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Relationship between time in range and corneal nerve fiber loss in asymptomatic patients with type 2 diabetes

Chinese Medical Journal 2022年第16期135卷 1978-1985页

作者： Wejing Zhao Jingyi Lu Lei Zhang Wei Lu Wei Zhu Yuqian Bao Jjian Zhou 'Department of Endocrinology and Metabolism Shanghai Jiao Tong Universty Ailatede Sith People's HospitalShanghai Cinical Center for DiabetesShanghai Key Clinical Center for Metabolic DiseaseShanghai Diabetes IstuteShanghai Key Laboratory of Diabetes MellitusShanghai 200233China Shanghai Clinical Center for Metabolic Diseases Shanghai Key Laboratory of Diabetes MeliusShanghai Diabetes IstituteShanghai Jiao Tong University Alilatedae Sith People's HospitalShanghai 200233China Department of Endocrinology and Metabolism Jinshan Branch of Shanghai Jiao Tong University Aflatedae Sixth People's HospitalShanghai 201500China

Background: Corneal confocal microscopy (CCM) is a noninvasive technique to detect early nerve damage of diabetic sensorimotor polyneuropathy (DSPN). Time in range (TIR) is an emerging metric of glycemic control which was reported to be associated with diabetic complications. We sought to explore the relationship between TIR and corneal nerve parameters in asymptomatic patients with type 2 diabetes (T2DM).Methods: In this cross-sectional study, 206 asymptomatic inpatients with T2DM were recruited. After 7 days of continuous glucose monitoring, the TIR was calculated as the percentage of time in the glucose range of 3.9 to 10.0 mmol/L. CCM was performed to determine corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length (CNFL). Abnormal CNFL was defined as ≤15.30 mm/mm2.Results: Abnormal CNFL was found in 30.6% (63/206) of asymptomatic subjects. Linear regression analyses revealed that TIR was positively correlated with CCM parameters both in the crude and adjusted models (all P< 0.05). Each 10% increase in TIR was associated with a 28.2% (95% CI: 0.595–0.866,P = 0.001) decreased risk of abnormal CNFL after adjusting for covariates. With the increase of TIR quartiles, corneal nerve fiber parameters increased significantly (allP for trend <0.01). The receiver operating characteristic curve indicated that the optimal cutoff point of TIR was 77.5% for predicting abnormal CNFL in asymptomatic patients.Conclusions: There is a significant independent correlation between TIR and corneal nerve fiber loss in asymptomatic T2DM patients. TIR may be a useful surrogate marker for early diagnosis of DSPN.

关键词： Continuous glucose monitoring Corneal confocal microscopy Time in range Type 2 diabetes

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成人前列腺肉瘤6例治疗报告(附文献复习)

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癌症 2005年第2期24卷 226-228页

作者：刘卓炜周芳坚秦自科韩辉余绍龙王欢中山大学肿瘤防治中心泌尿外科广东广州510060

背景与目的成人原发前列腺肉瘤罕见,多数患者确诊时肿瘤巨大,治疗方案不统一。本文报告6例成人前列腺肉瘤患者的临床治疗经验;并收集国内正式发表的11篇有关此病的治疗报道,结合文献讨论临床治疗方案。方法收集我院6例确诊为前列腺肉瘤... 详细信息

背景与目的成人原发前列腺肉瘤罕见,多数患者确诊时肿瘤巨大,治疗方案不统一。本文报告6例成人前列腺肉瘤患者的临床治疗经验;并收集国内正式发表的11篇有关此病的治疗报道,结合文献讨论临床治疗方案。方法收集我院6例确诊为前列腺肉瘤的患者,5例行前列腺、膀胱切除并尿流改道,1例全盆脏器切除、尿流改道并行结肠造瘘;3例术前双侧髂内动脉栓塞,4例术后辅助放疗。国内全组62例,根治性手术治疗32例。结果我院1例无瘤生存33个月;1例带瘤生存18个月;4例因肿瘤死亡,生存时间5-40个月。国内全组根治手术后1年生存率59%,2年生存率34%。结论根治性手术是目前治疗成人前列腺肉瘤的有效措施。

关键词：前列腺肿瘤肉瘤外科手术预后

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