Txheeb xyuas Meibomian Gland Dysfunction Biomarkers nyob rau hauv Ib pawg ntawm cov neeg mob cuam tshuam los ntawm DM Hom II Ntu Ⅰ
Jun 01, 2023
Abstract:
(1) Keeb kwm: Meibomian gland dysfunction (MGD) ntawm cov neeg mob ntshav qab zib mellitus (DM) yog ib qho tshwm sim ntawm qhov muag qhuav (DES).
(2) Cov txheej txheem: Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau txheeb xyuas qhov ntsuas qhov ntsuas thiab biomarkers muaj txiaj ntsig los txhim kho kev soj ntsuam thiab kho cov neeg mob no. Peb tau siv daim ntawv nug txog kab mob ntawm qhov muag (OSDI), Schirmer test I/II, kua muag zaj duab xis tawg lub sij hawm (TF-TSIS), fluorescein ntxiv rau lissamine ntsuab staining, Marx's kab (ML), thiab meibomian caj pas (MGs) morphology siv Sirius® Topographer (CSO, Costruzione Strumenti Oftalmici, Florence, Ltalis). Cov ntshav kuaj ntshav suav nrog cov piam thaj, glycated hemoglobin, lipid profile, cortisol, dehydroepiandrosterone sulfate (DHEA-S), androstenedione (ASD), thiab testosterone.
(3) Cov txiaj ntsig: Cortisol thiab ASD tau muaj txiaj ntsig zoo nrog kev nce hauv MG tortuosity, thiab nce qib ntawm triglycerides tau cuam tshuam nrog kev txo qis ntawm MGs ntev. DHEAS qib qis dua nrog lub hnub nyoog thiab tau cuam tshuam nrog ocular nto staining.
(4) Cov ntsiab lus: Cov kev tshawb fawb yav tom ntej, tej zaum suav nrog meibum lipid tsom xam thiab cov kua muag cytokine qib, kuj tseem tuaj yeem piav qhia ntxiv txog kev sib txuas ntawm cov tsis muaj, MG architecture, thiab kev ua haujlwm.
Nyem rau cistanche deserticola vs tubulosa rau testosterone
Ntsiab lus: meibomian caj pas tsis ua haujlwm; ntshav qab zib mellitus; cov tshuaj hormones; biomarkers
1. Taw qhia
Meibomian caj pas (MGs) yog hloov kho cov qog sebaceous nyob rau hauv lub sab sauv thiab sab tarsal phaj thiab muab faib vertically rau daim tawv muag daim duab. MGs muaj ntau dua nyob rau hauv daim tawv muag sab sauv thiab ntev dua, khaws cia ob npaug ntawm cov lipids piv rau daim tawv muag qis MGs [1]. Lipid secreted los ntawm MGs yog hu ua meibum uas tau tso tawm los ntawm lawv cov orifices pom tsuas yog posterior mus rau mucocutaneous hlws ris raws daim tawv muag ntawm daim tawv muag. Meibum plays lub luag haujlwm tseem ceeb hauv kev tsim kua muag zaj duab xis, txo cov evaporation ntawm cov aqueous txheej thiab tiv thaiv lub qhov muag nto raws li hydrophobic barrier [1].
Qhov kev puas tsuaj ntawm MGs ua rau meibomian gland dysfunction (MGD), ib qho mob ntev uas ua rau lub davhlau ya nyob twg occlusion, thiab hloov lipid secretion. MGD yog feem ntau yog vim li cas rau evaporative qhuav qhov muag syndrome (DES). Cov neeg mob feem ntau raug kev txom nyem los ntawm kev qhuav qhuav, thiab kub hnyiab, thiab txawv teb chaws lub cev, thiab tuaj yeem ntsib kev cuam tshuam ntawm lub neej [2]. Ntau cov kev tshawb fawb tau qhia txog kev sib txuas ntawm MGD thiab cov txheej txheem hauv lub cev, xws li androgen deficiency [3], hyperlipidemia [4], thiab ntshav qab zib mellitus (DM) [5]. Nws tsis ntev los no tau pom tias DM yog qhov tseem ceeb ntawm kev pheej hmoo rau kev txhim kho MGD [4].
