角膜共聚焦显微镜识别早期和明确的糖尿病心脏自主神经病变

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-04-11 DOI:10.1016/j.diabres.2025.112172

Shazli Azmi , Maryam Ferdousi , Alise Kalteniece , Ioannis N Petropoulos , Uazman Alam , Georgios Ponirakis , Omar Asghar , Andrew Marshall , Andrew JM Boulton , Nathan Efron , Rayaz A Malik

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引用次数: 0

摘要

目的：晚期心脏自主神经病变（CAN）与糖尿病患者死亡率增高相关。早期识别和减少危险因素可以限制can的进展。然而，早期CAN的诊断依赖于心脏自主反射测试（CART），这是不广泛使用。我们比较了角膜共聚焦显微镜（CCM）和CART在诊断CAN方面的诊断效用。研究设计与方法采用cart和CCM对238例1型和2型糖尿病患者和37例健康对照进行评估。结果随着CAN严重程度的增加，DB-HRV、E:I比、30:15比、角膜神经纤维密度（CNFD）、角膜神经分支密度（CNBD）和角膜神经纤维长度（CNFL）渐进式显著降低。CCM的受试者工作特征（ROC）曲线下面积（AUC）和敏感性/特异性与cart在识别早期和明确CAN方面相当。结论ccm是一种快速、无创的眼科检查方法，可用于早期确诊的CAN。

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Corneal confocal microscopy identifies early and definite diabetic cardiac autonomic neuropathy

Objective

Advanced cardiac autonomic neuropathy (CAN) is associated with increased mortality in people with diabetes. Early identification and reduction of risk factors can limit the progression of CAN. However, the diagnosis of early CAN relies on cardiac autonomic reflex testing (CART’s) which is not widely available. We have compared the diagnostic utility of corneal confocal microscopy (CCM) to CART’s in diagnosing CAN.

Research design and methods

Two-hundred and thirty eight individuals with type 1 and type 2 diabetes and thirty seven healthy controls were assessed using CARTs and CCM.

Results

There was a progressive and significant reduction in DB-HRV, E:I ratio, 30:15 ratio, corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fibre length (CNFL) with increasing severity of CAN. The receiver operating characteristic (ROC) area under the curve (AUC) and sensitivity/specificity of CCM were comparable to those of CARTs for identifying early and definite CAN.

Conclusion

CCM is a rapid, non-invasive ophthalmic test which could be used to detect early and established CAN.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.