Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2019, Vol 35, Num, 2     (Pages: 119-127)

The Relationship Between Obesity, Insulin Resistance, and Conjunctival Impression Cytology

Murat DAĞDEVIREN 1, Mustafa ALTAY 1, Zennure YILDIZ 2, Gülçin ŞIMŞEK 3, Mehmet ÇITIRIK 4, İhsan ATEŞ 5, Tanyel Sema DAĞDEVIREN 6, Canan YILDIZ 7, Tuğba ŞAHIN 2

1 Department of Endocrinology and Metabolism, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
2 Department of Ophthalmology, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
3 Department of Pathology, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
4 Department of Ophthalmology, University of Health Science, Ulucanlar Health Administration and Research Center, ANKARA, TURKEY
5 Department of Internal Medicine, University of Health Science, Ankara Numune Health Administration and Research Center, ANKARA, TURKEY
6 Department of Family Practice, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY
7 Department of Internal Medicine, University of Health Science, Keçiören Health Administration and Research Center, ANKARA, TURKEY

DOI: 10.5146/tjpath.2018.01451
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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.

Keywords : Conjunctiva, Impression cytology, Inflammation, Obesity