Kev koom tes ntawm DM thiab kev pheej hmoo ntawm kev loj hlob ntawm DES kuj tau txais kev txhawb nqa los ntawm kev tshuaj ntsuam meta tsis ntev los no uas tau txiav txim siab ntau dua 2.5 lab tus neeg mob los ntawm tag nrho ntawm 17 kev tshawb fawb [6]. Lub koom haum no muaj cov txheej txheem pathogenetic txiav txim siab tias MG yog hloov kho sebaceous qog thiab sebaceous qog cov qauv thiab kev ua haujlwm tau hloov pauv hauv cov neeg mob ntshav qab zib [4,5]. Nws tau raug suav hais tias hloov pauv cov tshuaj insulin ntau lawm / teb thiab hyperglycemia yog cov ntsiab lus tseem ceeb hauv cov kab mob ntawm MGD hauv cov neeg mob ntshav qab zib. Insulin yog ib qho tseem ceeb rau kev kho cov qog sebaceous metabolism; insulin tsis txaus yuav txhawb kev ua haujlwm tsis zoo [5].
Tsis tas li ntawd, hyperglycemia yog ib qho kev txhawb rau lipolysis hauv adipocytes thiab cov lus teb hauv MGs tuaj yeem txo qhov zoo ntawm meibum [7]. Cov txheej txheem pathogenetic no tau txais kev txhawb nqa los ntawm cov pov thawj tsis ntev los no uas qhia tias cov tshuaj insulin tuaj yeem txhawb kev loj hlob ntawm tib neeg meibomian gland epithelial hlwb (HMGECs), thaum cov piam thaj siab tau pom tias muaj tshuaj lom rau HMGECs [5]. MGD thiab cuam tshuam evaporative kua muag poob yog ua raws li los ntawm qhov o ntawm lub qhov muag nto nrog kev loj hlob ntawm cov kab mob uas txhawb nqa los ntawm cov lipids txawv txav li substrates [8]. Nws kuj tau pom tsis ntev los no hais tias qhov mob ntev ntev hauv cov neeg mob MGD muaj feem cuam tshuam nrog kev mob siab rau cytokines hauv cov kua muag zaj duab xis [9,10]. Hauv peb txoj kev tshawb fawb, peb saib cov cim ntshav thiab kev txhim kho MGD hauv cov neeg mob DM.
2. Cov khoom siv thiab cov txheej txheem
Txoj kev tshawb no hla ntu no suav nrog cov neeg mob uas muaj hom II DM thiab cov tsos mob ntawm MGD tuaj koom Department of Ophthalmology ntawm A. Fiorini Tsev Kho Mob hauv Terracina (Latina, Ltalis) hauv rau lub hlis dhau los. Txoj kev tshawb no tau ua raws li cov hauv paus ntsiab lus ntawm Kev Tshaj Tawm ntawm Helsinki, Lub Rooj Sib Tham Thoob Ntiaj Teb ntawm Kev Sib Haum Xeeb, thiab cov lus pom zoo ntawm Kev Kho Mob Zoo. Cov ntaub ntawv tso cai tau txais los ntawm txhua yam kev kawm ua ntej pib qhov kev kawm. Cov txheej txheem suav nrog yog cov neeg mob cuam tshuam los ntawm DM hom II nrog cov tsos mob ntawm MGD. Cov txheej txheem cais tawm suav nrog: kab mob ocular tsis ntev los no, kev tsis haum rau lub caij nyoog, keeb kwm ntawm kev phais qhov muag, kev siv tshuaj los yog qhov muag tee uas paub tias cuam tshuam rau lub qhov muag, tus neeg siv lub ntsej muag tam sim no lossis yav dhau los, cev xeeb tub los ntawm tus kheej qhia, kab mob thyroid, kab mob autoimmune. , kev siv tshuaj tiv thaiv kab mob, cov neeg haus luam yeeb thiab tshuaj tiv thaiv androgen thiab menopause hormonal hloov kho.
Txhua yam kev kawm raug thov kom ua tiav Ocular Surface Disease Index (OSDI) Allergan, Inc., Irvine, CA, USA. Cov lus nug [11]. Luv luv, cov neeg mob kos qhov kev siv ntawm lawv cov tsos mob ntawm qhov ntsuas ntawm 0–4 (0: tsis muaj sijhawm, 1: qee lub sijhawm, 2: ib nrab ntawm lub sijhawm, 3: feem ntau ntawm lub sijhawm, 4: txhua lub sijhawm). Qhov qhab nia kawg tau ntsuas thiab nyob ntawm 0 mus rau 100 ( qhab nia 0–12: ib txwm, 13–22: mob qhov muag qhuav me me, 23–32: mob qhov muag qhuav qhuav, ntau dua 33 : mob qhov muag qhuav heev). Biomicroscopic anterior segment kuaj tau tshwm sim thiab daim tawv muag ntawm daim tawv muag tau tshuaj xyuas rau qhov muaj telangiectasia, lub hau npog qhov txawv txav, occluded MGs orifices, thiab anterior / posterior hloov chaw ntawm mucocutaneous junction. Cov tom kawg raug soj ntsuam raws li Yamaguchi li al. [12]. Cov qhab nia Marx kab (ML) tau tshaj tawm hauv Table 1.
