IDF21-0021 Risk evaluation of retinopathy in patients with type 2 diabetes using harmonic features of the radial pulse wave

Abstract

Background: In developing and developed countries, diabetic retinopathy is one of the leading causes of blindness in the 20-70 age group, and a high percentage of diabetic patients will eventually have retinopathy. Past research results indicate that microalbuminuria and renal function loss can be used as predictors of retinopathy in patients with type 2 diabetes, but the conclusions are still inconsistent. Harmonic analysis of the radial pulse wave can be used as an evaluation method for large and small vascular diseases, and may be used in the prediction of diabetic retinopathy. Aim: The purposes of this study was to examine if characteristics of the radial pulse spectrum could be an evaluation method of retinopathy in patients with type 2 diabetes. Method: The study consists of 915 asymptomatic patients with type 2 diabetes who had no history of retinopathy through the Division of Endocrinology and Metabolism of Zhongxiao Branch of Taipei City Hospital (IRB: ISRCTN14306167). We conducted the pulse wave measurement at baseline and divided the enrolled patients into quartile groups based on the first harmonic amplitude of the radial pulse (C1) value (>0.981, 0.981 to 0.908, 0.908 to 0.847, and < 0.847). Participating patients received over 3 years of follow-up. The outcome was the retinopathy which was diagnosed by an ophthalmologist. Cox proportional hazards model were used. Results: Kaplan-Meier curves of primary composite endpoints showed that the decreasing quartile level of C1 resulted in the increasing incidence of diabetic retinopathy. The incidence of diabetic retinopathy in the C1<0.847 group was 3-4 times lower than that in the other groups. Clinical events were analyzed using Cox proportional hazards model to compare hazard ratios of clinical events among quartile groups. The Cox regression model also demonstrated that after adjusting for age, gender, smoking, C1 was still an independent predictor of diabetic retinopathy (HR, 0.058; 95% CI 0.005-0.682, P=0.024). Discussion: This report suggested that C1 provides independent predictive value for risk assessment of diabetic retinopathy in asymptomatic patients with type 2 diabetes.