TY - JOUR
T1 - Prediabetes is associated with impaired retinal vasodilation: the Maastricht study
AU - Sorensen, B.
AU - Houben, Boy
AU - Berendschot, T.T.J.M.
AU - Schouten, J.
AU - Kroon, B.
AU - van der Kallen, C.
AU - Henry, R.
AU - Koster, A.
AU - Dagnelie, P.C.
AU - Schaper, N.C.
AU - Schram, M.T.
AU - Stehouwer, C.D.A.
PY - 2015/12
Y1 - 2015/12
N2 - Aim: Type 2 diabetes (DM2) causes microvascular dysfunction (MVD). In addition, MVD can contribute to insulin resistance, predisposing to DM2. This hypothesis predicts that MVD should be present in impaired glucose metabolism (IGM; prediabetes). However, population-based studies of MVD and glucose metabolism are not available. We investigated this using the retinal arteriolar dilator response to flicker light. Methods: In a population-based study (n Z 2205), we determined retinal %-dilation (Dynamic Vessel Analyzer; Imedos, Germany) and glucose metabolism status (OGTT; classified as normal (NGM), IGM or DM2). Differences were compared with multivariable regression adjusted for age, sex, BMI, smoking, systolic-BP, lipid profile, retinopathy, (micro)albuminuria, the use of lipid-modifying and/or blood-pressure-lowering medication and prior cardiovascular disease. Results: 1263 individuals had NGM (42% men, aged 58 8 years (mean SD)), 336 IGM (61% men, aged 61 7 years) and 606 (due to oversampling) DM2 (69% men, aged 63 8 years). Arteriolar %-dilation was median 3.51, IQR 1.47 to 5.95, range 5.69 to +19.71. %-dilation (mean SD) was 4.42 3.45 in NGM, 3.77 3.06 in IGM, and 3.26 3.27 in DM2. Adjusted analyses showed decreased %-dilation in IGM (b Z 0.461, p Z 0.03) and DM2 (b Z 0.559, p Z 0.01) vs NGM. Conclusion: IGM and DM2 are associated with reduced flicker-light-induced retinal arteriolar dilation, independently of major cardiovascular risk factors. These findings support the concept that MVD precedes and thus may contribute to DM2.
AB - Aim: Type 2 diabetes (DM2) causes microvascular dysfunction (MVD). In addition, MVD can contribute to insulin resistance, predisposing to DM2. This hypothesis predicts that MVD should be present in impaired glucose metabolism (IGM; prediabetes). However, population-based studies of MVD and glucose metabolism are not available. We investigated this using the retinal arteriolar dilator response to flicker light. Methods: In a population-based study (n Z 2205), we determined retinal %-dilation (Dynamic Vessel Analyzer; Imedos, Germany) and glucose metabolism status (OGTT; classified as normal (NGM), IGM or DM2). Differences were compared with multivariable regression adjusted for age, sex, BMI, smoking, systolic-BP, lipid profile, retinopathy, (micro)albuminuria, the use of lipid-modifying and/or blood-pressure-lowering medication and prior cardiovascular disease. Results: 1263 individuals had NGM (42% men, aged 58 8 years (mean SD)), 336 IGM (61% men, aged 61 7 years) and 606 (due to oversampling) DM2 (69% men, aged 63 8 years). Arteriolar %-dilation was median 3.51, IQR 1.47 to 5.95, range 5.69 to +19.71. %-dilation (mean SD) was 4.42 3.45 in NGM, 3.77 3.06 in IGM, and 3.26 3.27 in DM2. Adjusted analyses showed decreased %-dilation in IGM (b Z 0.461, p Z 0.03) and DM2 (b Z 0.559, p Z 0.01) vs NGM. Conclusion: IGM and DM2 are associated with reduced flicker-light-induced retinal arteriolar dilation, independently of major cardiovascular risk factors. These findings support the concept that MVD precedes and thus may contribute to DM2.
U2 - 10.1016/j.artres.2015.10.014
DO - 10.1016/j.artres.2015.10.014
M3 - Article
SN - 1872-9312
VL - 12
SP - 42
JO - Artery Research
JF - Artery Research
M1 - 3.1
ER -
