临床眼科杂志2025，Vol.33Issue(4)：344-350,7.DOI:10.3969/j.issn.1006-8422.2025.04.011
2型糖尿病患者与正常人眼表参数差异与干眼患病风险预测
Differences in Ocular Surface Parameters between Type 2 Diabetes Patients and Healthy Individuals and Prediction of Dry Eye Disease Risk
摘要
Abstract
Objective To compare the differences in ocular surface parameters and meibomian gland function be-tween type 2 diabetes mellitus(T2DM)patients and healthy controls,and to explore risk factors and diagnostic references for dry eye in T2DM patients.Methods Prospective case-control study.They were randomly included in the First Affili-ated Hospital of Anhui Medical University from July to December 2024 randomly enrolling 47 T2DM patients and 39 healthy controls.Data on non-invasive tear film breakup time(NIBUT),tear meniscus height(TMH),Schirmer's test,eyelid lipid plug status,corneal fluorescein staining,meibomian gland loss,meibomian gland duct morphology scores,and ocular surface disease Index(OSDI)scores were collected.Participants were categorized into four groups based on dry eye diagnostic criteria:T2DM non-dry eye(n=16),T2DM dry eye(n=31),non-diabetes non-dry eye(n=20),and non-diabetes dry eye(n=19).Ocular surface parameters and meibomian gland differences among groups were compared.ROC curves were plotted to evaluate the predictive value of risk factors for dry eye in T2DM patients.Excluding subjects who were unable to collect tears,25 T2DM patients with dry eye and 19 non-diabetes with dry eye were included for tear insulin ELISA testing,comparing the differences in tear insulin levels and ocular surface parameters between T2DM patients with dry eye and non-diabetes with dry eye.Results Baseline data were well-matched.The T2DM dry eye group exhibited shorter first NIBUT and average NIBUT compared to the other three groups(all P<0.05).T2DM patients had significantly higher meibomian gland scores(Z=3.642,3.712,4.622,4.679,P<0.05)and higher proportions of gland duct bifurcation(χ2=8.691,8.069,11.088,10.272,P<0.0083)than healthy controls.The T2DM dry eye group showed a higher proportion of severe upper eyelid meibomian gland loss compared to both healthy non-dry eye and dry eye groups(χ2=16.767,19.815,P<0.0083).Logistic regression analysis indicated that gender was correlated with the prevalence of dry eye in patients with type 2 diabetes mellitus(T2DM).Combining upper eyelid meibomian gland loss,first NIBUT,sex and age achieved a sensitivity of 81.25%and specificity of 90.30%for predicting dry eye in T2DM patients.T2DM dry eye patients had lower tear insulin levels(Z=-2.109,P=0.035<0.05)and higher corneal fluorescein staining scores(Z=-2.605,P=0.009<0.05)than healthy dry eye patients.Conclusions T2DM patients exhibit a higher prevalence of dry eye with more severe meibomian gland dysfunction.Female sex is a risk factor for dry eye in T2DM.Combining first NIBUT,upper eyelid meibo-mian gland loss,sex,and age improves diagnostic accuracy and sensitivity for dry eye in T2DM patients.Moreover,cor-neal epithelial abnormalities and the tear insulin levels in T2DM with dry eye patients were lower in non-diabetes with dry eye patients.关键词
2型糖尿病/干眼/睑板腺功能障碍/ROC分析/胰岛素Key words
Type 2 Diabetes/Dry Eye Disease/Meibomian Gland Dysfunction/ROC analysis/Insulin引用本文复制引用
吴萌瑶,刘克军,朱冬升,杨娜娜,顾正宇..2型糖尿病患者与正常人眼表参数差异与干眼患病风险预测[J].临床眼科杂志,2025,33(4):344-350,7.基金项目
安徽医科大学基础-临床转化项目(2023xkjT041) （2023xkjT041）
安徽高校(自然)科学研究重点项目(KJ2021A0298) （自然）