Tear film break-up time (TFBUT) tau txiav txim raws li hauv qab no: cov ntsiab lus tau hais kom ntsais 3-4 zaug tom qab fluorescein instillation rau hauv qis fornix. TFBUT tau soj ntsuam los ntawm lub sijhawm nruab nrab ntawm lub ntsag kawg thiab cov tsos ntawm thawj qhov chaw dub; cov txiaj ntsig ntawm peb qhov ntsuas tau sau npe. [13] Ocular nto staining siv lissamine ntsuab tau siv los txiav txim siab Van Bijsterveld qhab nia (vBS): ocular nto muab faib ua peb thaj chaw; qhov ntswg bulbar conjunctiva, lub ntsej muag bulbar conjunctiva, thiab cornea. Txhua cheeb tsam raug soj ntsuam ntawm qhov ntsuas ntawm 0 mus rau 3, nrog 0 qhia tias tsis muaj qhov staining thiab 3 qhia tias muaj qhov sib txawv; qhov siab tshaj plaws tau qhab nia nrog qhov system no yog 9 [13].
Schirmer kuaj ntsuas cov kua muag kua muag thiab yog ua los ntawm cov ntaub ntawv tsis muaj menyuam yaus siv rau hauv qhov tsis zoo-ntev ntawm lub hnab ntim ntawm ob lub qhov muag. Lub wetted ntev, nyob rau hauv millimeter, yog ntsuas tom qab 5 min. Muaj ob hom kev xeem: yam tsis muaj tshuaj loog los ntsuas tag nrho cov kua muag zais, uas yog qhov sib npaug ntawm cov kua muag tawm thiab cov kua muag basal (Schirmer test I), thiab nrog tshuaj loog tshuaj loog los ntsuas cov kua muag basal secretion (Schirmer test II) [14 ]. Tsuas yog cov ntaub ntawv los ntawm tib lub qhov muag uas tau ua meibography tau suav nrog hauv cov txiaj ntsig. Meibography tau ua tiav ntawm ib qho kev xaiv qhov muag ntawm txhua qhov kev kawm siv Sirius® Topographer (CSO, Costruzione Strumenti Oftalmici, Florence, Ltalis) [15].
Only upper eyelids were analyzed. Three images for each eye were recorded. The device determines the dropout area semi-automatically by percentage and assesses meiboscore as follows: grade 0, no loss at all; grade 11 4, ≤25%; grade 2, 26–50%; grade 3, 51–75%; and grade 4, >75 feem pua (Daim duab 1).
2.1. Duab tsom xam
Peb qhov zoo tshaj plaws-tsim tus neeg sawv cev dluab ntawm ib lub qhov muag random, nrog cov duab zoo brightness thiab zoo sib xws, raug xaiv rau MGs ntev, dav, thiab cheeb tsam tsom xam. Ob tus neeg saib xyuas lub ntsej muag (AF thiab FA) tau ua cov duab thaij duab thaij duab. Luv luv, MG ntev tau suav hais tias siv Neuron, plug-in ntawm ImageJ (http://www.imagescience. org/Beijing/software, (mus txog rau 10 Lub Kaum Hli 2022)) uas tau siv yav dhau los rau semiautomated corneal paj hlwb tracing [16] tab sis kuj tseem yuav pab tau kom muaj nuj nqis MG ntev thiab dav (Daim duab 2).
