1
|
Yildiz P, Kebapci MN, Colak E, Mutlu F, Simsek T, Yildirim N. Relationship between hyperglycemia and intraocular pressure, corneal biomechanics, and corneal topography during the oral glucose tolerance test in nondiabetic patients. Int Ophthalmol 2024; 44:347. [PMID: 39138825 DOI: 10.1007/s10792-024-03264-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/29/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE Altered corneal biomechanics in patients with diabetes may affect intraocular pressure (IOP) measurements. Although a relationship between IOP and glucose levels has been reported in diabetic and nondiabetic patients, the mechanism by which hyperglycemia influences IOP is unclear. The aim of this study was to determine the effects of hyperglycemia on IOP, corneal biomechanics, and anterior segment parameters during the oral glucose tolerance test (OGTT) in nondiabetic patients. METHODS Twenty-one patients without DM who underwent OGTT were included in this study. A complete ophthalmologic examination was performed before the test. Blood glucose, insulin level, IOP (iCare rebound tonometer), Ocular Response Analyzer, and corneal topography (Pentacam) measurements were obtained at 0, 1, and 2 h during the OGTT. Data from the patients' right eyes were included in the analysis. RESULTS The mean age of the patients was 46.9 ± 11.0 years. There was a statistically significant difference in IOP between 1 and 2 h (p = 0.03) and a clinically significant difference between 0 and 1 h (p = 0.06). Corneal resistance factor was lower at 2 h than 1 h (p = 0.03), while central cornea thickness was increased at 1 h (p = 0.01) and 2 h (p = 0.05) compared to 0 h. There was positive partial correlation between hyperglycemia and IOP at 1 h (p = 0.049, r = 0.67). CONCLUSION The positive partial correlation between IOP and glucose level suggests that acute hyperglycemia may lead to increased IOP. However, further research is needed to explain the mechanism of IOP elevation in the hyperglycemic phase during OGTT.
Collapse
Affiliation(s)
- Pinar Yildiz
- Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Medine Nur Kebapci
- Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ertugrul Colak
- Department of Biostatistics, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Fezan Mutlu
- Department of Biostatistics, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Tulay Simsek
- Department of Ophthalmology, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Nilgun Yildirim
- Department of Ophthalmology, Eskişehir Osmangazi University, Eskisehir, Turkey
| |
Collapse
|
2
|
Ren R, Zhang GW, Yang WY, Xie Y, Wei M, Guan HJ, Ji M. Concentrations of glucose metabolites in the aqueous humour of diabetic cataract eyes. Eur J Ophthalmol 2023; 33:1931-1938. [PMID: 36814369 DOI: 10.1177/11206721231156496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
PURPOSE Glucose metabolism underpins diabetic cataracts (DCs), but the relationship between the two remains unclear. Here, we tested the aqueous humour (AH) of patients with DCs to elucidate glucose metabolite levels. METHODS In this study, aqueous humour (AH) samples were collected preoperatively from DC eyes (n = 37) and age-related cataract eyes (n = 37) from 74 patients (74 eyes) undergoing uncomplicated cataract surgery. The content of glucose, pyruvate, L-lactate were detected by biochemical methods and advanced glycation end-products (AGEs) was detemined using enzyme-linked immunosorbent assay (ELISA) technique. Furthermore, the ratios of glucose/pyruvate and L-lactate/pyruvate in the AH were calculated. In addition, we calculated the correlation between glucose levels and AGEs in the AH. RESULTS The concentrations of glucose, pyruvate and AGEs in the DC group were higher than those in the control group. Significantly lower levels of L-lactate in the AH were found in the DC group. We calculated the glucose/pyruvate ratio and the L-lactate/pyruvate ratio in the AH, which showed that glucose metabolism was changed in the AH from DC patients. Interestingly, we observed that AGEs in the AH were significantly correlated with increased anterior chamber glucose permeability. A stronger correlation was found in the subgroups of male patients, younger patients, and patients with poor glycaemic control status. CONCLUSIONS Comparison of the levels of glucose metabolism-related products in the AH in the DC group highlight a potential pathological mechanism for DC from a glucose metabolism perspective. The findings indicated an alteration in the metabolic pathways of energy metabolism and amino acids in the AH of DC patients.
