Evaluation of The Relation Between Glaucoma Parameters and Haemoglobin A1c in Patients with Primary Open Angle Glaucoma and Diabetes Mellitus
Öz
Aim: To evaluate the relationship between haemoglobin A1c (HbA1c) levels and glaucoma parameters. Materials and methods: Fasting blood glucose (FBG), postprandial blood glucose (PBG) and HbA1c levels of patients with Primary Open Angle Glaucoma (POAG), within 3 months of ophthalmic examination were recorded. Patients were classified into two groups according to the HbA1c levels and the parameters of the right eyes of each were included. Parameters of 37 patients with a level of HbA1c≤ 6% (Group 1) were compared with 43 patients with a level of HbA1c> 6% (Group 2). Best corrected visual acuity, (intraorbital pressure (IOP), cup/disc (c/d) ratio, retinal nerve fiber layer (RNFL) thickness and mean deviation (MD) score of visual field test were recorded. Results: There were no statistically significant difference between the groups in terms of age and gender (p=0.757, p=0.422; respectively). Although FBG was not significantly different between the groups, PBG was significantly higher in the Group 2 (p=0.097, p=0.015; respectively). No significant differences were detected for the mean IOP, c/d ratio, RNFL and MD scores between the groups (p=0.601, p=0.092, p=0.809, p=0.325; respectively). Significant positive correlation was detected between FBG, PBG and HbA1c levels (r=0.335, p=0.002; r=0.560, p=0.016; respectively). Conclusion: No significant relation was detected between HbA1c levels and IOP, c/d ratio, RNFL and MD parameters related to glaucoma in our study. Although it is a risk factor for glaucoma occurrence, no effect of diabetes on glaucoma progression was seen.
Anahtar Kelimeler
Kaynakça
- Referans1.Gupta D, Chen PP. Glaucoma. Am Fam Physician. 2016; 93:668-74.
- Referans2.Nakazawa T, Fukuchi T. What is glaucomatous optic neuropathy? Jpn J Ophthalmol. 2020;64:243-9.
- Referans3.Grzybowski A, Och M, Kanclerz P, Leffler C, Moraes CG. Primary open angle glaucoma and vascular risk factors: A review of population based studies from 1990 to 2019. J Clin Med. 2020;9:761. Referans4.Lee E, Harris A, Siesky B, Schaab T, McIntyre N, Tobe LA et al. The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes. Eur J Ophthalmol. 2014;24:542-9. Referans5.Song BJ, Aiello LP, Pasquale LR. Presence and risk factors for glaucoma in patients with diabetes. Curr Diab Rep. 2016;16:124.
- Referans6.Zhao D, Cho J, Kim MH, Friedman D, Guallar E. Diabetes, glucose metabolism, and glaucoma: the 2005-2008 National Health and Nutrition Examination Survey. PLoS One. 2014;9:e112460.
- Referans7.Oshitari T, Fujimoto N, Hanawa K, Adachi-Usami E, Roy S. Effect of chronic hyperglycemia on intraocular pressure in patients with diabetes. Am J Ophthalmol. 2007;143:363-5.
- Referans8.Matsuoka M, Ogata N, Matsuyama K, Yoshikawa T, Takahashi K. Intraocular pressure in Japanese diabetic patients. Clin Ophthalmol. 2012;6:1005-9.
- Referans9.Nucci C, Martucci A, Giannini C, Morrone LA, Bagetta G, Mancino R. Neuroprotective agents in the management of glaucoma. Eye (Lond). 2018;32:938-45.
- Referans10.Akkaya S, Can E, Öztürk F. Comparison of optic nerve head topographic parameters in patients with primary open-angle glaucoma with and without diabetes mellitus. J Glaucoma. 2016;25:49-53.
- Referans11.Hammes HP, Federoff HJ, Brownlee M. Nerve growth factor prevents both neuroretinal programmed cell death and capillary pathology in experimental diabetes. Mol Med. 1995;1:527-34.
- Referans12.Abu-El-Asrar AM, Dralands L, Missotten L, Al-Jadaan IA, Geboes K. Expression of apoptosis markers in the retinas of human subjects with diabetes. Invest Ophthalmol Vis Sci. 2004;45:2760-6.
- Referans13.Matsuoka M, Ogata N, Matsuyama K, Yoshikawa T, Takahashi K. Intraocular pressure in Japanese diabetic patients. Clin Ophthalmol. 2012;6:1005-9.
