Retinal vessel calibre and micro- and macrovascular complications in type 1 diabetes

• Published in: Diabetologia 2009-10, Vol.52 (10), p.2213-2217
• Main Authors: Grauslund, J, Hodgson, L, Kawasaki, R, Green, A, Sjølie, A. K, Wong, T. Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Angina pectoris; Biological and medical sciences; Blood and lymphatic vessels; Blood pressure; Cardiology. Vascular system; Cross-Sectional Studies; Denmark; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - epidemiology; Diabetic Neuropathies - etiology; Diabetic retinopathy; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; European Continental Ancestry Group; Eye and associated structures. Visual pathways and centers. Vision; Female; Fundamental and applied biological sciences. Psychology; Hospitals; Human Physiology; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Patients; Retinal Vessels - pathology; Short Communication; Vascular Diseases - epidemiology; Vascular Diseases - etiology; Veins & arteries; Vertebrates: nervous system and sense organs
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-009-1459-8

Aims/hypothesis The purpose of the study was to evaluate the association between retinal vascular calibre and micro- and macrovascular complications in a population-based cohort of Danish type 1 diabetic patients. Methods This was a cross-sectional study of 208 long-surviving type 1 diabetic patients from a population-based Danish cohort. Retinal photographs were obtained at a clinical examination attended by each participant in 2007-2008, and retinal vascular calibre was measured and summarised as the central retinal artery or vein equivalent (CRAE or CRVE) using a computer-based program and a standardised protocol. Associations between retinal vascular calibre and micro- and macrovascular complications were examined after adjusting for confounding clinical characteristics. Results Retinal photographs were gradable for 188 of 208 patients (90.3%). The median age and duration of diabetes for patients with gradable photos were 57.9 and 42 years, respectively. After multivariate adjustments, individuals with narrower retinal arterioles were more likely to have nephropathy (OR 2.17, 95% CI 1.29-3.68, per SD decrease in CRAE) and macrovascular disease (OR 3.17, 95% CI 1.59-6.34, per SD decrease in CRAE), but not neuropathy (OR 1.10, 95% CI 0.70-1.71, per SD decrease in CRAE). Retinal venular calibre was not associated with any micro- or macrovascular complications. Conclusions/interpretation In type 1 diabetic patients, retinal arteriolar narrowing is associated with nephropathy and macrovascular disease independently of other clinical characteristics. If supported by further prospective studies, measurement of retinal vessel diameter may allow a non-invasive evaluation of the risk of diabetes-related complications.