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당뇨병 미세혈관 합병증에서 생체 각막 공초점 현미경(In vivo Corneal Confocal Microscopy)과 신경성장인자(Nerve GrowthFactor)의 의의

Other Titles
 In vivo Corneal Confocal Microscopy and Nerve Growth Factor in Diabetic Microvascular Complications 
Authors
 남지선  ;  조영재  ;  이현철  ;  김경래  ;  임승길  ;  이은직  ;  차봉수  ;  안철우  ;  이형근  ;  이유미  ;  강은석  ;  정한영  ;  윤지은  ;  김혜진  ;  조민호  ;  박종숙  ;  김철식  ;  노태웅 
Citation
 Journal of Korean Diabetes Association (당뇨병), Vol.31(4) : 351-361, 2007 
Journal Title
 Journal of Korean Diabetes Association (당뇨병) 
ISSN
 1015-6461 
Issue Date
2007
Keywords
Diabetic microvascular complications ; In vivo corneal confocal microscopy ; Nerve growth factor
Abstract
Background In vivo corneal confocal microscopy (IVCCM) is being recognized as a non-invasive, early diagnostic tool for diabetic neuropathy, for it provides a clear image of corneal subbasal nerve plexus in detail. Nerve growth factors (NGF) are believed to regulate peripheral and central nervous system, neuronal differentiation, and regeneration of damaged nerves, and their role in diabetic neuropathy is being emphasized these days. Moreover, NGFs and receptors are also expressed in retina and renal mesangial cells, suggesting their possible role in the common pathogenesis of diabetic microvascular complications. We plan to examine corneal structures of diabetic patients and compare IVCCM with conventional tools and analyze their serum and tear NGF levels. Methods IVCCM, nerve conduction velocity (NCV), and serum, urine, and tear samplings were done to 42 diabetic patients. From IVCCM, we measured corneal nerve density, branch, and tortuosity, total corneal/epithelial thickness, and the number of endothelial/keratocyte cells, and we checked patients' biochemical profiles and serum and tear NGF levels. Results Patients with more severe neuropathy had less corneal endothelial cells (3105 ± 218 vs. 2537 ± 142 vs. 2350 ± 73/mm3 vs. 1914 ± 465/mm3,P = 0.02), higher serum NGF (36 ± 15 vs. 60 ± 57.66 vs. 80 ± 57.63 vs. 109 ± 60.81 pg/mL, P = 0.39) and tear NGF levels (135.00 ± 11.94 vs. 304.29 ± 242.44 vs. 538.50 ± 251.92 vs. 719.50 ± 92.63 pg/mL, P = 0.01). There was a positive correlation between neuropathy and corneal nerve tortuosity (r2 = 0.479, P = 0.044) and negative correlation between neuropathy and endothelial cell count (r2 = -0.709, P = 0.002). Interestingly, similar changes were seen in other microvascular complications as well. Conclusion Our results provide a possibility of using novel tools, IVCCM and NGF, as common diagnostic tools for diabetic microvascular complications, but it should be followed by a large population study.
Files in This Item:
T200700033.pdf Download
DOI
10.4093/jkda.2007.31.4.351
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Kyung Rae(김경래)
Kim, Chul Sik(김철식)
Kim, Hae Jin(김혜진)
Nam, Ji Sun(남지선) ORCID logo https://orcid.org/0000-0001-8655-5258
Noh, Tae Woong(노태웅)
Park, Jong Suk(박종숙) ORCID logo https://orcid.org/0000-0002-5385-1373
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Lee, Hyun Chul(이현철)
Lee, Hyung Keun(이형근) ORCID logo https://orcid.org/0000-0002-1123-2136
Lim, Sung Kil(임승길)
Cho, Min Ho(조민호)
Cho, Young Jae(조영재)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96587
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