Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy StudyCitation formats

  • External authors:
  • Shazli Azmi
  • Ioannis Petropoulos
  • Georgios Ponirakis
  • Uazman Alam
  • Omar Asghar
  • Andrew Marshall
  • Catherine Fullwood
  • Caroline Abbott
  • Giuseppe Lauria
  • Catharina G Faber
  • Handrean Soran
  • Nathan Efron
  • Rayaz Malik

Standard

Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study. / Ferdousi, Maryam; Kalteniece, Alise; Azmi, Shazli; Petropoulos, Ioannis; Ponirakis, Georgios; Alam, Uazman; Asghar, Omar; Marshall, Andrew; Fullwood, Catherine; Jeziorska, Maria; Abbott, Caroline; Lauria, Giuseppe; Faber, Catharina G; Soran, Handrean; Efron, Nathan; Boulton, Andrew; Malik, Rayaz.

In: Diabetes Care, Vol. 44, No. 1, 01.01.2021, p. 150-156.

Research output: Contribution to journalArticlepeer-review

Harvard

Ferdousi, M, Kalteniece, A, Azmi, S, Petropoulos, I, Ponirakis, G, Alam, U, Asghar, O, Marshall, A, Fullwood, C, Jeziorska, M, Abbott, C, Lauria, G, Faber, CG, Soran, H, Efron, N, Boulton, A & Malik, R 2021, 'Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study', Diabetes Care, vol. 44, no. 1, pp. 150-156. https://doi.org/10.2337/dc20-1482

APA

Ferdousi, M., Kalteniece, A., Azmi, S., Petropoulos, I., Ponirakis, G., Alam, U., Asghar, O., Marshall, A., Fullwood, C., Jeziorska, M., Abbott, C., Lauria, G., Faber, C. G., Soran, H., Efron, N., Boulton, A., & Malik, R. (2021). Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study. Diabetes Care, 44(1), 150-156. https://doi.org/10.2337/dc20-1482

Vancouver

Author

Ferdousi, Maryam ; Kalteniece, Alise ; Azmi, Shazli ; Petropoulos, Ioannis ; Ponirakis, Georgios ; Alam, Uazman ; Asghar, Omar ; Marshall, Andrew ; Fullwood, Catherine ; Jeziorska, Maria ; Abbott, Caroline ; Lauria, Giuseppe ; Faber, Catharina G ; Soran, Handrean ; Efron, Nathan ; Boulton, Andrew ; Malik, Rayaz. / Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study. In: Diabetes Care. 2021 ; Vol. 44, No. 1. pp. 150-156.

Bibtex

@article{fd6da5c4f3d348d0bd62768a4cf33e01,
title = "Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study",
abstract = "OBJECTIVE To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and the risk factors for corneal nerve loss. RESEARCH DESIGN AND METHODS A total of 490 participants, including 72 healthy control subjects, 149 with type 1 diabetes, and 269 with type 2 diabetes, underwent detailed assessment of peripheral neuropathy and CCM in relation to risk factors. RESULTS Corneal nerve fiber density (CNFD) (P < 0.0001 and P < 0.0001), corneal nerve fiber branch density (CNBD) (P < 0.0001 and P < 0.0001), and corneal nerve fiber length (CNFL) (P < 0.0001 and P = 0.02) were significantly lower in patients with type 1 and type 2 diabetes compared with control subjects. CNFD (P < 0.0001), CNBD (P < 0.0001), and CNFL (P < 0.0001) were lower in type 1 diabetes compared with type 2 diabetes. Receiver operating characteristic curve analysis for the diagnosis of DPN demonstrated a good area under the curve for CNFD of 0.81, CNBD of 0.74, and CNFL of 0.73. Multivariable regression analysis showed a significant association among reduced CNFL with age (b =-0.27, P = 0.007), HbA 1c (b=-1.1; P = 0.01), and weight (b=-0.14; P = 0.03) in patients with type 2 diabetes and with duration of diabetes (b=-0.13; P = 0.02), LDL cholesterol (b=1.8, P = 0.04), and triglycerides (b =-2.87; P = 0.009) in patients with type 1 diabetes. CONCLUSIONS CCM identifies more severe corneal nerve loss in patients with type 1 diabetes compared with type 2 diabetes and shows good diagnostic accuracy for DPN. Furthermore, the risk factors for a reduction in corneal nerve fiber length differ between type 1 and type 2 diabetes. ",
author = "Maryam Ferdousi and Alise Kalteniece and Shazli Azmi and Ioannis Petropoulos and Georgios Ponirakis and Uazman Alam and Omar Asghar and Andrew Marshall and Catherine Fullwood and Maria Jeziorska and Caroline Abbott and Giuseppe Lauria and Faber, {Catharina G} and Handrean Soran and Nathan Efron and Andrew Boulton and Rayaz Malik",
note = "Funding Information: Acknowledgments. The authors thank Dr. MitraTavakoli,whoundertookCCM,andDr.Hassan Fadavi, who undertook clinical assessment in a proportion of patients, both while working at the University of Manchester. Funding. The research received funding from the European Union Seventh Framework Programme FP7/2007–2013 (602273), Diabetes UK (RD05/0003048), and JDRF (8-2008-362). This work was also supported by the Manchester Biomedical Research Centre and the Greater Manchester Comprehensive Local Research Network. Publisher Copyright: {\textcopyright} 2020 by the American Diabetes Association. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jan,
day = "1",
doi = "10.2337/dc20-1482",
language = "English",
volume = "44",
pages = "150--156",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association ",
number = "1",

