한국컴퓨터정보학회논문지 (Journal of the Korea Society of Computer and Information)

  • 제25권3호
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  • Pages.185-190
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  • 2020
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  • 1598-849X(pISSN)
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  • 2383-9945(eISSN)
한국컴퓨터정보학회 (Korean Society of Computer Information)
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What is the meaning of hs-CRP and HbA1c in patients with dry eye syndrome in diabetes?

  • Kang, Ji-Hun (Dept. of Emergency Medicine at Inje University Busan Paik Hospital) ;
  • Shin, Sang-Yol (Dept. of Emergency Medical Service, Howon University)
  • 투고 : 2019.08.08
  • 심사 : 2020.03.15
  • 발행 : 2020.03.31
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초록

본 연구는 2016년 6월 16일부터 2016년 12월 31일까지 건강검진센터를 방문한 726명을 대상으로 Schirmer's 검사와 대사증후군 검사를 통해 전신적 만성 염증성 상태가 국소적 만성 염증성 상태로서의 안구건조증에 미치는 영향을 알아보고자 시행하였다. 대상자중 hs-CRP, HbA1c를 동시 측정한 214명을 대상으로 연구를 진행하였다. 연구대상자 중 고 연령일수록 (p<0.001), 성별로는 여성에서 유의하게 안구건조증이 증가하였으며(p=0.020), 공복혈당과 hs-CRP와는 연관이 없었다. 또한 HbA1c가 증가할수록 안구건조증에 대한 위험도가 증가하였다(β=1.960, p=0.025). 따라서 안구건조증은 만성 염증성 상태로 인한 눈물샘의 미세혈관 변화에 의한 것이 아니며 당뇨환자의 경우 단기간의 혈당 조절보다 장기간의 혈당 조절상태가 더욱 중요하게 작용할 수 있음을 알 수 있으며 당뇨병 환자에서 안구 건조증의 높은 유병률은 만성 염증으로 인한 미세 혈관 변화보다는 자율 기능 장애로 인한 것으로 생각된다.

The purpose of this study was to investigate the effects of systemic chronic inflammatory state on dry eye syndrome as a local chronic inflammatory condition. From June 16, 2016 to December 31, 2016, 726 patients who visited the general health examination center were screened using the Schirmer's test and the metabolic syndrome screening test. A total of 214 patients who were studied for hs-CRP and HbA1c were simultaneously selected for the study as well. Dry eye syndrome significantly increased in higher age groups (p<0.001) and women (p=0.020); there was no significant relationship with fasting plasma glucose, hs-CRP. In addition, as HbA1c increased the risk for dry eye syndrome also increased (β=1.960, p=0.025). Therefore, dry eye syndrome may not caused by microvascular changes in the lacrimal gland due to chronic inflammatory conditions. In diabetic patients, long-term blood glucose control may be more important than short-term blood glucose control. The high prevalence of dry eye syndrome in diabetic patients is thought to be due to autonomic dysfunction rather than microvascular changes caused by chronic inflammation.

