Observational studyDiabetologia2023
(Pre)diabetes and a higher level of glycaemic measures are continuously associated with corneal neurodegeneration assessed by corneal confocal microscopy: the Maastricht Study.
Observational study in Diabetologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study.Diabetologia · 2026Article
- A novel glycolipid composite index predicting cardiovascular disease in Chinese adults with abnormal glucose metabolism: a nationwide cohort study.Frontiers in cardiovascular medicine · 2026Article
- Diabetic keratopathy and nuclear proteins (Review).Molecular medicine reports · 2026Review
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- Long-term Nerve Regeneration in Diabetic Keratopathy Mediated by a Novel NGF Delivery System.Diabetes · 2025Article
- Alterations in Corneal Nerve Structure and Function in Prediabetes.Journal of diabetes research · 2025Article
- Assessing corneal dendritic cells in glucose dysregulation small-fibre neuropathy.Journal of the peripheral nervous system : JPNS · 2024Article
- Greater exposure to PMEnvironmental health : a global access science source · 2024Observational
- Plasma Sphingomyelins as Biomarkers for Diabetic Retinal Neurodegeneration: The Maastricht Study.Ophthalmology scienceArticle
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Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisTo assess the associations between glucose metabolism status and a range of continuous measures of glycaemia with corneal nerve fibre measures, as assessed using corneal confocal microscopy.
methodsWe used population-based observational cross-sectional data from the Maastricht Study of N=3471 participants (mean age 59.4 years, 48.4% men, 14.7% with prediabetes, 21.0% with type 2 diabetes) to study the associations, after adjustment for demographic, cardiovascular risk and lifestyle factors, between glucose metabolism status (prediabetes and type 2 diabetes vs normal glucose metabolism) plus measures of glycaemia (fasting plasma glucose, 2 h post-load glucose, HbA
resultsAfter full adjustment, a more adverse glucose metabolism status was associated with a lower composite Z-score for corneal nerve fibre measures (β coefficients [95% CI], prediabetes vs normal glucose metabolism -0.08 [-0.17, 0.03], type 2 diabetes vs normal glucose metabolism -0.14 [-0.25, -0.04]; linear trend analysis showed a p value of 0.001), and higher levels of measures of glycaemia (fasting plasma glucose, 2 h post-load glucose, HbA CONCLUSIONS/
interpretationTo our knowledge, this is the first population-based study to show that a more adverse glucose metabolism status and higher levels of glycaemic measures were all linearly associated with corneal neurodegeneration after adjustment for an extensive set of potential confounders. Our results indicate that glycaemia-associated corneal neurodegeneration is a continuous process that starts before the onset of type 2 diabetes. Further research is needed to investigate whether early reduction of hyperglycaemia can prevent corneal neurodegeneration.
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