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Association Between Fuchs Endothelial Corneal Dystrophy, Diabetes Mellitus, and Multimorbidity
Cari L Nealon1, Christopher W Halladay2, Bryan R Gorman3,4
1Eye Clinic, VA Northeast Ohio Healthcare System, Cleveland, OH.
Cornea
|May 12, 2023
Summary
Fuchs endothelial corneal dystrophy (FECD) risk is higher in females and individuals of European ancestry, particularly those with diabetes mellitus. Multimorbidity and specific laboratory values also indicate increased FECD risk.
Area of Science:
- Ophthalmology
- Genetics
- Epidemiology
Background:
- Fuchs endothelial corneal dystrophy (FECD) is a progressive corneal disease.
- Understanding risk factors for FECD is crucial for early detection and management.
Purpose of the Study:
- To identify demographic variables and health conditions associated with FECD risk.
- To investigate the association between diabetes mellitus and FECD.
Main Methods:
- Developed and validated a FECD case-control algorithm using electronic health records.
- Analyzed data from the VA Million Veteran Program cohort.
- Employed logistic regression to assess risk factor associations.
Main Results:
- FECD cases were associated with female sex, European genetic ancestry, and increased comorbidities.
- 213 diagnostic codes and 5 laboratory values showed significant association with FECD.
- Diabetes mellitus, especially insulin-dependent and type 1, significantly increased FECD risk.
Conclusions:
- Female sex, European ancestry, and multimorbidity are confirmed risk factors for FECD.
- Evidence supports diabetes mellitus as a significant contributor to FECD risk.
- A threshold model is proposed where comorbidities like diabetes intensify FECD, warranting further research into their relationship.
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