Longitudinal assessment of neuropathy in type 1 diabetes using novel ophthalmic markers (LANDMark): Study design and baseline characteristics
Longitudinal assessment of neuropathy in type 1 diabetes using novel ophthalmic markers (LANDMark): Study design and baseline characteristics
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DOI：
10.1016/j.diabres.2014.02.011
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发表时间：
2014-05-01
影响因子：
5.1
通讯作者：
Efron, Nathan
中科院分区：
文献类型：
--
作者：
Pritchard, Nicola;Edwards, Katie;Efron, Nathan
目的：角膜神经形态和角膜感觉阈值最近被探索作为评估糖尿病神经病变的潜在替代标志物。我们介绍了“使用新型眼科标志物对1型糖尿病神经病变进行纵向评估”（LANDMark）研究的基线结果。方法：LANDMark研究是一项为期4年、两地点的自然历史研究，共有3组参与者：1型糖尿病伴神经病变（T1W）、1型糖尿病无神经病变（T1WO）和无糖尿病或神经病变的对照组。所有参与者都接受详细的神经病变年度评估，包括使用角膜共聚焦显微镜测量角膜神经参数和使用非接触角膜美学测量测量角膜灵敏度。结果：T1W组76人，T1WO组166人，对照组154人。T1W组（1.0 +/- 1.1 mbars）的角膜感觉阈值明显高于T1WO组（0.7 +/- 0.7 mbars）和对照组（0.6 +/- 0.4 mbars） （p < 0.001）， T1WO组与对照组之间无差异。T1W组角膜神经纤维长度（14.0 +/- 6.4 mm/mm(2)）低于T1WO组（19.1 +/- 5.8 mm/mm(2)）和对照组（23.2 +/- 6.3 mm/mm(2)） （p < 0.001）。与对照组相比，T1WO组的角膜神经纤维长度较低。结论：LANDMark基线研究结果证实，角膜敏感性仅在1型神经病变患者中降低。然而，无神经病变的1型患者角膜神经纤维长度减少，有神经病变的1型患者角膜神经纤维长度减少的幅度更大。2014爱思唯尔爱尔兰有限公司版权所有。
Aims: Corneal nerve morphology and corneal sensation threshold have recently been explored as potential surrogate markers for the evaluation of diabetic neuropathy. We present the baseline findings of the 'Longitudinal Assessment of Neuropathy in type 1 Diabetes using novel ophthalmic Markers'(LANDMark) study.Methods: The LANDMark study is a 4-year, two-site, natural history study of three participant groups: type 1 diabetes with neuropathy (T1W), type 1 diabetes without neuropathy (T1WO) and control participants without diabetes or neuropathy. All participants undergo a detailed annual assessment of neuropathy including corneal nerve parameters measured using corneal confocal microscopy and corneal sensitivity measured using non-contact corneal aesthesiometry.Results: 76 T1W, 166 T1WO and 154 control participants were enrolled into the study. Corneal sensation threshold was significantly higher (i.e., sensitivity was lower) in T1W (1.0 +/- 1.1 mbars) than T1WO (0.7 +/- 0.7 mbars) and controls (0.6 +/- 0.4 mbars) (p < 0.001), with no difference between T1WO and controls. Corneal nerve fibre length was lower in T1 W (14.0 +/- 6.4 mm/mm(2)) compared to T1WO (19.1 +/- 5.8 mm/mm(2)) and controls (23.2 +/- 6.3 mm/mm(2)) (p < 0.001). Corneal nerve fibre length was lower in T1WO compared to controls.Conclusions: The LANDMark baseline findings confirm a reduction in corneal sensitivity only in Type 1 patients with neuropathy. However, corneal nerve fibre length is reduced in Type 1 patients without neuropathy with an even greater deficit in Type 1 patients with neuropathy. (C) 2014 Elsevier Ireland Ltd. All rights reserved.