Obesity negatively impacts corneal nerves in patients with diabetes mellitus
Abstract Background To investigate the relationship between obesity and corneal nerve metrics in patients with type 2 diabetes mellitus (DM). Methods This cross-sectional study included a total of 385 healthy controls and 663 patients with DM. Metrics for corneal nerve and epithelial cells were eval...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | Eye and Vision |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40662-025-00433-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850173163002920960 |
|---|---|
| author | Calesta Hui Yi Teo Chang Liu Mingyi Yu Isabelle Xin Yu Lee Ansa Anam Ching-Yu Cheng Yadana Htunwai Jasmine Shimin Koh Suresh Rama Chandran Yu-Chi Liu |
| author_facet | Calesta Hui Yi Teo Chang Liu Mingyi Yu Isabelle Xin Yu Lee Ansa Anam Ching-Yu Cheng Yadana Htunwai Jasmine Shimin Koh Suresh Rama Chandran Yu-Chi Liu |
| author_sort | Calesta Hui Yi Teo |
| collection | DOAJ |
| description | Abstract Background To investigate the relationship between obesity and corneal nerve metrics in patients with type 2 diabetes mellitus (DM). Methods This cross-sectional study included a total of 385 healthy controls and 663 patients with DM. Metrics for corneal nerve and epithelial cells were evaluated using in-vivo confocal microscopy (IVCM). Corneal nerve and epithelial cell parameters were quantified and compared between patients with and without obesity and across six different body mass index (BMI) categories. Multivariable regression analyses were conducted to determine the association between corneal nerve metrics and BMI in patients with DM. Results Of the DM participants, 162 (25.4%) had obesity. Compared to the non-obese group, patients with obesity had significantly lower corneal nerve fiber density (CNFD, P < 0.0001), corneal nerve fiber length (CNFL, P = 0.002), and corneal nerve branch density (CNBD, P = 0.005). Analyses across different BMI categories showed a progressive decline in corneal nerve parameters including CNFD (P < 0.0001), CNFL (P < 0.0001), CNBD (P < 0.0001), corneal nerve fiber total branch density (P = 0.003), corneal nerve fiber area (P = 0.04), and corneal nerve fiber fractal dimension (P = 0.02) with increasing obesity severity. Multivariable regression analyses demonstrated that lower CNFD (β: − 0.21, 95% CI: − 0.29 to − 0.13, P < 0.0001), shorter CNFL (β: − 0.12, 95% CI: − 0.17 to − 0.07, P < 0.0001), and lower CNBD (β: − 0.17, 95% CI: − 0.30 to − 0.04, P = 0.01) were significantly associated with BMI after adjusting for confounders. There were no significant differences in the corneal epithelial parameters between the obese and non-obese groups. Conclusions General obesity, specifically higher BMI, adversely affects corneal nerve health in individuals with DM. Evaluation of corneal nerves and resultant keratopathy should be considered in patients with DM and concomitant obesity. |
| format | Article |
| id | doaj-art-78c08924ddcd45e4ae47c3e7cab11cd1 |
| institution | OA Journals |
| issn | 2326-0254 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Eye and Vision |
| spelling | doaj-art-78c08924ddcd45e4ae47c3e7cab11cd12025-08-20T02:19:55ZengBMCEye and Vision2326-02542025-04-0112111210.1186/s40662-025-00433-5Obesity negatively impacts corneal nerves in patients with diabetes mellitusCalesta Hui Yi Teo0Chang Liu1Mingyi Yu2Isabelle Xin Yu Lee3Ansa Anam4Ching-Yu Cheng5Yadana Htunwai6Jasmine Shimin Koh7Suresh Rama Chandran8Yu-Chi Liu9Yong Loo Lin School of Medicine, National University of SingaporeCorneal and Refractive Surgery Group, Singapore Eye Research InstituteCorneal and Refractive Surgery Group, Singapore Eye Research InstituteCorneal and Refractive Surgery Group, Singapore Eye Research InstituteDepartment of Ophthalmology, MTI Khyber Teaching HospitalCorneal and Refractive Surgery Group, Singapore Eye Research InstituteCorneal and Refractive Surgery Group, Singapore Eye Research InstituteDepartment of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital CampusDepartment of Endocrinology, Singapore General HospitalCorneal and Refractive Surgery Group, Singapore Eye Research InstituteAbstract Background To investigate the relationship between obesity and corneal nerve metrics in patients with type 2 diabetes mellitus (DM). Methods This cross-sectional study included a total of 385 healthy controls and 663 patients with DM. Metrics for corneal nerve and epithelial cells were evaluated using in-vivo confocal microscopy (IVCM). Corneal nerve and epithelial cell parameters were quantified and compared between patients with and without obesity and across six different body mass index (BMI) categories. Multivariable regression analyses were conducted to determine the association between corneal nerve metrics and BMI in patients with DM. Results Of the DM participants, 162 (25.4%) had obesity. Compared to the non-obese group, patients with obesity had significantly lower corneal nerve fiber density (CNFD, P < 0.0001), corneal nerve fiber length (CNFL, P = 0.002), and corneal nerve branch density (CNBD, P = 0.005). Analyses across different BMI categories showed a progressive decline in corneal nerve parameters including CNFD (P < 0.0001), CNFL (P < 0.0001), CNBD (P < 0.0001), corneal nerve fiber total branch density (P = 0.003), corneal nerve fiber area (P = 0.04), and corneal nerve fiber fractal dimension (P = 0.02) with increasing obesity severity. Multivariable regression analyses demonstrated that lower CNFD (β: − 0.21, 95% CI: − 0.29 to − 0.13, P < 0.0001), shorter CNFL (β: − 0.12, 95% CI: − 0.17 to − 0.07, P < 0.0001), and lower CNBD (β: − 0.17, 95% CI: − 0.30 to − 0.04, P = 0.01) were significantly associated with BMI after adjusting for confounders. There were no significant differences in the corneal epithelial parameters between the obese and non-obese groups. Conclusions General obesity, specifically higher BMI, adversely affects corneal nerve health in individuals with DM. Evaluation of corneal nerves and resultant keratopathy should be considered in patients with DM and concomitant obesity.https://doi.org/10.1186/s40662-025-00433-5Corneal nervesCorneal epitheliumObesityBody mass indexDiabetes mellitus |
| spellingShingle | Calesta Hui Yi Teo Chang Liu Mingyi Yu Isabelle Xin Yu Lee Ansa Anam Ching-Yu Cheng Yadana Htunwai Jasmine Shimin Koh Suresh Rama Chandran Yu-Chi Liu Obesity negatively impacts corneal nerves in patients with diabetes mellitus Eye and Vision Corneal nerves Corneal epithelium Obesity Body mass index Diabetes mellitus |
| title | Obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| title_full | Obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| title_fullStr | Obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| title_full_unstemmed | Obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| title_short | Obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| title_sort | obesity negatively impacts corneal nerves in patients with diabetes mellitus |
| topic | Corneal nerves Corneal epithelium Obesity Body mass index Diabetes mellitus |
| url | https://doi.org/10.1186/s40662-025-00433-5 |
| work_keys_str_mv | AT calestahuiyiteo obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT changliu obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT mingyiyu obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT isabellexinyulee obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT ansaanam obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT chingyucheng obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT yadanahtunwai obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT jasmineshiminkoh obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT sureshramachandran obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus AT yuchiliu obesitynegativelyimpactscornealnervesinpatientswithdiabetesmellitus |