Main MGs tau txhais raws li tag nrho cov MGs nyob rau hauv ib daim duab; MG ntev yog MG ntev/thav duab cheeb tsam hloov mus rau mm/mm2. MG qhov dav tau suav rau saum, nruab nrab, thiab hauv qab ntawm txhua lub caj pas thiab tshaj tawm raws li MG qhov dav / thaj tsam hloov mus rau mm / mm2. Tag nrho MG tus naj npawb thiab MG ntev thiab dav tau suav los ntawm kev suav cov MGs loj, qhov ntev, thiab dav, feem. MG cheeb tsam tau txheeb xyuas siv cov txheej txheem dhau los tau tshaj tawm [15,17] tab sis txawv ntawm cov qauv no, peb teeb tsa cov duab sab nrauv rau dawb, thiab sab hauv rau xim dub los tsim lub ntsej muag binary hauv av tseeb. Ib tug polygon ciam teb ib ncig ntawm cov qog tau tsim thiab cawm. Tus nqi tau tshaj tawm raws li thaj tsam hauv mm2 (Daim duab 3).
Cov ntshav yoo mov tau sau los txheeb xyuas qib qabzib, glycated hemoglobin (HbA1c) triglycerides, tag nrho cov roj (cholesterol), HDL (high-density lipoprotein) cholesterol, LDL (low-density lipoprotein), dehydroepiandrosterone sulfate (DHEA-S), androstenedione (ASD) , cortisol thiab testosterone qib.
2.2. Kev txheeb cais
Cov kev hloov pauv tsis tu ncua tau nthuav tawm raws li qhov ntsuas ± tus qauv yuam kev ntawm qhov ntsuas. Hais txog Kolmogorov-Smirnov xeem thiab Shapiro-Wilk xeem, peb cov ntaub ntawv tau kwv yees li ib txwm faib. p-tus nqi tau siab dua 0.05 rau txhua qhov sib txawv tshwj tsis yog rau qib testosterone. Spearman correlation tau ua los ntsuas qhov kev siv zog thiab kev taw qhia ntawm kev koom tes ntawm ob qhov sib txawv. Ib txoj kev ANOVA xeem tau siv rau kev sib piv ntawm ntau cov qauv. Linear regression tsom xam tau ua los tshuaj xyuas cov biomarkers raws li MG qhov sib txawv tau siv meibography. Kev ntsuam xyuas kev rov qab siv txoj kev xaiv ua khub tau ua los txheeb xyuas qhov sib txawv tseem ceeb tshaj plaws cuam tshuam nrog MGD. Intraclass correlation coefficient (ICC) raug xam los ntawm ob tus neeg saib xyuas lub ntsej muag rau MGs ntev, dav, thiab cheeb tsam. Kev txheeb xyuas txheeb cais tau pom zoo siv SPSS version 22 (SPSS Inc., Chicago, IL, USA), thiab p-tus nqi tsawg dua 0.05 tau suav tias yog qhov tseem ceeb.
Lub mechanism ntawm Cistanche boosts testosterone nyhuv
Cistanche tau pom los txhawb qib testosterone ntau ntau txoj hauv kev. Ua ntej, nws muaj cov tebchaw hu ua echinacoside thiab acteoside, uas tau pom tias txhim khu kev tsim cov tshuaj luteinizing hormone (LH) hauv pituitary caj pas. LH txhawb nqa Leydig hlwb hauv cov qe ntshav los tsim testosterone. Cistanche kuj tseem muaj cov polysaccharides thiab phenylethanoid glycosides, uas tau pom tias muaj cov tshuaj tua kab mob antioxidant thiab tiv thaiv kab mob. Qhov no tuaj yeem pab txo qis oxidative kev nyuaj siab thiab mob hauv cov qog nqaij hlav, uas tuaj yeem cuam tshuam rau testosterone ntau lawm Tsis tas li ntawd, Cistanche tau pom tias yuav ua rau kom muaj kev qhia ntawm cov noob koom nrog hauv testosterone synthesis thiab txo cov haujlwm ntawm cov enzymes uas ua rau testosterone, xws li {{1} }alpha-reductase. Zuag qhia tag nrho, kev sib xyaw ua ke ntawm cov txheej txheem no tau xav tias yuav pab txhawb rau Cistanche's testosterone-boosting teebmeem.
Yuav tsum tau txuas ntxiv ...
Alessandro Abbouda 1,* , Antonio Florido 1,2 , Filippo Avogaro 1,2 , John Bladen 3 thiab Enzo Maria Vingolo 1,2
1 Department of Ophthalmology, Alfredo Fiorini Tsev Kho Mob, 04019 Terracina, Ltalis
2 Department of Biotechnology thiab Medical-Surgical Sciences, "Sapienza" University of Rome, 04100 Latina, Ltalis
3 Oculoplastic Department King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
