Purpose: 

The purpose of this study was to compare the corneal endothelial morphology and cell density of diabetic smokers and nonsmokers with 50 to 70 age-matched healthy subjects and to determine whether smoking increases the effects of type 2 diabetes mellitus (DM) on these corneal parameters.

Methods: 

This prospective cohort study included 200 patients who were assigned to 4 groups, including smokers with type 2 DM (group 1), nonsmokers with type 2 DM (group 2), healthy smokers (group 3), and healthy nonsmokers (control group, group 4). Noncontact specular microscopy was used to measure central endothelial cell density (ECD), coefficient of variation of cell area, percentage of hexagonal cells, and central corneal pachymetry (CCT).

Results: 

According to the ECD and CCT values (P < 0.001 and P = 0.013, respectively), a significant difference was observed between the groups. The mean ECD was lowest in diabetic smokers (1917 ± 399 cells/mm²). Healthy smokers and diabetic smokers had significantly lower ECD compared with the control group (P = 0.03 and P < 0.001, respectively). Healthy smokers and diabetic smokers had significantly lower ECD compared with diabetic nonsmokers (P = 0.012 and P < 0.001, respectively). The cornea was significantly thicker in the diabetic smokers than in the control group (P = 0.013).

Conclusions: 

The coexistence of DM and smoking causes a significant decrease in ECD and an increase in CCT. Cigarette smoking is more harmful to corneal endothelial cells than DM alone.

中文翻译：

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2 型糖尿病和吸烟对角膜内皮形态和细胞密度变化的影响

目的： 

本研究的目的是将糖尿病吸烟者和不吸烟者的角膜内皮形态和细胞密度与 50 至 70 名年龄匹配的健康受试者进行比较，并确定吸烟是否会增加 2 型糖尿病 (DM) 对这些角膜参数的影响。

方法： 

这项前瞻性队列研究纳入了 200 名患者，被分为 4 组，包括 2 型糖尿病吸烟者（第 1 组）、2 型糖尿病非吸烟者（第 2 组）、健康吸烟者（第 3 组）和健康非吸烟者（对照组、组4). 非接触式镜面显微镜用于测量中央内皮细胞密度（ECD）、细胞面积变异系数、六角形细胞百分比和中央角膜厚度测量（CCT）。

结果： 

根据ECD和CCT值（分别为P <0.001和P =0.013），组间观察到显着差异。糖尿病吸烟者的平均 ECD 最低（1917 ± 399 个细胞/mm ²）。与对照组相比，健康吸烟者和糖尿病吸烟者的 ECD 显着降低（分别为P = 0.03 和P < 0.001）。与糖尿病非吸烟者相比，健康吸烟者和糖尿病吸烟者的 ECD 显着降低（分别为P = 0.012 和P < 0.001）。糖尿病吸烟者的角膜明显比对照组厚（P = 0.013）。

结论： 

DM和吸烟的共存导致ECD显着降低和CCT显着增加。吸烟比单独吸烟对角膜内皮细胞的危害更大。