Abstract
Objective: Retina and endothelium constitute fields in which the hyperglycemia’s pathological effects of type 2 diabetes mellitus (T2DM) can be detected. However, the precise time of these lesions’ appearance and factors contributing to it are still under investigation. Thus, we studied the early retinal lesions and endothelial function in patients with a recent diagnosis of T2DM (<6 months) and their association with adverse prognostic factors. Design and method: Patients with a recent diagnosis of T2DM receiving no other diabetic medication except from Metformin, and volunteers matched for age and blood pressure (BP) participated in the study. Somatometric data, BP measurements (ambulatory and office) and hematological parameters (lipids, renal function, fasting glucose, glycosylated hemoglobin) were recorded. Endothelial function was assessed by Asymmetric Dimethylarginine (ADMA). Retinal vessel diameters (central retinal arteriolar equivalent-CRAE / central retinal venular equivalent-CRVE) and their ratio (arteriovenous ratio-AVR) were assessed with a non-mydriatic fundus camera using special software. Results: We studied 165 participants, 81 T2DM patients and 84 non-T2DM volunteers. No differences were found between the 2 groups in retinopathy and ADMA measurements. ADMA was associated with female sex (p = 0.037), Body Mass Index (p = 0.033) and AVR (p = 0.047). AVR was significantly associated with age, male sex, ADMA, estimated Glomerular Filtration Rate (eGFR), smoking, office, day and nighttime diastolic, 24-hour, and nighttime systolic BP. Linear regression analysis showed the independent correlation of AVR with nighttime systolic blood pressure (p = 0.002) and age (p = 0.019) taking into consideration gender, smoking, eGFR, ADMA and T2DM. Conclusions: In patients with a very recent diagnosis of Type 2 Diabetes Mellitus, the retinal vessels diameters do not differ compared with individuals of similar age and blood pressure. However, the AVR index correlates with age and nighttime BP, highlighting the important contribution of the latter in early target organ damage in this population.
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