Corneal Characteristics of Mongolian Population with Type 2 Diabetic Peripheral Neuropathy in Inner Mongolia, China: an Assessment Using Corneal Confocal Microscopy

Overview

Journal BMC Ophthalmol

Publisher Biomed Central

Specialty Ophthalmology

Date 2023 Nov 16

PMID 37968622

Authors

Chi Zhang

Lei Zhu

Xiuwen Liang

Yue Li

Guotong Sun

Ji Hu

Honghong Zhang

Affiliations

Soon will be listed here.

Abstract

Objective: To quantify corneal nerve fiber parameters in a Mongolian population with diabetic peripheral neuropathy (DPN) by corneal confocal microscopy.

Methods: This study conducted a comprehensive evaluation of 114 participants from Hulunbuir between January 2020 and December 2021. The participants included healthy controls, Mongolian and Han patients with type 2 diabetes mellitus. Demographic, medical, and laboratory data were collected, and neuropathy was evaluated by confocal corneal microscopy. And compare various parameters between Han and Mongolian were performed using SPSS software.

Results: The average waist circumference of Mongolian diabetic patients was larger than that of Han diabetic patients (P < 0.05). The mean HbA1c of Mongolian was 9.30 (8.15, 10.30) %, and that of Han was 8.30 (7.20, 9.40) % (P = 0.023). The average values of Corneal Nerve Fiber Density (CNFD), Corneal Nerve Fiber Length (CNFL) and corneal nerve branch density (CNBD) in Mongolian diabetic patients were significantly lower than those in Han diabetic patients (P < 0.05). The correlation coefficient between CNFL and age was - 0.368. ROC results show that CNBD has a certain diagnostic value for DPN in Mongolian patients with type 2 diabetes and the optimal cut-off point value is 24.99(no./mm), the sensitivity is 80.0%, and the specificity is 77.8%.

Conclusion: The corneal confocal microscopy could possibly represent a promising adjuvant technique for the early diagnosis and assessment of PDN in Mongolian T2DM patients.

References

Cao J, Qu J, Odilov B, Lu B, Zhang Y, Li L . Corneal Nerve Parameter Reference Values for Chinese Adults Assessed by Corneal Confocal Microscopy. J Diabetes Res. 2022; 2022:4913031. PMC: 8898861. DOI: 10.1155/2022/4913031. View

Chen W, Wu X, Li S, Zhang Y, Huang Y, Zhuang Y . Optical coherence tomography of the retina combined with color Doppler ultrasound of the tibial nerve in the diagnosis of diabetic peripheral neuropathy. Front Endocrinol (Lausanne). 2022; 13:938659. PMC: 9634106. DOI: 10.3389/fendo.2022.938659. View

Utami D, Findyartini A . Plant-based Diet for HbA1c Reduction in Type 2 Diabetes Mellitus: an Evidence-based Case Report. Acta Med Indones. 2018; 50(3):260-267. View

Ferdousi M, Kalteniece A, Azmi S, Petropoulos I, Ponirakis G, Alam U . Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study. Diabetes Care. 2020; 44(1):150-156. PMC: 7783929. DOI: 10.2337/dc20-1482. View

Cosmo E, Midena G, Frizziero L, Bruno M, Cecere M, Midena E . Corneal Confocal Microscopy as a Quantitative Imaging Biomarker of Diabetic Peripheral Neuropathy: A Review. J Clin Med. 2022; 11(17). PMC: 9457345. DOI: 10.3390/jcm11175130. View

Wang M, Ma J, Pan L, Chen T, Wang H, Wang Y . Prevalence of and risk factors for refractive error: a cross-sectional study in Han and Mongolian adults aged 40-80 years in Inner Mongolia, China. Eye (Lond). 2019; 33(11):1722-1732. PMC: 7002754. DOI: 10.1038/s41433-019-0469-0. View

Asghar O, Petropoulos I, Alam U, Jones W, Jeziorska M, Marshall A . Corneal confocal microscopy detects neuropathy in subjects with impaired glucose tolerance. Diabetes Care. 2014; 37(9):2643-6. PMC: 4140158. DOI: 10.2337/dc14-0279. View

Volmer-Thole M, Lobmann R . Neuropathy and Diabetic Foot Syndrome. Int J Mol Sci. 2016; 17(6). PMC: 4926450. DOI: 10.3390/ijms17060917. View

Petropoulos I, Manzoor T, Morgan P, Fadavi H, Asghar O, Alam U . Repeatability of in vivo corneal confocal microscopy to quantify corneal nerve morphology. Cornea. 2012; 32(5):e83-9. DOI: 10.1097/ICO.0b013e3182749419. View

10.

Watson J, Dyck P . Peripheral Neuropathy: A Practical Approach to Diagnosis and Symptom Management. Mayo Clin Proc. 2015; 90(7):940-51. DOI: 10.1016/j.mayocp.2015.05.004. View

11.

Goossens G . The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes Facts. 2017; 10(3):207-215. PMC: 5644968. DOI: 10.1159/000471488. View

12.

Nitoda E, Kallinikos P, Pallikaris A, Moschandrea J, Amoiridis G, Ganotakis E . Correlation of diabetic retinopathy and corneal neuropathy using confocal microscopy. Curr Eye Res. 2012; 37(10):898-906. DOI: 10.3109/02713683.2012.683507. View

13.

Li G, Wang H, Wang K, Wang W, Dong F, Qian Y . Prevalence, awareness, treatment, control and risk factors related to hypertension among urban adults in Inner Mongolia 2014: differences between Mongolian and Han populations. BMC Public Health. 2016; 16:294. PMC: 4818445. DOI: 10.1186/s12889-016-2965-5. View

14.

Tavakoli M, Ferdousi M, Petropoulos I, Morris J, Pritchard N, Zhivov A . Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set. Diabetes Care. 2015; 38(5):838-43. PMC: 4407754. DOI: 10.2337/dc14-2311. View

15.

Wu W, Xie Z, Zhang Q, Ma Y, Bi X, Yang X . Hyperoside Ameliorates Diabetic Retinopathy Anti-Oxidation, Inhibiting Cell Damage and Apoptosis Induced by High Glucose. Front Pharmacol. 2020; 11:797. PMC: 7273924. DOI: 10.3389/fphar.2020.00797. View

16.

Zhang H, Han X, Wang M, Hu Q, Li S, Wang M . The Association between Genomic DNA Methylation and Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus. J Diabetes Res. 2019; 2019:2494057. PMC: 6875377. DOI: 10.1155/2019/2494057. View

17.

Smith A, Russell J, Feldman E, Goldstein J, Peltier A, Smith S . Lifestyle intervention for pre-diabetic neuropathy. Diabetes Care. 2006; 29(6):1294-9. DOI: 10.2337/dc06-0224. View

18.

Gasparotti R, Padua L, Briani C, Lauria G . New technologies for the assessment of neuropathies. Nat Rev Neurol. 2017; 13(4):203-216. DOI: 10.1038/nrneurol.2017.31. View

19.

Bai H, Liu H, Suyalatu S, Guo X, Chu S, Chen Y . Association Analysis of Genetic Variants with Type 2 Diabetes in a Mongolian Population in China. J Diabetes Res. 2015; 2015:613236. PMC: 4531200. DOI: 10.1155/2015/613236. View

20.

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan B . IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021; 183:109119. PMC: 11057359. DOI: 10.1016/j.diabres.2021.109119. View