Abstract
BackgroundThis study aims to explore retinal vessel calibre in individuals at risk of coronary artery disease (CAD), diagnosed with impaired fasting glucose (IFG) or diabetes mellitus (DM), and whether indices of CAD extent and severity modifies these associations with DM.MethodsA cross-sectional study was undertaken of 1680 patients presenting to Westmead Hospital (Sydney, Australia) for evaluation of potential CAD. Baseline digital retinal photographs, cardiovascular risk factor measurements, fasting blood tests and self-reported diabetes by patient questionnaire was recorded. Extent and severity of CAD was assessed using Extent and Gensini scores from angiography findings, respectively. Multivariate analysis including age and hypertension was undertaken to assess the association between retinal vessel calibre and IFG or DM.ResultsA total of 748 patients were included; 96 (12.8%) and 189 (25.3%), respectively, had IFG or DM (together termed ‘hyperglycaemia’). No consistent association between hyperglycaemia and retinal arteriolar calibre was apparent. Wider retinal venular calibre (second and third tertile) carried a significantly higher odds of DM in men only (multivariable-adjusted OR 2.447, p = 0.005; and OR 2.76, p = 0.002; respectively). No equivalent association was apparent in women. This association was marginally significant (p = 0.08) in patients with CAD Extent scores below the median (i.e. less diffuse CAD). Retinal vessel calibre was not associated with impaired fasting glucose.ConclusionsThis study reports a significant association between retinal venular widening and diabetes mellitus in men. This association was marginally stronger among participants with less diffuse CAD.
Highlights
Diabetes mellitus (DM) is a major cause of morbidity and its microvascular complication, diabetic retinopathy, which is a leading cause of blindness in working aged adults [1]
This study aims to explore retinal vessel calibre in individuals at risk of coronary artery disease (CAD), diagnosed with impaired fasting glucose (IFG) or diabetes mellitus (DM), and whether indices of CAD extent and severity modifies these associations with DM
Retinal vessel calibre was not associated with impaired fasting glucose
Summary
Diabetes mellitus (DM) is a major cause of morbidity and its microvascular complication, diabetic retinopathy, which is a leading cause of blindness in working aged adults [1]. Multiple studies have since demonstrated associations between retinal vessel calibre and cardiovascular risk factors/events including hypertension [9], metabolic syndrome [10], obesity [11], coronary artery disease [12] and stroke [13]. In known persons with diabetes, retinal vessel calibres have been linked to the development of disease complications including retinopathy [14, 15] and nephropathy [14, 24, 25]. This study aims to explore retinal vessel calibre in individuals at risk of coronary artery disease (CAD), diagnosed with impaired fasting glucose (IFG) or diabetes mellitus (DM), and whether indices of CAD extent and severity modifies these associations with DM
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