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DOI: 10.5146/tjpath.2018.01451
The Relationship Between Obesity, Insulin Resistance, and Conjunctival Impression Cytology
Murat DAĞDEVIREN1, Mustafa ALTAY1, Zennure YILDIZ2, Gülçin ŞIMŞEK3, Mehmet ÇITIRIK4, İhsan ATEŞ5, Tanyel Sema DAĞDEVIREN6, Canan YILDIZ7, Tuğba ŞAHIN2
1Department of 1Endocrinology and Metabolism, niversity of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
2Department of Ophthalmology, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
3Department of Pathology, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
4Department of Ophthalmology, University of Health Science, Ulucanlar Health Administration and Research Center, ANKARA, TURKEY
5Department of Internal Medicine, University of Health Science, Ankara Numune Health Administration and Research Center, ANKARA, TURKEY
6Department of Family Practice, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
7Department of Internal Medicine, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
Keywords: Conjunctiva, Impression cytology, Inflammation, Obesity

Objective: This study was designed to determine whether obesity causes the development of metaplasia in conjunctival epithelial cells.

Material and Method: A total of 61 volunteer participants who had no previous history of illness or drug use were involved in this study. Of those, 20 were obese, and 41 were of normal weight. We measured the glucose and insulin values of all volunteers. We also measured the Body Mass Index (BMI) and Homeostasis Model Assessment for Insulin Resistance (HOMA IR). The impression cytology method was used to analyze the conjunctival epithelium cells, and to classify them between Grades 0 to 3 according to the Nelson criteria.

Results: There was a certain level of loss of goblet cells on the 90% level as well as squamous metaplasia (Grade 2-3) in 80% of the obese participants and impression cytology was found to be normal in only two patients. The expected results were observed in 56.1% of the control group where the squamous metaplasia rate was nearly 17% (p<0.001). 90.9% of the grade 3 patients were obese. The variables as independent predictors were found to indicate the existence of abnormal cytology in the conjunctiva at various levels; BMI (OR: 1.24; p=0.002) and HOMA IR (OR= 28.6; p= 0.001) in a Model I multivariable regression model, and the existence of obesity (OR: 11.91; p=0.002) and HOMA IR (OR= 15.08; p<0.001) in a Model II multivariable regression model.

Conclusion: Obesity was found to be a disorder that causes metaplasia in the conjunctival epithelium cells for the first time.


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