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Diabetes Mellitus Type 1 has a Higher Impact on Corneal Endothelial Cell Density and Pachymetry than Diabetes Mellitus Type 2, Independent of Age: A Meta-Regression Model
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Amador-Muñoz, Diana Patricia
Conforti, Valentina
Matheus, Luisa Marina
Molano-Gonzalez, Nicolas
Payán-Gómez, César
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2021-04-13
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Objetivo: Los pacientes con diabetes mellitus (DM) suelen presentar queratopatía. Sin embargo, el compromiso del endotelio corneal en la DM tipo 1 (DM1) y la DM tipo 2 (DM2) no se ha caracterizado adecuadamente hasta el momento. Métodos: Se realizó una búsqueda sistemática de la literatura para encontrar artículos sobre humanos que combinaran la DM1 y/o la DM2 con el endotelio corneal. El período abarcó desde el inicio hasta junio de 2020. La metarregresión evaluó el papel de cada tipo de DM en la densidad de células endoteliales corneales (DCE) y la paquimetría. Los modelos estadísticos incluyeron la edad como modulador para discriminar entre los cambios normales debidos a la edad y el efecto de la enfermedad, y para determinar el impacto de la duración de la enfermedad. Results: The initial search identified 752 records, of which 17 were included in the meta-regression. Patients with T1DM had, on average, 193 cells/mm2 lesser than control patients (P , 0.00001). Patients with T2DM had 151 cells/mm2 less compared with control patients (P , 0.00001). The loss of corneal endothelial cells was expected because the aging was similar in patients with T1DM and T2DM and their control groups. Patients with T1DM and T2DM showed an increase in pachymetry versus control patients, and in both groups, it was associated with the duration of the disease. Conclusions: Both types of DM reduced CED and increased pachymetry. These differences were higher in patients with T1DM versus control patients than patients with T2DM versus control patients. In T1DM, CED reduction was not correlated with the time from diagnosis. In both groups, patients had CED reduction due to aging similar to that of their matched control patients.
Abstract
Purpose: Patients with diabetes mellitus (DM) often have keratopathy. However, the compromise of the corneal endothelium in type 1 DM (T1DM) and type 2 DM (T2DM) has so far not been well characterized. Methods: We performed a systematic literature search to find articles on humans combining T1DM and/or T2DM and the corneal endothelium. The period was from inception to June 2020. The meta-regression evaluated the role of each type of DM on corneal endothelial cell density (CED) and pachymetry. The statistical models included age as a modulator to discriminate between the normal changes due to age and the effect of the disease and to determine the impact of the disease duration. Results: The initial search identified 752 records, of which 17 were included in the meta-regression. Patients with T1DM had, on average, 193 cells/mm2 lesser than control patients (P , 0.00001). Patients with T2DM had 151 cells/mm2 less compared with control patients (P , 0.00001). The loss of corneal endothelial cells was expected because the aging was similar in patients with T1DM and T2DM and their control groups. Patients with T1DM and T2DM showed an increase in pachymetry versus control patients, and in both groups, it was associated with the duration of the disease. Conclusions: Both types of DM reduced CED and increased pachymetry. These differences were higher in patients with T1DM versus control patients than patients with T2DM versus control patients. In T1DM, CED reduction was not correlated with the time from diagnosis. In both groups, patients had CED reduction due to aging similar to that of their matched control patients.
Palabras clave
Diabetes mellitus tipo 1 , Diabetes mellitus tipo 2 , Endotelio , Córnea , Metanálisis
Keywords
Diabetes mellitus type 1 , Diabetes mellitus type 2 , Endothelium , Corneal , Meta-analysis
