Effects Of Blood Glucose Control On Meibomian Gland Function In Patients With Type 2 Diabetes Mellitus

Objectives To analysis differences and the related factors of the Meibomian gland function in patients with type 2 diabetes mellitus with different level of glycosylated hemoglobin by Lipiview?ocular surface interferometry.Methods From May 2018 to December 2018,167 patients with type 2 diabetes diagnosed by Endocrinology Department of Hebei General Hospital and 68 non-diabetic patients recruited at the same time were selected for prospective study.Patients with type2 diabetes were divided into two groups based on the level of glycosylated hemoglobin(HbA1c),which was bounded by 7%.Standard patient evaluaion of eye dryness(SPEED)questionnaires were conducted in all subjects.Lipiview?ocular surface interferometry was used to examine the lipid layer thickness(LLT),partial blink(PB)and percentage of partial glands(MGP),and the tear break up time(TBUT),tear meniscus height(TMH),Schirmer I test(SIT)and Line of Marx(LOM)should also be examined,and to evaluate the secretion of the meibomian gland by meibomian gland evaluator(MGE),it includes meibomian gland yielding liquid secretion(MGYLS),meibomian gland yielding secretion score(MGYSS).And the correlation analysis of each index was carried out.Results There were significant differences in LLT(Z=-3.335,P=0.003),MGP(Z=5.649,P<0.001),MGYLS(Z=-2.830,P=0.014)and TBUT(Z=-2.813,P=0.015)between type 2 diabetes mellitus with HbA1c>7%and type 2 diabetes mellitus with HbA1c<7%.In the HbA1c>7%group,compared with the control group,LLT(Z=-2.707,P=0.020),MGP(Z=8.801,P<0.001),MGYLS(Z=-5.176,P<0.001),MGYSS(Z=-7.033,P<0.001),TBUT(Z=-3.889,P<0.001),Schirmer I test(Z=-3.484,P=0.001),TMH(Z=-2.767,P=0.017),Line of Marx(Z=-5.918,P<0.001)were statistically significant.Compared with the control group,the results of MGP(Z=2.562,P=0.031),MGYSS(Z=-4.337,P<0.001),Schirmer I test(Z=-3.584,P=0.001)and Line of Marx(Z=-4.903,P<0.001)were statistically significant in the HbA1c<7%group.The prevalence of MGD in HbA1c>7%group was significantly higher than that in non-diabetic group(?~2=9.437,P=0.002).The number of meibomian gland yielding liquid secretion(MGYLS)was positively correlated with the meibomian gland yielding secretion score(MGYSS)(r_s=0.872,P<0.001).Conclusions In type 2 diabetes mellitus patients with higher glycosylated hemoglobin level than those with normal glycosylated hemoglobin level,the absence of meibomian gland is more serious,the number of meibomian gland yielding liquid secretion is more likely to decrease,resulting in the decrease of lipid layer thickness,tear film instability and other signs of meibomian gland dysfunction,it is easier to cause meibomian gland dysfunction or even dry eye.Lipiview?ocular surface interferometry can effectively assist the detection and diagnosis of meibomian gland dysfunction in diabetic patients,and can more objectively and accurately evaluate the degree of meibomian gland dysfunction in diabetic patients,thus providing strong evidence for future diagnosis and treatment.Figure 9;Table 9;Reference 126...