Collapse
Affiliation(s)
- Ruoxin Ren
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
- Dalian Medical University, Dalian, China
| | - Guo-Wei Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Wen-Yu Yang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Yi Xie
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Miao Wei
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Huai-Jin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Min Ji
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| |
Collapse
|
3
|
Kingsbury KD, Skeie JM, Cosert K, Schmidt GA, Aldrich BT, Sales CS, Weller J, Kruse F, Thomasy SM, Schlötzer-Schrehardt U, Greiner MA. Type II Diabetes Mellitus Causes Extracellular Matrix Alterations in the Posterior Cornea That Increase Graft Thickness and Rigidity. Invest Ophthalmol Vis Sci 2023; 64:26. [PMID: 37326594 DOI: 10.1167/iovs.64.7.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Purpose There is a pressing need to investigate the impact of type II diabetes mellitus on the posterior cornea in donor tissues given its increasing prevalence and potential impact on endothelial keratoplasty surgical outcomes. Methods Immortalized human cultured corneal endothelial cells (CECs; HCEC-B4G12) were grown in hyperglycemic media for 2 weeks. Extracellular matrix (ECM) adhesive glycoprotein expression and advanced glycation end products (AGEs) in cultured cells and corneoscleral donor tissues, as well as the elastic modulus for the Descemet membrane (DMs) and CECs of diabetic and nondiabetic donor corneas, were measured. Results In CEC cultures, increasing hyperglycemia resulted in increased transforming growth factor beta-induced (TGFBI) protein expression and colocalization with AGEs in the ECM. In donor corneas, the thicknesses of the DM and the interfacial matrix (IFM) between the DM and stroma both increased from 8.42 ± 1.35 µm and 0.504 ± 0.13 µm in normal corneas, respectively, to 11.13 ± 2.91 µm (DM) and 0.681 ± 0.24 µm (IFM) in non-advanced diabetes (P = 0.013 and P = 0.075, respectively) and 11.31 ± 1.76 µm (DM) and 0.744 ± 0.18 µm (IFM) in advanced diabetes (AD; P = 0.0002 and P = 0.003, respectively). Immunofluorescence in AD tissues versus controls showed increased AGEs (P < 0.001) and markedly increased labeling intensity for adhesive glycoproteins, including TGFBI, that colocalized with AGEs. The elastic modulus significantly increased between AD and control tissues for the DMs (P < 0.0001) and CECs (P < 0.0001). Conclusions Diabetes and hyperglycemia alter human CEC ECM structure and composition, likely contributing to previously documented complications of endothelial keratoplasty using diabetic donor tissue, including tearing during graft preparation and reduced graft survival. AGE accumulation in the DM and IFM may be a useful biomarker for determining diabetic impact on posterior corneal tissue.
Collapse
Affiliation(s)
- Kenten D Kingsbury
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa Lions Eye Bank, Coralville, Iowa, United States
| | - Jessica M Skeie
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa Lions Eye Bank, Coralville, Iowa, United States
| | - Krista Cosert
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, United States
- Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, Davis, California, United States
| | | | - Benjamin T Aldrich
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa Lions Eye Bank, Coralville, Iowa, United States
| | - Christopher S Sales
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa Lions Eye Bank, Coralville, Iowa, United States
| | - Julia Weller
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Friedrich Kruse
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Sara M Thomasy
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, United States
- Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, Davis, California, United States
| | | | - Mark A Greiner
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa Lions Eye Bank, Coralville, Iowa, United States
| |
Collapse
|
4
|
Chan TIL, Yip YWY, Man TTC, Pang CP, Brelén ME. Comparing the Rise in Glucose Concentration in Blood, Aqueous and Interstitial Fluid During a Glucose Tolerance Test. Transl Vis Sci Technol 2022; 11:3. [DOI: 10.1167/tvst.11.11.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tina I. L. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Yolanda W. Y. Yip
