Analysis of the Relationship between Serum HbA1c,25(OH)D,MMP-9 and Postoperative Dry Eye in Patients with Type 2 Diabetes Mellitus Complicated with Cataract
Objective:To investigate the relationship between serum hemoglobin A1c(HbA1c)),25 hydroxyvitamin D[25(OH)D],matrix metalloproteinase-9(MMP-9)and postoperative dry eye in patients with type 2 diabetes mellitus(T2DM)complicated with cataract.Methods:162 patients with T2DM complicated with cataract who underwent phacoemulsification combined with intraocular lens implantation in our hospital from January 2019 to December 2023 were selected,patients were divided into dry eye group(53 cases)and non-dry eye group(109 cases)according to whether dry eye occurred after surgery.The levels of serum HbAic,25(OH)D and MMP-9 were detected.The factors of postoperative dry eye in patients with T2DM complicated with cataract surgery were analyzed by multivari-ate Logistic regression,the predictive value of serum HbAic,25(OH)D and MMP-9 levels for postoperative dry eye in patients with T2DM complicated with cataract were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with non-dry eye group,the levels of serum HbA1c and MMP-9 in dry eye group increased,and the level of 25(OH)D decreased(P＜0.05).Multivariate Logistic regression analysis showed that prolonged course of T2DM(OR=1.245,95％CI:1.007～1.539),elevated HbA1c(OR=3.132,95％CI:1.745～5.624),and elevated MMP-9(OR=1.206,95％CI:1.091～1.333)were independent risk factors for postoperative dry eye in patients with T2DM complicated with cataract surgery,Elevated 25(OH)D(OR=0.854,95％CI:0.773～0.945)was an independent protective factor(P＜0.05).ROC curve analysis showed that,the area under the curve of combined prediction of serum HbA1c,25(OH)D and MMP-9 levels for postoperative dry eye in T2DM patients with cataract was 0.921(95％CI:0.868～0.957),which was greater than 0.793(95％CI:0.723～0.853),0.779(95％CI:0.707～0.840)and 0.783(95％CI:0.711～0.844)predicted by serum HbAlc,25(OH)D and MMP-9 levels alone.Conclusion:Elevated preoperative serum HbA1c and MMP-9 levels and the decrease of 25(OH)D levels in patients with T2DM complicated with cataract are closely related to postoperative dry eye,and the combination of serum HbA1c,25(OH)D and MMP-9 has a value in predicting postoperative dry eye in patients with T2DM complicated with cataract surgery.
Type 2 diabetes mellitusCataractDry eyeHemoglobin A1c25 hydroxyvitamin DMatrix metal loproteinase-9
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