Glucose metabolism in the idiopathic blepharoptosis: utility of the Oral Glucose Tolerance Test (OGTT) and of the Insulin Resistance Index.
BACKGROUND
Diabetes mellitus (DM), neuromuscular, hereditary or immunological disorders are the most common identified causes of blepharoptosis. However, in about 15-25% they remained uncertain.


OBJECTIVE
To determined the role of glucose metabolism abnormality in idiopathic blepharoptosis.


METHODS
We identified 162 patients with unilateral idiopathic blepharoptosis and 128 control subjects. In all we evaluated a glucose and insulin levels at fasting and after 2 h-OGTT. In addition we determined insulin resistance (IR), by HOMA-index.


RESULTS
Following a 2 h-OGTT the prevalence of undiagnosed glucose metabolism abnormality was significantly higher in blepharoptosis patients vs. control group (P<.001). The IR was documented in 129 patients (78%), of whom 55 (34%) had Impaired Glucose Tolerance (IGT), 36 (22%) newly diagnosed DM (NDDM) and 38 (30%) only IR. The Body Mass Index, blood pressure, serum lipids, triglycerides and smoking were not associated with an increased risk of developing ptosis. Conversely, waist circumference were significantly increased in blepharoptosis patients (P=.003).


CONCLUSIONS
In this study we focused on emerging evidence that prediabetic status may represent a risk factor for developing blepharoptosis. We propose that 2 h-OGTT and mainly HOMA-index should be determined as a rule in all patients with idiopathic blepharoptosis.
Department of Neuroscience, S. Giovanni di Dio Hospital, Via Largo Bologna, 88900, Crotone, Italy. nico_bosco@libero.it
Domenico
D
Bosco
Raffaele
R
Costa
Massimiliano
M
Plastino
Damiano
D
Branca
Piero
P
Cotronei
Teresa
T
Sperlì
Nicola
N
Santacroce
Antonio
A
Siniscalchi
Domenico
D
Consoli
Claudio
C
Ceccotti
Pasquale
P
Mungari
Antonietta
A
Fava
D001763:Blepharoptosis / Q000209:etiology / Q000378:metabolism*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000175:diagnosis / Q000453:epidemiology; D044882:Glucose Metabolism Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D055105:Waist Circumference
D001786:Blood Glucose; D008055:Lipids; D005947:Glucose