- Referans14.Sato T, Roy S. Effect of high glucose on fibronectin expression and cell proliferation in trabecular meshwork cells. Invest Ophthalmol Vis Sci 2002;43:170 -5.
- Referans15.Li AF, Tane N, Roy S. Fibronectin overexpression inhibits trabecular meshwork cell monolayer permeability. Mol Vis 2004;10:750 -7.
- Referans16.Lenters-Westra E, Schindhelm RK, Bilo HJ, Slingerland RJ. Haemoglobin A1c: Historical overview and current concepts. Diabetes Res Clin Pract. 2013;99:75-84.
- Referans17.The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-86.
- Referans18.Klein BE, Klein R, Jensen SC. Open-angle glaucoma and older-onset diabetes. The Beaver Dam Eye Study. Ophthalmology. 1994;101:1173-7.
- Referans19.Dielemans I, de Jong PT, Stolk R, Vingerling JR, Grobbee DE, Hofman A. Primary open-angle glaucoma, intraocular pressure, and diabetes mellitus in the general elderly population. The Rotterdam Study. Ophthalmology. 1996;103:1271-5.
- Referans20.Chopra V, Varma R, Francis BA, Wu J, Torres M, Azen SP, Los Angeles Latino Eye Study Group. Type 2 diabetes mellitus and the risk of open-angle glaucoma the Los Angeles Latino Eye Study. Ophthalmology. 2008;115: 227-32.e1.
- Referans21.Tan GS, Wong TY, Fong CW, Aung T; Singapore Malay Eye Study. Diabetes, metabolic abnormalities, and glaucoma. Arch Ophthalmol. 2009;127:1354-61.
- Referans22.Hymowitz MB, Chang D, Feinberg EB, Roy S. Increased intraocular pressure and hyperglycemic level in diabetic patients. PLoS One. 2016;11:e0151833.
- Referans23.Jeong SY, Park SJ, Chin HS, Kim SH, Kim NR. Spectral-domain optical coherence tomography features in open-angle glaucoma with diabetes mellitus and inadequate glycemic control. Invest Ophthalmol Vis Sci. 2016;57:3024-31.
- Referans24.Lonneville YH, Ozdek SC, Onol M, Yetkin I, Gurelik G, Hasanreisoglu B. The effect of blood glucose regulation on retinal nerve fiber layer thickness in diabetic patients. Ophthalmologica. 2003;217:347–50.
- Referans25.Sugimoto M, Sasoh M, Ido M, Narushima C, Uji Y. Retinal nerve fiber layer decrease during glycemic control in type 2 diabetes. J Ophthalmol. 2010;2010: 569215.
- Referans26.Öndaş O, Bozkurt E. Diyabetik retinopati gelişmemiş tip 1 diyabetli hastalarda retina sinir lifi tabakası kalınlığında erken dönemde gelişebilecek değişiklikler. MN Oftalmoloji. 2019;26:32-6.
- Referans27.Ergin A, Güllü R, Çakmak Y, Durukan AH. Diyabetes mellituslu olgularda santral Kornea kalınlığı ve retina sinir lifi kalınlığı. Gülhane Tıp Dergisi 2007;49:91-5.
- Referans28.Hou H, Shoji T, Zangwill LM, Moghimi S, Saunders LJ, Hasenstab K et al. Progression of primary open-angle glaucoma in diabetic and nondiabetic patients. Am J Ophthalmol. 2018;189:1-9.
- Referans29.Lin HC, Stein JD, Nan B, Childers D, Newman-Casey PA, Thompson DA et al. Association of geroprotective effects of metformin and risk of open-angle glaucoma in persons with diabetes mellitus. JAMA Ophthalmol. 2015; 133:915-23.
