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Open Access 01-07-2020 | Prediabetes | Article

Type 2 diabetes and HbA_1c are independently associated with wider retinal arterioles: the Maastricht study

Authors: Wenjie Li, Miranda T. Schram, Tos T. J. M. Berendschot, Carroll A. B. Webers, Abraham A. Kroon, Carla J. H. van der Kallen, Ronald M. A. Henry, Nicolaas C. Schaper, Fan Huang, Behdad Dashtbozorg, Tao Tan, Jiong Zhang, Samaneh Abbasi-Sureshjani, Bart M. ter Haar Romeny, Coen D. A. Stehouwer, Alfons J. H. M. Houben

Published in: Diabetologia | Issue 7/2020

Abstract

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: β = 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 β = 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.

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Title: Type 2 diabetes and HbA1c are independently associated with wider retinal arterioles: the Maastricht study
Authors: Wenjie Li
Miranda T. Schram
Tos T. J. M. Berendschot
Carroll A. B. Webers
Abraham A. Kroon
Carla J. H. van der Kallen
Ronald M. A. Henry
Nicolaas C. Schaper
Fan Huang
Behdad Dashtbozorg
Tao Tan
Jiong Zhang
Samaneh Abbasi-Sureshjani
Bart M. ter Haar Romeny
Coen D. A. Stehouwer
Alfons J. H. M. Houben
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prediabetes
Type 2 Diabetes
Published in: Diabetologia / Issue 7/2020
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-020-05146-z

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Type 2 diabetes and HbA_1c are independently associated with wider retinal arterioles: the Maastricht study

Abstract

Aims/hypothesis

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Conclusions/interpretation

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