes and with a normal glucose tolerance underwent the same examinations. In 11 of the 14 diabetic patients lens autofluorescence was increased to levels higher than the age-related mean + 2SD of healthy subjects. For the entire study population, control and diabetic subjects, lens fluorescence was positively correlated with HbA1c (p < 0.0001, r = 0.73), fasting plasma glucose (p = 0.002, r = 0.60) and the plasma glucose level 2 h after an OGTT (p = 0.004, r = 0.55). Cornea autofluorescence was also significantly increased in the group of newly diagnosed NIDDM patients, but only 9 patients had values above the mean + 2SD of the healthy subjects. NIDDM could be detected by ocular fluorometry with a sensitivity of 79% and a specificity of 100%. We conclude that lens and cornea autofluorescence is abnormally increased in the majority of patients with newly diagnosed NIDDM. The sensitivity and specificity of the method indicate that lens fluorometry may potentially be useful for screening for undiagnosed NIDDM in the general population. Additionally, we propose that the method may be a clinically useful indicator of cumulative glycaemia and risk of development of secondary complications in patients with diabetes.
胰岛素依赖型糖尿病患者的晶状体和角膜自体荧光已被证实有所增加，且与血糖控制及糖尿病病程呈正相关。我们研究了非胰岛素依赖型糖尿病（NIDDM）临床发病时的晶状体和角膜自体荧光，并与年龄匹配的糖耐量正常受试者进行了比较。对14名在检查前不到6个月被诊断为NIDDM的受试者进行了眼部荧光测定、糖化血红蛋白A1c、血浆脂质状况、动脉血压及口服葡萄糖耐量试验（OGTT）。11名年龄和性别匹配、无糖尿病家族史且糖耐量正常的健康受试者接受了相同检查。14名糖尿病患者中有11名的晶状体自体荧光增加至高于健康受试者年龄相关平均值+2SD的水平。对于整个研究人群，包括对照组和糖尿病组受试者，晶状体荧光与糖化血红蛋白A1c（p<0.0001，r = 0.73）、空腹血糖（p = 0.002，r = 0.60）以及OGTT后2小时的血浆葡萄糖水平（p = 0.004，r = 0.55）呈正相关。新诊断的NIDDM患者组的角膜自体荧光也显著增加，但只有9名患者的值高于健康受试者的平均值+2SD。通过眼部荧光测定法检测NIDDM的敏感性为79%，特异性为100%。我们得出结论，大多数新诊断的NIDDM患者的晶状体和角膜自体荧光异常增加。该方法的敏感性和特异性表明，晶状体荧光测定法可能对普通人群中未诊断的NIDDM筛查有潜在用途。此外，我们提出该方法可能是糖尿病患者累积血糖水平及继发并发症发生风险的临床有用指标。
