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Diabetologia

Erschienen in:

01.11.2007 | Article

The relationship of retinal vascular calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

verfasst von: G. Tikellis, J. J. Wang, R. Tapp, R. Simpson, P. Mitchell, P. Z. Zimmet, J. Shaw, T. Y. Wong

Erschienen in: Diabetologia | Ausgabe 11/2007

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Abstract

Aims/hypothesis

The aim of the study was to examine the relationship of retinal vascular calibre with glucose intolerance, diabetes and retinopathy in a population-based cohort.

Methods

The Australian Diabetes, Obesity and Lifestyle study recruited adults aged ≥25 years old from across Australia. Participants were classified using an oral glucose tolerance test as having normal glucose tolerance (NGT), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), known diabetes or newly diagnosed diabetes. Digital retinal photographs were taken of all participants with diabetes, IGT and IFG, and a sample of those with NGT, and graded for the presence of retinopathy. Retinal vascular calibre was measured from photographs by a computer-assisted method.

Results

Of the 1,998 participants with gradable retinal images, 16% had known diabetes, 17% newly diagnosed diabetes, 42% IGT, 6% IFG and 19% NGT. After multivariable adjustment, retinal arteriolar calibre was significantly larger in people with known diabetes (178.9 μm) compared with participants with NGT (174.6 μm, p = 0.02), IGT/IFG (175.5 μm, p = 0.02) or newly diagnosed diabetes (175.6 μm, p = 0.047). One SD increase in mean arteriolar calibre was associated with higher odds of diabetes compared with NGT (odds ratio [OR] = 1.28, 95%CI = 1.06–1.55). After multivariable adjustment, each SD increase in venular calibre was associated with higher odds of having retinopathy in persons with IGT/IFG (OR = 1.78, 95%CI = 1.36–2.34) or in persons with diabetes (OR = 1.68, 95%CI = 1.23–2.29).

Conclusions/interpretation

Diabetes is associated with larger retinal arteriolar calibre and retinopathy with larger retinal venular calibre. The contrasting associations may reflect different underlying pathophysiological processes in the natural history of diabetes.

Dunstan D, Zimmet P, Welborn T et al (2002) The rising prevalence of diabetes and impaired glucose tolerance. Diabetes Care 25:829–834CrossRef

Zimmet P (1999) Diabetes epidemiology as a trigger to diabetes research. Diabetologia 42:499–518CrossRef

Engelgau M, Narayan K, Herman W (2000) Screening for type 2 diabetes. Diabetes Care 23:1563–1580CrossRef

Mitchell P, Smith W, Wang J, Attebo K (1998) Prevalence of diabetic retinopathy in an older community. The Blue Mountains Eye Study. Ophthalmology 105:406–411CrossRef

Hubbard L, Brothers R, King W et al (1999) Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the Atherosclerosis Risk in Communities Study. Ophthalmology 106:2269–2280CrossRef

Wong TY, Knudtson MD, Klein R, Klein BE, Meuer SM, Hubbard LD (2004) Computer-assisted measurement of retinal vessel diameters in the Beaver Dam Eye Study: methodology, correlation between eyes, and effect of refractive errors. Ophthalmology 111:1183–1190CrossRef

Wong TY, Klein R, Sharrett AR et al (2002) Retinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons. JAMA 287:2528–2533CrossRef

Wong TY, Shankar A, Klein R, Klein BE, Hubbard LD (2005) Retinal arteriolar narrowing, hypertension, and subsequent risk of diabetes mellitus. Arch Intern Med 165:1060–1065CrossRef

Ikram MK, Janssen JA, Roos AM et al (2006) Retinal vessel diameters and risk of impaired fasting glucose or diabetes: the Rotterdam study. Diabetes 55:506–510CrossRef

10.

Klein R, Klein B, Moss S, Wong T, Sharrett AR (2006) Retinal vascular caliber in persons with type 2 diabetes. The Wisconsin Epidemiological Study of Diabetic Retinopathy: XX. Ophthalmology 113:1488–1498CrossRef

11.

Wong T, Shankar A, Klein R, Klein B (2004) Retinal vessel diameters and the incidence of gross proteinuria and renal insufficiency in people with type 1 diabetes. Diabetes 53:179–184CrossRef

12.

Nguyen T, Wong T (2006) Retinal vascular manifestations of metabolic disorders. Trends Endocrinol Metab 17:262–268CrossRef

13.

Wong T, Barr E, Tapp R et al (2005) Retinopathy in persons with impaired glucose metabolism: the Australian Diabetes Obesity and Lifestyle (AusDiab) study. Am J Ophthalmol 140:1157–1159CrossRef

14.

Diabetes Prevention Program Research Group (2007) The prevalence of retinopathy in impaired glucose tolerance and recent-onset diabetes in the Diabetes Prevention Program. Diabet Med 24:137–144CrossRef

15.