}

RIS

TY - JOUR

T1 - Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study

AU - Ferdousi, Maryam

AU - Kalteniece, Alise

AU - Azmi, Shazli

AU - Petropoulos, Ioannis

AU - Ponirakis, Georgios

AU - Alam, Uazman

AU - Asghar, Omar

AU - Marshall, Andrew

AU - Fullwood, Catherine

AU - Jeziorska, Maria

AU - Abbott, Caroline

AU - Lauria, Giuseppe

AU - Faber, Catharina G

AU - Soran, Handrean

AU - Efron, Nathan

AU - Boulton, Andrew

AU - Malik, Rayaz

N1 - Funding Information: Acknowledgments. The authors thank Dr. MitraTavakoli,whoundertookCCM,andDr.Hassan Fadavi, who undertook clinical assessment in a proportion of patients, both while working at the University of Manchester. Funding. The research received funding from the European Union Seventh Framework Programme FP7/2007–2013 (602273), Diabetes UK (RD05/0003048), and JDRF (8-2008-362). This work was also supported by the Manchester Biomedical Research Centre and the Greater Manchester Comprehensive Local Research Network. Publisher Copyright: © 2020 by the American Diabetes Association. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - OBJECTIVE To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and the risk factors for corneal nerve loss. RESEARCH DESIGN AND METHODS A total of 490 participants, including 72 healthy control subjects, 149 with type 1 diabetes, and 269 with type 2 diabetes, underwent detailed assessment of peripheral neuropathy and CCM in relation to risk factors. RESULTS Corneal nerve fiber density (CNFD) (P < 0.0001 and P < 0.0001), corneal nerve fiber branch density (CNBD) (P < 0.0001 and P < 0.0001), and corneal nerve fiber length (CNFL) (P < 0.0001 and P = 0.02) were significantly lower in patients with type 1 and type 2 diabetes compared with control subjects. CNFD (P < 0.0001), CNBD (P < 0.0001), and CNFL (P < 0.0001) were lower in type 1 diabetes compared with type 2 diabetes. Receiver operating characteristic curve analysis for the diagnosis of DPN demonstrated a good area under the curve for CNFD of 0.81, CNBD of 0.74, and CNFL of 0.73. Multivariable regression analysis showed a significant association among reduced CNFL with age (b =-0.27, P = 0.007), HbA 1c (b=-1.1; P = 0.01), and weight (b=-0.14; P = 0.03) in patients with type 2 diabetes and with duration of diabetes (b=-0.13; P = 0.02), LDL cholesterol (b=1.8, P = 0.04), and triglycerides (b =-2.87; P = 0.009) in patients with type 1 diabetes. CONCLUSIONS CCM identifies more severe corneal nerve loss in patients with type 1 diabetes compared with type 2 diabetes and shows good diagnostic accuracy for DPN. Furthermore, the risk factors for a reduction in corneal nerve fiber length differ between type 1 and type 2 diabetes.

AB - OBJECTIVE To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and the risk factors for corneal nerve loss. RESEARCH DESIGN AND METHODS A total of 490 participants, including 72 healthy control subjects, 149 with type 1 diabetes, and 269 with type 2 diabetes, underwent detailed assessment of peripheral neuropathy and CCM in relation to risk factors. RESULTS Corneal nerve fiber density (CNFD) (P < 0.0001 and P < 0.0001), corneal nerve fiber branch density (CNBD) (P < 0.0001 and P < 0.0001), and corneal nerve fiber length (CNFL) (P < 0.0001 and P = 0.02) were significantly lower in patients with type 1 and type 2 diabetes compared with control subjects. CNFD (P < 0.0001), CNBD (P < 0.0001), and CNFL (P < 0.0001) were lower in type 1 diabetes compared with type 2 diabetes. Receiver operating characteristic curve analysis for the diagnosis of DPN demonstrated a good area under the curve for CNFD of 0.81, CNBD of 0.74, and CNFL of 0.73. Multivariable regression analysis showed a significant association among reduced CNFL with age (b =-0.27, P = 0.007), HbA 1c (b=-1.1; P = 0.01), and weight (b=-0.14; P = 0.03) in patients with type 2 diabetes and with duration of diabetes (b=-0.13; P = 0.02), LDL cholesterol (b=1.8, P = 0.04), and triglycerides (b =-2.87; P = 0.009) in patients with type 1 diabetes. CONCLUSIONS CCM identifies more severe corneal nerve loss in patients with type 1 diabetes compared with type 2 diabetes and shows good diagnostic accuracy for DPN. Furthermore, the risk factors for a reduction in corneal nerve fiber length differ between type 1 and type 2 diabetes.

U2 - 10.2337/dc20-1482

DO - 10.2337/dc20-1482

M3 - Article

VL - 44

SP - 150

EP - 156

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 1

ER -