ABSTRACT
Objective To investigate the relationship between corneal basal nerve change and type 2 diabetic retinopathy based on confocal laser microscopy.Methods Together 118 patients with type 2 diabetes (T2D) were collected in our hospital from February 2016 to February 2017,including 57 patients with diabetic retinopathy (DR group) and 61 patients without DR (NDR group).For comparison,60 healthy volunteers were selected as the control group.And all the subjects were examined by corneal confocal laser microscopy to analyze the relationship between the morphological parameters of the corneal nerve and clinical variables.Results Corneal nerve fiber density,corneal nerve branch density and corneal nerve branch length in DR group were (20.03 ±4.22) · mm-2,(22.01 ± 7.05) · mm-2 and (9.50 ± 1.76) mm ·mm-2,significantly less than those of the control group and NDR group (all P ＜ 0.05);and corneal nerve fiber curvature was (0.30 ± 0.03),significantly higher than that of the control group and NDR group (all P ＜ 0.05);In DR patients,phase Ⅲ patients had smaller the corneal nerve fiber density,corneal nerve branch density and corneal nerve branch length,but the larger corneal nerve fiber curvature than the phase Ⅰ and Ⅱ patients (all P ＜ 0.05);course of disease of DR group was (12.04 ± 2.48) years,which was significantly higher than that of NDR group (P ＜ 0.05),while fasting C peptide and fasting insulin were (1.41 ± 0.58) μg · L-1 and (20.05 ± 7.91) mU · L-1,respectively,significantly lower than those of NDR group (all P ＜ 0.05);The duration of T2D was negatively correlated with the corneal nerve branch density and corneal nerve branch length (r =-0.322,-0.317,all P ＜0.05);Fasting C peptide was positively correlated with the corneal nerve branch density (r =0.298,P ＜ 0.05),and negatively correlated with the corneal nerve curvature (r =-0.311,P ＜ 0.05).Conclusion Patients with T2D retinopathy have abnormal morphology of corneal nerve.And confocal laser scanning microscopy is conducive to the early detection of microvascular disease in T2D patients with a longer course of disease or a low level of fasting C peptide.
ABSTRACT
Objective To study the relationships between retinal microvascular disease and acute coronary event (ACE) among aged people. Methods A controlled study for senile people in communities was conducted. Xinglong Zhuang Coal Mine Community in Jining city, Shandong province was chosen to carry out the study, and the residents in that area aged≥60 years were asked to take questionnaire survey, physical and laboratory examinations. There were 139 cases met the diagnostic criteria of ACE being in the observation group, and 1 509 cases without ACE were assigned in the control group. The gender, age, smoking, alcohol intake, hypertension, diabetes mellitus, education, physical exercise, retinal microvascular disease, fasting blood-glucose, high density lipoprotein cholesterin (HDL-C), low density lipoprotein cholesterin (LDL-C), triacylglycerol (TG), systolic pressure, diastolic pressure, body mass index (BMI) were collected in the two groups to perform univariate analysis. Multivariate non-conditional logistic regression analysis was used for the factors with statistical significance to screen out the independent risk factors that could affect the occurrence of ACE. Results The univariate analysis showed:the risk factors that might cause the occurrence of ACE included age, gender, smoking, hypertension, diabetes mellitus, LDL-C, systolic pressure, diastolic pressure, BMI, and retinal microvascular disease (P<0.05 or P<0.01). In the ACE patients of observation group, the rates of presence of arteriovenous crossing sign [44.6%(62/139) vs. 27.8%(419/1 509)], hard exudates [9.4%(13/139) vs. 4.9%(74/1 509)] and cotton-wool patches [19.4%(27/139) vs. 7.3%(110/1 509)] in retinal microvascular disease were significantly higher than those in control group (P<0.05 or P<0.01). The logistic regression analysis showed:age [P=0.002, odds ratio (OR)=1.06, 95%confidence interval (95%CI)=1.04-1.09], smoking (P=0.032, OR=2.17, 95%CI=2.04-2.30), retinal microvascular disease (P = 0.010, OR = 2.33, 95%CI = 0.97 - 1.27), hypertension (P < 0.001, OR = 5.21, 95%CI=4.11-6.36), diabetes mellitus (P=0.021, OR=1.03, 95%CI=1.01-1.05) and LDL-C (P=0.020, OR=2.80, 95%CI = 2.65 - 2.99) were the independent risk factors for the occurrence of ACE. Conclusions Retinal microvascular disease is the independent risk factor for the occurrence of ACE. The retinal angiography can be a useful examination to forecast ACE.