Barr E, Wong T, Tapp R, Harper CA, Zimmett PZ, Atkins, R, Shaw JE, AusDiab Steering Committee (2006) Is peripheral neuropathy associated with retinopathy and albuminuria in individuals with impaired glucose metabolism? The 1999–2000 AusDiab. Diabetes Care 29:1114–1116CrossRef

16.

Dunstan D, Zimmet P, Welborn T et al (2002) The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)—methods and response rates. Diabetes Res Clin Pract 57:119–129CrossRef

17.

Tapp R, McCarty D, Shaw J et al (2003) The prevalence and risk factors associated with diabetic retinopathy in the Australian population. Diabetes Care 26:1731–1737CrossRef

18.

World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Department of Noncommunicable Disease Surveillance, Geneva

19.

Aldington S, Kohner E, Meuer S, Klein R, Sjolie A (1995) Methodology for retinal photography and assessment of diabetic retinopathy: EURODIAB IDDM Complications Study. Diabetologia 38:437–444CrossRef

20.

21.

Hubbard LD, Brothers RJ, King WN et al (1999) Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the Atherosclerosis Risk in Communities Study. Ophthalmology 106:2269–2280CrossRef

22.

Knudtson MD, Lee KE, Hubbard LD, Wong TY, Klein R, Klein BE (2003) Revised formulas for summarizing retinal vessel diameters. Curr Eye Res 27:143–149CrossRef

23.

Liew G, Sharrett AK, R, Klein R et al (2007) Measurement of retinal vascular caliber: issues and alternatives to using the arteriole to venule ratio. Invest Ophthalmol Vis Sci 48:52–57CrossRef

24.

Knudtson MD, Klein BE, Klein R et al (2004) Variation associated with measurement of retinal vessel diameters at different points in the pulse cycle. Br J Ophthalmol 88:57–61CrossRef

25.

Bulpitt C, Dollery C, Kohner E (1970) The marginal plasma zone in the retinal microcirculation. Cardiovasc Res 4:207–212CrossRef

26.

Wong T, Islam A, Klein R et al (2006) Retinal vascular caliber, cardiovascular risk factors, and inflammation: the Multi-Ethnic Study of Atherosclerosis (MESA). Invest Ophthalmol Vis Sci 47:2341–2350CrossRef

27.

Wong TY, Klein R, Sharrett AR et al (2002) Retinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons. JAMA 287:2528–2533CrossRef

28.

Wong TY, Shankar A, Klein R, Klein BE, Hubbard LD (2005) Retinal arteriolar narrowing, hypertension, and subsequent risk of diabetes mellitus. Arch Intern Med 165:1060–1065CrossRef

29.

Frederiksen C, Jeppesen P, Knudsen S, Poulsen P, Mogensen C, Bek T (2006) The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy. Graefes Arch Clin Exp Ophthalmol 244:1255–1261CrossRef

30.

Stefansson E (1997) Ocular oxygenation and the treatment of diabetic retinopathy. Br J Ophthalmol 81:274–278CrossRef

31.

Bek T (1999) Diabetic maculopathy caused by disturbances in retinal vasomotion. A new hypothesis. Acta Ophthalmol Scand 77:376–380CrossRef

32.

Kristinsson JK, Gottfredsdottir MS, Stefansson E (1997) Retinal vessel dilatation and elongation precedes diabetic macular oedema. Br J Ophthalmol 81:274–278CrossRef

33.

Gardner TW, Antonetti DA, Barber AJ, LaNoue KF, Levison SW (2002) Diabetic retinopathy: more than meets the eye. Surv Ophthalmol 47(Suppl 2):S253–S262CrossRef

34.

Klein R, Klein BE, Moss SE et al (2004) The relation of retinal vessel caliber to the incidence and progression of diabetic retinopathy: XIX: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Opthalmol 122:76–83CrossRef

35.

Grunwald JE, Riva CE, Baine J, Brucker AJ (1992) Total retinal volumetric blood flow rate in diabetic patients with poor glycemic control. Invest Ophthalmol Vis Sci 33:356–363

36.

Saldivar E, Cabrales P, Tsai AG, Intaglietta M (2003) Microcirculatory changes during chronic adaptation to hypoxia. Am J Physiol Heart Circ Physiol 285:H2064–H2071CrossRef

37.

Ikram MK, de Jong FJ, Vingerling JR et al (2004) Are retinal arteriolar or venular diameters associated with markers for cardiovascular disorders? The Rotterdam Study. Invest Ophthalmol Vis Sci 45:2129–2134CrossRef

38.

Clermont A, Bursell S (2007) Retinal blood flow in diabetes. Microcirculation 14:49–61CrossRef

39.

Caballero AE (2005) Metabolic and vascular abnormalities in subjects at risk for type 2 diabetes: the early start of a dangerous situation. Arch Med Res 36:241–249CrossRef

Titel: The relationship of retinal vascular calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study
verfasst von: G. Tikellis
J. J. Wang
R. Tapp
R. Simpson
P. Mitchell
P. Z. Zimmet
J. Shaw
T. Y. Wong
Publikationsdatum: 01.11.2007
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 11/2007
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-007-0822-x

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Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

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