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참고문헌

  1. Do Yeh Yoon, Joo Hyun Kim, Hyun Sun Jeon, Won Ryang Wee, Joon Young Hyon, "Correlations between Tear Osmolarity and Ocular and Systemic Parameters in Primary Sjogren's Syndrome", J Korean Ophthalmol Soc, Vol. 53, pp. 603-910, 2017.
  2. Nelson JD, Craig JP, Akpek EK, Azar DT, Belmonte C, Bron AJ, Clayton JA, Dogru M, Dua HS, Foulks GN, Gomes J AP, Hammitt KM, Holopainen J, Jones L, Joo CK, Liu Z, Nichols JJ, Nichols KK, Novack GD, Sangwan V, Stapleton F, Tomlinson A, Tsubota K, Willcox MDP, Wolffsohn JS, Sullivan DA. "TFOS DEWS II introduction", Ocul Surf, Vol. 15, pp. 269-275, 2017. https://doi.org/10.1016/j.jtos.2017.05.005
  3. Pflugfelder SC, Tseng SC, Sanabria O, Kell H, Garcia CG, Felix C, Feuer W, Reis BL, "Evaluation of subjective assessments and objective diagnostic tests for diagnosing tearfilm disorders known to cause ocular irritation", Cornea, Vol. 17, No. 1, pp. 38-56, 1998. https://doi.org/10.1097/00003226-199801000-00007
  4. Jerry Y. Niederkorn, Michael E. Stern, Stephen C. Pflugfelder, Cintia S. De Paiva, Rosa M. Corrales, Jianping Gao and Karyn Siemasko, "Desiccating stress induces T cell-mediated Sjogren''s Syndrome like lacrimal kerato conjunctivitis", J Immunol, Vol. 176, No. 7, pp. 3950-3957, 2006. https://doi.org/10.4049/jimmunol.176.7.3950
  5. Ridker PM, Rifai N, Clearfield M, Downs JR, Weis SE, Miles JS, "Measurement of C-reactive protein for the targeting of statin therapy in the primaryprevention of acute coronary events", N Engl J Med, Vol. 344, pp. 1959-65, 2001. https://doi.org/10.1056/NEJM200106283442601
  6. Ramos-Remus C, Suarez-Almazor M, Russell AS, "Low tear production in patients with diabetes mellitus is not due to Sjogren's syndrome", Clin Exp Rheumatol, Vol. 12, No. 4, pp. 375-380, 1994.
  7. Paul M Ridker, Josh D Silvertown, "Inflammation, C-reactive protein, and atherothrombosis", J Periodontol, Vol. 79, No. 8, pp. 1544-1551, 2008. https://doi.org/10.1902/jop.2008.080249
  8. Bron AJ, "The Doyne Lecture Reflections on the tears", Eye, Vol. 11, No. 5, pp. 538-602, 1997."
  9. Boyd BF, "The Important Developments in Dry eye", Highlights of Ophthalmology, Vol. 29, pp. 54-66, 2001.
  10. Wang F, Gao N, Yin J, Yu FS, "Reduced innervation and delayedre-innervation after epithelial wounding in type 2 diabetic Goto-Kakizaki rats", Am J Pathol, Vol. 181, pp. 2058-2066, 2012. https://doi.org/10.1016/j.ajpath.2012.08.029
  11. Peck T, Olsakovsky L, Aggarwal S. "Dry eye syndrome in meno-pause and perimenopausal age group", J Midlife Health, Vol. 8, pp. 51-54, 2017.
  12. Wan Seok Kang, Hyun Tae Choi, Min Ahn, In Cheon You, "The Change of Tear Film in Classification of Diabetic Retinopathy", Korean Ophthalmol Soc, Vol. 55, pp. 486-492, 2014. https://doi.org/10.3341/jkos.2014.55.4.486
  13. Lemp LA, "Diagnosis and Treatment of Tear Deficiencies", Duane's Clinical Ophth almology, Vol. 4, pp. 1-10, 1980.
  14. Ono M, Yoshino K, Tsubota K, Saito I, "Subclass expression of IgA in lacrimal glands of patients with Sjogren's syndrome", Adv Exp Med Biol, Vol. 350, pp. 185-188, 1994. https://doi.org/10.1007/978-1-4615-2417-5_32
  15. Seifart U, Strempel I, "The dry eye syndrome and diabetes mellitus", Ophthalmologe, Vol. 91, pp. 235-239, 1994.
  16. Schulze MB, Rimm EB, Li T, Rifai N, Stampfer MJ, Hu FB, "C-reactive protein and incident cardiovascular events among men with diabetes", Diabetes Care, Vol. 27, pp. 889-894, 2004. https://doi.org/10.2337/diacare.27.4.889
  17. Ridker PM, "C-reactive protein: eighty years from discovery to emergence as a major risk marker for cardiovascular disease", Clin Chem, Vol. 55, pp. 209-215, 2009. https://doi.org/10.1373/clinchem.2008.119214
  18. Schram MT, Chaturvedi N, Schalkwijk CG, Fuller JH, Stehouwer CD, "Markers of inflammation are ross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes - the EURODIAB Prospective Complications Study", Diabetologia, Vol. 48, pp. 370-379, 2005. https://doi.org/10.1007/s00125-004-1628-8
  19. Dogru M, Kojima T, Simsek C, Tsubota K, "Potential role of oxidative stress in ocular surface inflammation and dry eye disease", Invest Ophthalmol Vis Sci, Vol. 59, pp. 163-168, 2008.
  20. Hye Jong Oh, and Cheol Won Choi, "Relationship of the hs-CRP Levels with FBG, Fructosamine, and HbA1c in Non-diabetic Obesity Adults", Korean J Clin Lab Sci, Vol. 50, pp. 190-196, 2018. https://doi.org/10.15324/kjcls.2018.50.2.190