Diabetes Mellituslu Primer Açık Açılı Glokom Hastalarında Glokom Parametreleri ve Hemoglobin A1c Düzeylerinin İlişkisinin İncelenmesi
Öz
Amaç: Çalışmamızda, glokom tanılı hastalarda hemoglobin A1c (HbA1c) düzeyi ile glokom parametreleri arasındaki ilişkinin araştırılması amaçlandı. Gereç ve yöntemler: Glokom Birimi’mizde takip edilmekte olan primer açık açılı glokom (PAAG) tanılı hastaların göz muayenesinden önceki veya sonraki 3 ay içinde ölçülmüş açlık kan şekeri (AKŞ) ve tokluk kan şekeri (TKŞ) ile HbA1c düzeyleri kaydedildi. Hastalar, HbA1c düzeyine göre iki gruba ayrıldı ve sağ gözlerine ait oftalmolojik muayene bulguları kaydedildi. HbA1c≤ %6 olan (Grup 1) 37 hastanın verileri, HbA1c> %6 olan (Grup 2) 43 hasta ile karşılaştırıldı. Tüm hastaların en iyi düzeltilmiş görme keskinlikleri, göz içi basınç (GİB), cup/disk (c/d) oranı, retina sinir lifi tabakası (RNFL) kalınlığı ve görme alanı mean deviasyon (MD) skoru kaydedildi. Bulgular: İki gruptaki hastaların yaş ve cinsiyet dağılımları arasında anlamlı farklılık bulunmadı (sırasıyla; p=0.757, p=0.422). Gruplar arasında ortalama AKŞ açısından anlamlı farklılık olmadığı, ortalama TKŞ değerinin ise Grup 2’de anlamlı olarak daha yüksek olduğu görüldü (sırasıyla; p=0.097, p=0.015). Ortalama GİB, c/d, RNFL ve MD skoru açısından gruplar arasında anlamlı farklılık saptanmadı (sırasıyla; p=0.601, p=0.092, p=0.809, p=0.325). AKŞ ve TKŞ değerlerinin, HbA1c düzeyi ile istatistiksel olarak anlamlı pozitif korelasyon gösterdiği görüldü (sırasıyla; r=0.335, p=0.002; r=0.560, p=0.016). Sonuç: Çalışmamızda HbA1c düzeyinin; göz içi basıncı (GİB), c/d oranı, RNFL ve MD skoru gibi glokom ile ilişkili parametreler üzerinde anlamlı etkisinin olmadığı görüldü. Diabet, glokom ortaya çıkışı ya da GİB yüksekliği için risk faktörü iken diabet varlığının glokom progresyonunda bir etkisi görülmemiştir.
Anahtar Kelimeler
Kaynakça
- Referans1.Gupta D, Chen PP. Glaucoma. Am Fam Physician. 2016; 93:668-74.
- Referans2.Nakazawa T, Fukuchi T. What is glaucomatous optic neuropathy? Jpn J Ophthalmol. 2020;64:243-9.
- Referans3.Grzybowski A, Och M, Kanclerz P, Leffler C, Moraes CG. Primary open angle glaucoma and vascular risk factors: A review of population based studies from 1990 to 2019. J Clin Med. 2020;9:761. Referans4.Lee E, Harris A, Siesky B, Schaab T, McIntyre N, Tobe LA et al. The influence of retinal blood flow on open-angle glaucoma in patients with and without diabetes. Eur J Ophthalmol. 2014;24:542-9. Referans5.Song BJ, Aiello LP, Pasquale LR. Presence and risk factors for glaucoma in patients with diabetes. Curr Diab Rep. 2016;16:124.
- Referans6.Zhao D, Cho J, Kim MH, Friedman D, Guallar E. Diabetes, glucose metabolism, and glaucoma: the 2005-2008 National Health and Nutrition Examination Survey. PLoS One. 2014;9:e112460.
- Referans7.Oshitari T, Fujimoto N, Hanawa K, Adachi-Usami E, Roy S. Effect of chronic hyperglycemia on intraocular pressure in patients with diabetes. Am J Ophthalmol. 2007;143:363-5.
- Referans8.Matsuoka M, Ogata N, Matsuyama K, Yoshikawa T, Takahashi K. Intraocular pressure in Japanese diabetic patients. Clin Ophthalmol. 2012;6:1005-9.
- Referans9.Nucci C, Martucci A, Giannini C, Morrone LA, Bagetta G, Mancino R. Neuroprotective agents in the management of glaucoma. Eye (Lond). 2018;32:938-45.
- Referans10.Akkaya S, Can E, Öztürk F. Comparison of optic nerve head topographic parameters in patients with primary open-angle glaucoma with and without diabetes mellitus. J Glaucoma. 2016;25:49-53.
- Referans11.Hammes HP, Federoff HJ, Brownlee M. Nerve growth factor prevents both neuroretinal programmed cell death and capillary pathology in experimental diabetes. Mol Med. 1995;1:527-34.