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Tony T. C. Man
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Mårten Erik Brelén
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| |
Collapse
|
5
|
Ohn K, Noh YH, Moon JI, Jung Y. Measurement of corneal biomechanical properties in diabetes mellitus using the Corvis ST. Medicine (Baltimore) 2022; 101:e30248. [PMID: 36086751 PMCID: PMC10980441 DOI: 10.1097/md.0000000000030248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/26/2022] Open
Abstract
We sought to assess changes in corneal biomechanical parameters in patients with diabetes mellitus (DM) in comparison with those among healthy controls using Corvis ST (CST). The study group included 209 eyes from healthy control subjects and 33 eyes from diabetic subjects, respectively. Following an ophthalmological examination, measurements with CST were taken. Additionally, hemoglobin A1c and blood glucose values were collected. Results were then compared to those of the control group after adjusting for potential confounding factors, including age-, intraocular pressure (IOP)-, central corneal thickness (CCT)-, spherical equivalent (SE)- and axial length (AL). After adjusting for potential confounding factors, including the age, IOP, CCT, SE, and AL, patients with DM presented significantly lower whole-eye movement (WEM) (ms) values than patients without DM (21.71 ± 0.84 vs. 22.15 ± 0.64 ms; P < .001). There was a significant and negative correlation between WEM (ms) and hemoglobin A1c in DM patients (r = -0.733; P = .001). In univariate and multivariate general linear mixed model (GLMM) analyses, IOP (P < .001 and P < .001, respectively) and the presence of DM (P = .001 and P < .001, respectively) significantly affected WEM (ms). In DM, significant changes in corneal biomechanical properties were detectable. The DM group showed significantly less deformable cornea and sclera than did the normal controls, even after adjusting for age, IOP, CCT, SE, and AL. These findings may cause misinterpretation of IOP measurements in diabetic patients. Therefore, the measurement of corneal biomechanics should be taken into consideration in clinical practice.
Collapse
Affiliation(s)
- Kyoung Ohn
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Ho Noh
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Il Moon
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Younhea Jung
- Department of Ophthalmology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
6
|
Mussi N, Stuard WL, Sanches JM, Robertson DM. Chronic Hyperglycemia Compromises Mitochondrial Function in Corneal Epithelial Cells: Implications for the Diabetic Cornea. Cells 2022; 11:2567. [PMID: 36010643 PMCID: PMC9406817 DOI: 10.3390/cells11162567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Mitochondrial dysfunction is a major pathophysiological event leading to the onset of diabetic complications. This study investigated the temporal effects of hyperglycemia on mitochondrial metabolism in corneal epithelial cells. To accomplish this, human telomerase-immortalized corneal epithelial cells were cultured in a defined growth medium containing 6 mM glucose. To simulate hyperglycemia, cells were cultured in a medium containing 25 mM D-glucose, and control cells were cultured in mannitol. Using metabolic flux analysis, there was a hyperosmolar-mediated increase in mitochondrial respiration after 24 h. By day 5, there was a decrease in spare respiratory capacity in cells subject to high glucose that remained suppressed throughout the 14-day period. Although respiration remained high through day 9, glycolysis was decreased. Mitochondrial respiration was decreased by day 14. This was accompanied by the restoration of glycolysis to normoglycemic levels. These changes paralleled a decrease in mitochondrial polarization and cell cycle arrest. Together, these data show that chronic but not acute hyperglycemic stress leads to mitochondrial dysfunction. Moreover, the hyperglycemia-induced loss of spare respiratory capacity reduces the ability of corneal epithelial cells to respond to subsequent stress. Compromised mitochondrial function represents a previously unexplored mechanism that likely contributes to corneal complications in diabetes.
