Abstract

BackgroundThe retinal microvasculature offers unique non-invasive evaluation of systemic microvascular abnormalities. Previous studies reported associations between retinal microvascular parameters (RMPs) and diabetes. The aim of this study was to assess associations between RMPs and diabetes in a cross-sectional analysis of older persons from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).MethodsRMPs (central retinal arteriolar/venular equivalents, arteriolar to venular ratio, fractal dimension, and tortuosity) were measured from optic disc-centred fundus images using semi-automated software. Associations were assessed between RMPs and diabetes status with adjustment for potential confounders.ResultsData were included for 1762 participants with 209 classified as having diabetes. Participants had a mean age of 62.1 ± 8.5 years, and 54% were female. As expected, participants with diabetes had significantly higher mean glycated haemoglobin A1c compared to participants without diabetes (57.4 ± 17.6 mmol/mol versus 37.0 ± 4.2 mmol/mol, respectively). In unadjusted and minimally adjusted regression, arteriolar to venular ratio, arteriolar tortuosity and venular tortuosity were significantly associated with diabetes (minimally adjusted odds ratio [OR] = 0.85; 95% confidence intervals [CIs] 0.73, 0.99; P = 0.04, OR = 1.18; 95% CI 1.02, 1.37; P = 0.03 and OR = 1.20; 95% CI 1.04, 1.38; P = 0.01, respectively), although all failed to remain significant following adjustment for potential confounders. No additional associations between other RMPs and diabetes were detected.ConclusionDespite previously reported associations between diabetes and RMPs, our study failed to corroborate these associations in an older community-based cohort.

Highlights

  • The retinal microvasculature offers unique non-invasive evaluation of systemic microvascular abnormalities

  • Several studies have reported associations between retinal microvascular parameters (RMPs) and diabetes, but the findings between longitudinal and cross-sectional studies have not always been consistent, in part due to variation in the reported unit measures included in statistical analyses and the availability of potential confounding variables considered in adjusted models [18,19,20,21,22,23,24,25,26,27, 34,35,36,37,38,39]

  • In this cross-sectional analysis of 1762 older persons from the NICOLA study categorised as either diabetic or non-diabetic, we found that Retinal arteriolar/venular ratio (AVR) and arteriolar and venular tortuosity were significantly associated with diabetes when adjusted for age and sex (Table 3), but none remained significantly associated with diabetes following adjustment for multiple potential confounders

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Summary

Introduction

The retinal microvasculature offers unique non-invasive evaluation of systemic microvascular abnormalities. Previous studies reported associations between retinal microvascular parameters (RMPs) and diabetes. The aim of this study was to assess associations between RMPs and diabetes in a cross-sectional analysis of older persons from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). Increased retinal arteriolar [24] and venular tortuosity [24, 25] were reported to be significantly increased in individuals with type 2 diabetes or elevated HbA1c. The aim of this study was to assess RMPs in association with measures of HbA1c and diabetes status in a cross-sectional analysis of older persons from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA)

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