Research Of The Correlation Between Corneal Neuropathy And Diabetic Foot In Diabetes

OBJECTIVE:To invesgate the correlation between corneal neuropathy and diabetic foot in diabetic patients.METHODS:42 diabetic paitents were invited to participate in the study,they were stratefied into two subgroups:non-diabetic foot group(16patients,32 eyes),diabetic foot group(14 patient,28 eyes),and 20 healty volunteers(control group 20 volunteers,40 eyes).Individuals underwent confocal microscopy examination,and analyzed corneal nerve fiber length(CNFL),corneal nerve fiber density(CNFD),corneal nerve fiber branch density(CNFBD),and corneal nerve turtuosity(CNT).CNFL,CNFD,CNBD and NT were compared among three groups,and analyzed the corrolations between age,duration,HbA1c,neuropathy symptom score(NSS),disability score(NDS)and nerve parameters.REUSLT:There were significant differences in corneal nerve parameters among three groups.Compared with control group,non-diabetic foot group had reduced CNFL,CNFD,CNFBD(13.470±2.753mm/mm2vs 16.699±1.613mm/mm~2,27.645±6.173mm/mm~2 vs32.344±4.552mm/mm~2,38.380±11.894mm/mm~2 vs 47.552±5.005mm/mm~2),and increased CNT(1.432±0.348mm/mm~2 vs 0.759±0.365mm/mm~2).And diabetic foot group had reduced CNFL,CNFD,CNFBD(9.701±1.834mm/mm~2 vs 13.470±2.753mm/mm~2?19.102±4.523mm/mm~2 vs 27.645±6.173mm/mm~2?22.645±6.883mm/mm~2 vs38.380±11.894mm/mm~2)and increased CNT(2.006±0.432mm/mm~2 vs1.432±0.348mm/mm~2)compared with non-diabetic foot group.In addition,we found that age showed negative with CNFD(r=-0.419,p=0.006),CNFBD(r=-0.352,p=0.022),and positive with CNT(r=0.347,p=0.024).Duration showd negative correlation with CNFL(r=-0.328,p=0.034),CNFD(r=-0.337,p=0.029),CNFBD(r=-0.404,p=0.008),and had positive correlation with CNT(r=0.332,p=0.032).NSS showed negative correlation with CNFL(r=-0.364,p=0.018),CNFD(r=-0.332,p=0.032),CNFBD(r=-0.340,p=0.028),and had no correlation with CNT.NSS showed negative correlation with CNFL(r=-0.364,p=0.018),CNFD(r=-0.322,p=0.032),CNFBD(r=-0.340,p=0.028),and had no correlation with CNT.NSS showed negative correlation with CNFL(r=-0.319,p=0.039),CNFD(r=-0.399,p=0.009),CNFBD(r=-0.369,p=0.016),and had positive correlation with CNT(r=0.392,p=0.010).And we did not found that HbA1c showed any correlation with corneal nerve parameters.CONCLUSION:corneal neuropathy of diabetic foot is more obvious than non-diabetic foot,suggest that corneal nerve parametes may be used for evaluating the condition of diabetic patients,and forecasting diabetic foot.And corneal neuropathy of diabetes may be correlated with duration and peripheral neuropathy(NSS NDS).