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Abstract：
OBJECTIVE: To assess the Meibomian glands, ocular surface and tear function in patients with type 2 diabetes, and study the correlation between these conditions.
METHODS: Prospective study of 76 males, 37 with type 2 diabetes with an average of duration between 7±5 years, and 36 males from control group. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NIBUT) and the tear lipid layer pattern was performed using interferometry system and tear meniscus height/TMH. Ocular surface was studied with lissamine green staining and morphology of the glands with evaluation of Marx\'s line (lid margin abnormalities); meibomian secretion was expressed and was also assessed the quality. The results were analyzed using the statistical Kruskal-Wallis and Mann-Whitney, and correlations by Spearman Rho.
RESULTS: The mean age was 59±8 years; 71% of participants presented MGD (76% diabetics and 67% controls). OSDI were significantly higher (p=0.01) in the diabetic group. A positive correlation was found between glycemia and symptoms (p=0.0005) and strong correlation between Hb1Ac and OSDI in MGD. NIBUT was lower in the control group (2.47±1.2s) than for the diabetic group (2.9±1.2s), with a significant inverse correlation (52.22%) with MG inflammation.
CONCLUSIONS: MGD in type 2 diabetic patients is more severe compared with nondiabetic patients. Longer duration of diabetes is associated with major symptoms and changes in MG. Diabetic group showed major changes in lids and tear function, accounting for evaporative dry eye and presenting a high degree of correlation with MG inflammation and obstruction.
METHODS: Prospective study of 76 males, 37 with type 2 diabetes with an average of duration between 7±5 years, and 36 males from control group. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NIBUT) and the tear lipid layer pattern was performed using interferometry system and tear meniscus height/TMH. Ocular surface was studied with lissamine green staining and morphology of the glands with evaluation of Marx\'s line (lid margin abnormalities); meibomian secretion was expressed and was also assessed the quality. The results were analyzed using the statistical Kruskal-Wallis and Mann-Whitney, and correlations by Spearman Rho.
RESULTS: The mean age was 59±8 years; 71% of participants presented MGD (76% diabetics and 67% controls). OSDI were significantly higher (p=0.01) in the diabetic group. A positive correlation was found between glycemia and symptoms (p=0.0005) and strong correlation between Hb1Ac and OSDI in MGD. NIBUT was lower in the control group (2.47±1.2s) than for the diabetic group (2.9±1.2s), with a significant inverse correlation (52.22%) with MG inflammation.
CONCLUSIONS: MGD in type 2 diabetic patients is more severe compared with nondiabetic patients. Longer duration of diabetes is associated with major symptoms and changes in MG. Diabetic group showed major changes in lids and tear function, accounting for evaporative dry eye and presenting a high degree of correlation with MG inflammation and obstruction.
摘要：
目的：评估睑板腺，2型糖尿病患者的眼表和泪液功能，并研究这些条件之间的相关性。
方法：对76名男性进行前瞻性研究，37例2型糖尿病患者，平均病程在7±5年之间，36名男性来自对照组。完成眼表疾病指数（OSDI）问卷后，使用干涉测量系统和泪液半月板高度/TMH进行非侵入性泪膜破裂时间（NIBUT）和泪液脂质层模式。用lissamine绿色染色研究了眼部表面，并评估了Marx\'s线（眼睑边缘异常）的腺体形态；表达了睑板膜分泌，并评估了质量。结果使用统计Kruskal-Wallis和Mann-Whitney进行分析，以及SpearmanRho的相关性。
结果：平均年龄为59±8岁；71％的参与者出现MGD（76％的糖尿病患者和67％的对照组）。OSDI在糖尿病组中显著高于(p=0.01)。在MGD中，血糖与症状之间呈正相关（p=0.0005），而Hb1Ac与OSDI之间呈强相关。对照组NIBUT(2.47±1.2s)低于糖尿病组(2.9±1.2s),与MG炎症呈显著负相关(52.22%)。
结论：2型糖尿病患者的MGD比非糖尿病患者更为严重。糖尿病持续时间较长与MG的主要症状和变化有关。糖尿病组表现为眼睑和泪液功能的主要变化，考虑蒸发性干眼，并与MG炎症和梗阻高度相关。
方法：对76名男性进行前瞻性研究，37例2型糖尿病患者，平均病程在7±5年之间，36名男性来自对照组。完成眼表疾病指数（OSDI）问卷后，使用干涉测量系统和泪液半月板高度/TMH进行非侵入性泪膜破裂时间（NIBUT）和泪液脂质层模式。用lissamine绿色染色研究了眼部表面，并评估了Marx\'s线（眼睑边缘异常）的腺体形态；表达了睑板膜分泌，并评估了质量。结果使用统计Kruskal-Wallis和Mann-Whitney进行分析，以及SpearmanRho的相关性。
结果：平均年龄为59±8岁；71％的参与者出现MGD（76％的糖尿病患者和67％的对照组）。OSDI在糖尿病组中显著高于(p=0.01)。在MGD中，血糖与症状之间呈正相关（p=0.0005），而Hb1Ac与OSDI之间呈强相关。对照组NIBUT(2.47±1.2s)低于糖尿病组(2.9±1.2s),与MG炎症呈显著负相关(52.22%)。
结论：2型糖尿病患者的MGD比非糖尿病患者更为严重。糖尿病持续时间较长与MG的主要症状和变化有关。糖尿病组表现为眼睑和泪液功能的主要变化，考虑蒸发性干眼，并与MG炎症和梗阻高度相关。
