(Pre)diabetes and a higher level of glycaemic measures are continuously associated with corneal neurodegeneration assessed by corneal confocal microscopy: the Maastricht Study
Authors' conclusion
To our knowledge, this is the first population-based study to show that a more adverse glucose metabolism status and higher levels of glycaemic measures were all linearly associated with corneal neurodegeneration after adjustment for an extensive set of potential confounders. Our results indicate that glycaemia-associated corneal neurodegeneration is a continuous process that starts before the onset of type 2 diabetes. Further research is needed to investigate whether early reduction of hyperglycaemia can prevent corneal neurodegeneration.
Study context
- Population
- Maastricht Study participants; mean age 59.4 years, 48.4% men, 14.7% with prediabetes, 21.0% with T2D
- Participants
- 3,471 participants
- Exposure
- Prediabetes and T2D vs normal glucose metabolism; continuous glycaemic measures
- Outcome
- Composite Z-score of corneal nerve fibre measures (corneal confocal microscopy)
Methodological detailspopulation-based, observational, linear regression, linear trend analysis
- Population-based
- Observational
- Linear regression
- Linear trend analysis
Main finding
As reported in the abstract
Β coefficient
−0.08
95% CI −0.17 to 0.03
Prediabetes
Β coefficient
−0.14
95% CI −0.25 to −0.04
Type 2 diabetes
- Linear trend across glucose metabolism status
- p value of 0.001
Observational data: associations, not effects.
Further findings
Composite Z-score per SD higher glycaemic measure
- FPG, β per SD
- −0.09 [−0.13, −0.05] (95% CI)
- 2 h post-load glucose, β per SD
- −0.07 [−0.11, −0.03] (95% CI)
- HbA1c, β per SD
- −0.08 [−0.11, −0.04] (95% CI)
- Skin autofluorescence, β per SD
- −0.05 [−0.08, −0.01] (95% CI)
- Duration of diabetes, β per SD
- −0.09 [−0.17, −0.001] (95% CI)
- All significantly associated
Individual corneal nerve fibre measures
- In general, directionally similar associations
Original publication
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