TY - JOUR
T1 - Type 2 diabetes and HbA1c are independently associated with wider retinal arterioles
T2 - the Maastricht study
AU - Li, Wenjie
AU - Schram, Miranda T
AU - Berendschot, Tos T J M
AU - Webers, Carroll A B
AU - Kroon, Abraham A
AU - van der Kallen, Carla J H
AU - Henry, Ronald M A
AU - Schaper, Nicolaas C
AU - Huang, Fan
AU - Dashtbozorg, Behdad
AU - Tan, Tao
AU - Zhang, Jiong
AU - Abbasi-Sureshjani, Samaneh
AU - Ter Haar Romeny, Bart M
AU - Stehouwer, Coen D A
AU - Houben, Alfons J H M
PY - 2020/7
Y1 - 2020/7
N2 - Aims/hypothesis Retinal microvascular diameters are biomarkers of cardio-metabolic risk. However, the association of (pre)diabetes with retinal microvascular diameters remains unclear. We aimed to investigate the association of prediabetes (impaired fasting glucose or impaired glucose tolerance) and type 2 diabetes with retinal microvascular diameters in a predominantly white population. Methods In a population-based cohort study with oversampling of type 2 diabetes (N = 2876; n = 1630 normal glucose metabolism [NGM], n = 433 prediabetes and n = 813 type 2 diabetes, 51.2% men, aged 59.8 +/- 8.2 years; 98.6% white), we determined retinal microvascular diameters (measurement unit as measured by retinal health information and notification system [RHINO] software) and glucose metabolism status (using OGTT). Associations were assessed with multivariable regression analyses adjusted for age, sex, waist circumference, smoking, systolic blood pressure, lipid profile and the use of lipid-modifying and/or antihypertensive medication. Results Multivariable regression analyses showed a significant association for type 2 diabetes but not for prediabetes with arteriolar width (vs NGM; prediabetes: beta = 0.62 [95%CI -1.58, 2.83]; type 2 diabetes: 2.89 [0.69, 5.08]; measurement unit); however, there was a linear trend for the arteriolar width across glucose metabolism status (p for trend = 0.013). The association with wider venules was not statistically significant (prediabetes: 2.40 [-1.03, 5.84]; type 2 diabetes: 2.87 [-0.55, 6.29], p for trend = 0.083; measurement unit). Higher HbA(1c) levels were associated with wider retinal arterioles (standardised beta = 0.043 [95% CI 0.00002, 0.085]; p = 0.050) but the association with wider venules did not reach statistical significance (0.037 [-0.006, 0.080]; p = 0.092) after adjustment for potential confounders. Conclusions/interpretation Type 2 diabetes, higher levels of HbA(1c) and, possibly, prediabetes, are independently associated with wider retinal arterioles in a predominantly white population. These findings indicate that microvascular dysfunction is an early phenomenon in impaired glucose metabolism.
AB - Aims/hypothesis Retinal microvascular diameters are biomarkers of cardio-metabolic risk. However, the association of (pre)diabetes with retinal microvascular diameters remains unclear. We aimed to investigate the association of prediabetes (impaired fasting glucose or impaired glucose tolerance) and type 2 diabetes with retinal microvascular diameters in a predominantly white population. Methods In a population-based cohort study with oversampling of type 2 diabetes (N = 2876; n = 1630 normal glucose metabolism [NGM], n = 433 prediabetes and n = 813 type 2 diabetes, 51.2% men, aged 59.8 +/- 8.2 years; 98.6% white), we determined retinal microvascular diameters (measurement unit as measured by retinal health information and notification system [RHINO] software) and glucose metabolism status (using OGTT). Associations were assessed with multivariable regression analyses adjusted for age, sex, waist circumference, smoking, systolic blood pressure, lipid profile and the use of lipid-modifying and/or antihypertensive medication. Results Multivariable regression analyses showed a significant association for type 2 diabetes but not for prediabetes with arteriolar width (vs NGM; prediabetes: beta = 0.62 [95%CI -1.58, 2.83]; type 2 diabetes: 2.89 [0.69, 5.08]; measurement unit); however, there was a linear trend for the arteriolar width across glucose metabolism status (p for trend = 0.013). The association with wider venules was not statistically significant (prediabetes: 2.40 [-1.03, 5.84]; type 2 diabetes: 2.87 [-0.55, 6.29], p for trend = 0.083; measurement unit). Higher HbA(1c) levels were associated with wider retinal arterioles (standardised beta = 0.043 [95% CI 0.00002, 0.085]; p = 0.050) but the association with wider venules did not reach statistical significance (0.037 [-0.006, 0.080]; p = 0.092) after adjustment for potential confounders. Conclusions/interpretation Type 2 diabetes, higher levels of HbA(1c) and, possibly, prediabetes, are independently associated with wider retinal arterioles in a predominantly white population. These findings indicate that microvascular dysfunction is an early phenomenon in impaired glucose metabolism.
KW - Clinical diabetes
KW - DIAMETERS
KW - DISEASE
KW - Epidemiology
KW - Human
KW - IMPAIRED FASTING GLUCOSE
KW - MELLITUS
KW - MICROVASCULAR DYSFUNCTION
KW - Microvascular disease
KW - Pathogenic mechanism
KW - Pathophysiology
KW - RETINOPATHY
KW - RISK
KW - VASCULAR CALIBER
KW - VESSEL CALIBER
KW - metabolism
U2 - 10.1007/s00125-020-05146-z
DO - 10.1007/s00125-020-05146-z
M3 - Article
C2 - 32385602
SN - 0012-186X
VL - 63
SP - 1408
EP - 1417
JO - Diabetologia
JF - Diabetologia
IS - 7
ER -