TY - JOUR
T1 - Carotid stiffness is associated with retinal microvascular dysfunction- The Maastricht Study
AU - van der Heide, Frank C. T.
AU - Zhou, Tan Lai
AU - Henry, Ronald M. A.
AU - Houben, Alfons J. H. M.
AU - Kroon, Abraham A.
AU - Dagnelie, Pieter C.
AU - van Dongen, Martien C. J. M.
AU - Eussen, Simone J. P. M.
AU - Berendschot, Tos T. J. M.
AU - Schouten, Jan S. A. G.
AU - Webers, Carroll A. B.
AU - Schram, Miranda T.
AU - van Greevenbroek, Marleen M. J.
AU - Wesselius, Anke
AU - Schalkwijk, Casper G.
AU - Koster, Annemarie
AU - Savelberg, Hans H. C. M.
AU - Schaper, Nicolaas C.
AU - Reesink, Koen D.
AU - Stehouwer, Coen D. A.
N1 - This article is protected by copyright. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - OBJECTIVE: This study investigated whether arterial stiffening is a determinant of subtle retinal microvascular changes that precede diabetic retinopathy.RESEARCH DESIGN AND METHODS: This study used cross-sectional data from the Maastricht Study, a type 2 diabetes-enriched population-based cohort study. We used multivariable linear regression analysis to investigate, in individuals without and with type 2 diabetes, the associations of carotid distensibility coefficient and carotid-femoral pulse wave velocity with retinal microvascular diameters and flicker light-induced dilation and adjusted for cardiovascular and lifestyle risk factors.RESULTS: The retinal microvascular diameter study population consisted of N=2434 participants (51.4% men, mean ± SD age 59.8 ± 8.1 years and 28.1% type 2 diabetes). No measures of arterial stiffness were significantly associated with microvascular diameters. Greater carotid distensibility coefficient (i.e. lower carotid stiffness) was significantly associated with greater retinal arteriolar flicker light-induced dilation (per standard deviation, standardized beta [95%CI] 0.06 [0.00; 0.12]) and non-significantly, but directionally similarly, associated with greater retinal venular flicker light-induced dilation (0.04 [-0.02; 0.10]). Carotid-femoral pulse wave velocity (i.e. aortic stiffness) was not associated with retinal microvascular flicker light-induced dilation. The associations between carotid distensibility coefficient and retinal arteriolar and venular flicker light-induced dilation were two- to threefold stronger in individuals with type 2 diabetes than in those without.CONCLUSION: In this population-based study greater carotid, but not aortic, stiffness was associated with worse retinal flicker light-induced dilation and this association was stronger in individuals with type 2 diabetes. Hence, carotid stiffness may be a determinant of retinal microvascular dysfunction.
AB - OBJECTIVE: This study investigated whether arterial stiffening is a determinant of subtle retinal microvascular changes that precede diabetic retinopathy.RESEARCH DESIGN AND METHODS: This study used cross-sectional data from the Maastricht Study, a type 2 diabetes-enriched population-based cohort study. We used multivariable linear regression analysis to investigate, in individuals without and with type 2 diabetes, the associations of carotid distensibility coefficient and carotid-femoral pulse wave velocity with retinal microvascular diameters and flicker light-induced dilation and adjusted for cardiovascular and lifestyle risk factors.RESULTS: The retinal microvascular diameter study population consisted of N=2434 participants (51.4% men, mean ± SD age 59.8 ± 8.1 years and 28.1% type 2 diabetes). No measures of arterial stiffness were significantly associated with microvascular diameters. Greater carotid distensibility coefficient (i.e. lower carotid stiffness) was significantly associated with greater retinal arteriolar flicker light-induced dilation (per standard deviation, standardized beta [95%CI] 0.06 [0.00; 0.12]) and non-significantly, but directionally similarly, associated with greater retinal venular flicker light-induced dilation (0.04 [-0.02; 0.10]). Carotid-femoral pulse wave velocity (i.e. aortic stiffness) was not associated with retinal microvascular flicker light-induced dilation. The associations between carotid distensibility coefficient and retinal arteriolar and venular flicker light-induced dilation were two- to threefold stronger in individuals with type 2 diabetes than in those without.CONCLUSION: In this population-based study greater carotid, but not aortic, stiffness was associated with worse retinal flicker light-induced dilation and this association was stronger in individuals with type 2 diabetes. Hence, carotid stiffness may be a determinant of retinal microvascular dysfunction.
KW - aortic stiffness
KW - arterial stiffness
KW - carotid stiffness
KW - diabetic retinopathy
KW - microvascular dysfunction
KW - retinal microvascular diameter
KW - type 2 diabetes mellitus
U2 - 10.1111/micc.12702
DO - 10.1111/micc.12702
M3 - Article
C2 - 33905576
SN - 1073-9688
VL - 28
JO - Microcirculation
JF - Microcirculation
IS - 6
M1 - e12702
ER -