- Referans12.Abu-El-Asrar AM, Dralands L, Missotten L, Al-Jadaan IA, Geboes K. Expression of apoptosis markers in the retinas of human subjects with diabetes. Invest Ophthalmol Vis Sci. 2004;45:2760-6.
- Referans13.Matsuoka M, Ogata N, Matsuyama K, Yoshikawa T, Takahashi K. Intraocular pressure in Japanese diabetic patients. Clin Ophthalmol. 2012;6:1005-9.
- Referans14.Sato T, Roy S. Effect of high glucose on fibronectin expression and cell proliferation in trabecular meshwork cells. Invest Ophthalmol Vis Sci 2002;43:170 -5.
- Referans15.Li AF, Tane N, Roy S. Fibronectin overexpression inhibits trabecular meshwork cell monolayer permeability. Mol Vis 2004;10:750 -7.
- Referans16.Lenters-Westra E, Schindhelm RK, Bilo HJ, Slingerland RJ. Haemoglobin A1c: Historical overview and current concepts. Diabetes Res Clin Pract. 2013;99:75-84.
- Referans17.The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-86.
- Referans18.Klein BE, Klein R, Jensen SC. Open-angle glaucoma and older-onset diabetes. The Beaver Dam Eye Study. Ophthalmology. 1994;101:1173-7.
- Referans19.Dielemans I, de Jong PT, Stolk R, Vingerling JR, Grobbee DE, Hofman A. Primary open-angle glaucoma, intraocular pressure, and diabetes mellitus in the general elderly population. The Rotterdam Study. Ophthalmology. 1996;103:1271-5.
- Referans20.Chopra V, Varma R, Francis BA, Wu J, Torres M, Azen SP, Los Angeles Latino Eye Study Group. Type 2 diabetes mellitus and the risk of open-angle glaucoma the Los Angeles Latino Eye Study. Ophthalmology. 2008;115: 227-32.e1.
- Referans21.Tan GS, Wong TY, Fong CW, Aung T; Singapore Malay Eye Study. Diabetes, metabolic abnormalities, and glaucoma. Arch Ophthalmol. 2009;127:1354-61.
- Referans22.Hymowitz MB, Chang D, Feinberg EB, Roy S. Increased intraocular pressure and hyperglycemic level in diabetic patients. PLoS One. 2016;11:e0151833.
- Referans23.Jeong SY, Park SJ, Chin HS, Kim SH, Kim NR. Spectral-domain optical coherence tomography features in open-angle glaucoma with diabetes mellitus and inadequate glycemic control. Invest Ophthalmol Vis Sci. 2016;57:3024-31.
- Referans24.Lonneville YH, Ozdek SC, Onol M, Yetkin I, Gurelik G, Hasanreisoglu B. The effect of blood glucose regulation on retinal nerve fiber layer thickness in diabetic patients. Ophthalmologica. 2003;217:347–50.
- Referans25.Sugimoto M, Sasoh M, Ido M, Narushima C, Uji Y. Retinal nerve fiber layer decrease during glycemic control in type 2 diabetes. J Ophthalmol. 2010;2010: 569215.
- Referans26.Öndaş O, Bozkurt E. Diyabetik retinopati gelişmemiş tip 1 diyabetli hastalarda retina sinir lifi tabakası kalınlığında erken dönemde gelişebilecek değişiklikler. MN Oftalmoloji. 2019;26:32-6.
- Referans27.Ergin A, Güllü R, Çakmak Y, Durukan AH. Diyabetes mellituslu olgularda santral Kornea kalınlığı ve retina sinir lifi kalınlığı. Gülhane Tıp Dergisi 2007;49:91-5.
- Referans28.Hou H, Shoji T, Zangwill LM, Moghimi S, Saunders LJ, Hasenstab K et al. Progression of primary open-angle glaucoma in diabetic and nondiabetic patients. Am J Ophthalmol. 2018;189:1-9.
- Referans29.Lin HC, Stein JD, Nan B, Childers D, Newman-Casey PA, Thompson DA et al. Association of geroprotective effects of metformin and risk of open-angle glaucoma in persons with diabetes mellitus. JAMA Ophthalmol. 2015; 133:915-23.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 19 Haziran 2023 |
| Gönderilme Tarihi | 1 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 2 Sayı: 2 |
Kaynak Göster
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