Dataset Information

Association of Diabetes With Central Corneal Thickness Among a Multiethnic Asian Population.

ABSTRACT:

Importance

Thicker or thinner central corneas may lead to either overestimation or underestimation of intraocular pressure, which is the most important causal and treatable risk factor for glaucoma. However, the findings on the associations between diabetes, random glucose, and glycated hemoglobin A1c (HbA1c) with central corneal thickness (CCT) are conflicting.

Objective

To evaluate the associations between diabetes, random glucose, and HbA1c with CCT in a multiethnic Asian population.

Design, setting, and participants

Cross-sectional analysis of the Singapore Epidemiology of Eye Diseases (SEED) Study conducted from 2004 to 2011. A total of 10?033 Chinese, Malay, and Indian individuals 40 years or older residing in Singapore were recruited. Participants with incomplete information on diabetes status (448 participants), prior refractive or cataract surgery (1940 eyes), and corneal edema or dystrophy (29 eyes) were excluded. A meta-analysis was conducted to estimate the overall association of diabetes with CCT.

Exposures

Standardized clinical examinations and interviewer-administered questionnaire to collect information about demographic, systemic, and ocular factors.

Main outcomes and measures

Measurement of CCT using ultrasound pachymetry.

Results

A total of 8846 adults (mean [SD] age, 57.9 [9.9] years; 4447 women [50.3%]) (17?201 eyes) were included in the final analyses. The CCT profile was similar among participants with and without diabetes (mean [SD] CCT, 545.3 [33.7] ?m vs 544.8 [33.9] ?m; P?=?.39). Following adjustments of age, sex, ethnicity, corneal curvature, axial length, and body mass index, CCT was a mean (SD) of 4.9 (0.8) ?m (95% CI, 3.3-6.5 ?m) thicker in patients with diabetes than those without diabetes. Multivariable analyses also showed that thicker CCT was associated with higher random glucose (per 10 mg/dL [to convert to mmol/L, multiply by 0.0555], ??=?0.3; 95% CI, 0.2-0.4) and higher HbA1c (per percentage, ??=?1.5; 95% CI, 1.0-2.1) (all P?Conclusions and relevanceThese findings suggest that diabetes and hyperglycemia were associated with thicker CCT. This study provides useful information on the interpretation of intraocular pressure in patients with diabetes.

SUBMITTER: Luo XY

PROVIDER: S-EPMC6324536 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of Diabetes With Central Corneal Thickness Among a Multiethnic Asian Population.

Luo Xiao-Yang XY Dai Wei W Chee Miao-Li ML Tao Yijin Y Chua Jacqueline J Tan Nicholas Y Q NYQ Tham Yih-Chung YC Aung Tin T Wong Tien Yin TY Cheng Ching-Yu CY

JAMA network open 20190104 1

<h4>Importance</h4>Thicker or thinner central corneas may lead to either overestimation or underestimation of intraocular pressure, which is the most important causal and treatable risk factor for glaucoma. However, the findings on the associations between diabetes, random glucose, and glycated hemoglobin A1c (HbA1c) with central corneal thickness (CCT) are conflicting.<h4>Objective</h4>To evaluate the associations between diabetes, random glucose, and HbA1c with CCT in a multiethnic Asian popul ...[more]

PMID: 30646192

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Project description:ImportanceWith the rapidly aging population, the burden of visual impairment (VI) and cognitive decline is expected to increase. Previous cross-sectional studies suggest an association between these 2 health outcomes. However, few longitudinal reports have examined this association, and to our knowledge, no studies have been performed in Asian populations. Further investigation on this association may help to better identify individuals at risk of cognitive decline.ObjectiveTo examine the longitudinal association between VI and decline in cognitive function in a multiethnic Asian population.Design, setting, and participantsIn this longitudinal, population-based, prospective cohort study, Chinese, Indian, and Malay adults 60 years or older at baseline were recruited from the Singapore Epidemiology of Eye Diseases (SEED) study. At baseline, participants from the SEED study were recruited under 3 studies: the Singapore Malay Eye Study (SiMES; 2004-2006), the Singapore Indian Eye Study (SINDI; 2007-2009), and the Singapore Chinese Eye Study (SCES; 2009-2011). Eligible participants were reexamined after 6 years (2011-2013 for SiMES, 2013-2015 for SINDI, and 2015-2017 for SCES). Data analysis was performed from November 1 to 24, 2019.ExposuresVisual impariment was defined as presenting visual acuity worse than 20/40 based on the better-seeing eye.Main outcomes and measuresCognitive function was assessed using a locally validated Abbreviated Mental Test (AMT). The association between baseline VI and change in AMT score was determined using the multivariable linear regression model adjusting for baseline age; sex; race/ethnicity; presence of diabetes, hyperlipidemia, hypertension, and chronic kidney disease; history of cardiovascular disease; smoking status; alcohol intake; body mass index; educational status; and AMT score.ResultsA total of 2478 individuals (1256 [50.7%] male; 1073 Chinese, 768 Indian, and 637 Malay adults) with mean (SD) age of 67.6?(5.6) years were evaluated, of whom 489 (19.7%) had reduction in AMT scores over 6 years. Baseline VI was associated with a decrease in AMT score over 6 years (??=?-0.27; 95% CI, -0.37 to -0.17; P?<?.001). When change in vision over 6 years was evaluated, unchanged or deteriorated VI was associated with a decrease in AMT score over 6 years (??=?-0.29; 95% CI, -0.40 to -0.18; P?<?.001). Among individuals with baseline VI and a substantial decrease in AMT score of 3 units or more over 6 years, the leading causes of VI were undercorrected refractive error (14 [45.2%]) and cataract (11 [35.5%]).Conclusions and relevanceIn this study, poor vision was independently associated with a decline in cognitive function. Causes of visual loss in these cases were mostly preventable, further suggesting that preserving good vision may be an important interventional strategy for mitigating cognitive decline.

Dataset Information

Association of Diabetes With Central Corneal Thickness Among a Multiethnic Asian Population.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Publications

Association of Diabetes With Central Corneal Thickness Among a Multiethnic Asian Population.

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