Collapse
|
7
|
Jeong IS, Lee EJ, Kim MS, Yu JO, Yun HS, Jeong JH, Hwang YS. Incidence and Predictors of Cataract among People with Type 2 Diabetes Mellitus: Using Secondary Data Analysis from the Ansan Cohort of the Korean Genome and Epidemiology Study. J Korean Acad Nurs 2022; 52:24-35. [DOI: 10.4040/jkan.21081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/26/2021] [Accepted: 08/18/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Ihn Sook Jeong
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Eun Joo Lee
- Department of Nursing, Dong-Eui University, Busan, Korea
| | - Myo Sung Kim
- Department of Nursing, Dong-Eui University, Busan, Korea
| | - Jung Ok Yu
- College of Nursing, Dong-A University, Busan, Korea
| | - Hae Sun Yun
- Department of Nursing Science, Kyungsung University, Busan, Korea
| | | | | |
Collapse
|
8
|
Kurihara T, Lee D, Shinojima A, Kinoshita T, Nishizaki S, Arita Y, Hidaka Y, Nishi Y, Shirakawa Y, Kimura S, Tsuneyoshi Y, Torii H, Tsubota K, Negishi K. Glucose levels between the anterior chamber of the eye and blood are correlated based on blood glucose dynamics. PLoS One 2021; 16:e0256986. [PMID: 34469502 PMCID: PMC8409619 DOI: 10.1371/journal.pone.0256986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ damages. The eye is a glucose highly demanding organ in our body, and the anterior chamber (AC) in the eye has been suggested for a noninvasive blood glucose monitoring site. However, calculating blood glucose levels from measuring glucose levels in AC has been difficult and unclear. In this study, we aimed to examine glucose levels from AC and find a correlation with blood glucose levels. A total of 30 patients with cataracts (men and women, study 1; 7 and 3, study 2; 9 and 11) who visited Keio University Hospital from 2015 to 2018 and agreed to participate in this study were recruited. Glucose levels from AC and the blood were examined by a UV-hexokinase or H2O2-electrode method before/during the cataract surgery. These values were analyzed with regression analyses depending on the groups (blood glucose-ascending and descending groups). In the blood glucose-descending group, glucose levels from AC were strongly correlated with blood glucose levels (a high R2 value, 0.8636). However, the relatively moderate correlation was seen in the blood glucose-ascending group (a low R2 value, 0.5228). Taken together, we showed different correlation ratios on glucose levels between AC and the blood, based on blood glucose dynamics. Stacking data regarding this issue would enable establishing noninvasive blood glucose monitoring from measuring glucose levels in AC more correctly, which will be helpful for proper and prompt managements for glucose-mediated complications.
Collapse
Affiliation(s)
- Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail: (TK); (KN)
| | - Deokho Lee
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Ari Shinojima
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Taku Kinoshita
- Fuji Xerox Co., Ltd, Tokyo, Japan
- SEED Co., Ltd., Tokyo, Japan
| | | | - Yoko Arita
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Hidaka
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyo Nishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Yukari Tsuneyoshi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Tsubota Laboratory, Inc., Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail: (TK); (KN)
| |
Collapse
|
9
|
Rankenberg J, Rakete S, Wagner BD, Patnaik JL, Henning C, Lynch A, Glomb MA, Nagaraj RH. Advanced glycation end products in human diabetic lens capsules. Exp Eye Res 2021; 210:108704. [PMID: 34302851 DOI: 10.1016/j.exer.2021.108704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
Advanced glycation end products (AGEs) accumulate with age in human lens capsules. AGEs in lens capsules potentiate the transforming growth factor beta-2-mediated mesenchymal transition of lens epithelial cells, which suggests that they play a role in posterior capsule opacification after cataract surgery. We measured AGEs by liquid chromatography-mass spectrometry in capsulorhexis specimens obtained during cataract surgery from nondiabetic and diabetic patients with and without established retinopathy. Our data showed that the levels of most AGEs (12 out of 13 measured) were unaltered in diabetic patients and diabetic patients with retinopathy compared to nondiabetic patients. There was one exception: glucosepane, which was significantly higher in diabetic patients, both with (6.85 pmol/μmol OH-proline) and without retinopathy (8.32 pmol/μmol OH-proline), than in nondiabetic patients (4.01 pmol/μmol OH-proline). Our study provides an explanation for the similar incidence of posterior capsule opacification between nondiabetic and diabetic cataract patients observed in several studies.
Collapse
Affiliation(s)
- Johanna Rankenberg
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Stefan Rakete
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; Present Address: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital LMU, Munich, Germany
| | - Brandie D Wagner
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; Colorado School of Public Health, Aurora, CO, USA
| | - Jennifer L Patnaik
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Christian Henning
- Institute of Chemistry-Food Chemistry, Martin-Luther-University Halle-Wittenberg, 06120 Halle/ Saale, Germany
| | - Anne Lynch
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA
| | - Marcus A Glomb
- Institute of Chemistry-Food Chemistry, Martin-Luther-University Halle-Wittenberg, 06120 Halle/ Saale, Germany
| | - Ram H Nagaraj
- Sue-Anschutz Eye Center, Department of Ophthalmology, School of Medicine, Aurora, CO, USA; School of Pharmacy, University of Colorado, Aurora, CO, USA.
| |
Collapse
|