Subclinical Microvascular Lesions among Normoglycemic and Prediabetic Subjects—The PROP-ABC Study

Abstract

Background: We investigated the occurrence of microvascular lesions in nondiabetic offspring of parents with T2DM enrolled in the PROP-ABC (Pathobiology and Reversibility of Prediabetes in A Biracial Cohort)* study. Design and Methods: We assessed albumin:creatinine ratio (MCR), vibration perception threshold (Vibratron II, Physitemp Instruments Inc, Clifton, NJ) and nonmydriatric retinal images (Zeiss digital camera, Carl Zeiss Meditec AG, Jena, Germany). Results: There were 223 subjects (117 black, 106 white; 70% female), of whom 122 had prediabetes (impaired fasting glucose or impaired glucose tolerance) and 101 had normal glucose regulation (NGR; FPG <100 mg/dl and 2hrPG<140 mg/dl). The mean (± SD) age was 53.3 ± 9.1 years. Retinal lesions were found in 24 subjects (10.8% of the cohort), comprising macular changes (n=9), optic disc changes (n=8), epiretinal membrane (n=6), diabetic retinopathy (n=4), and vitreous opacities (n=2). The frequency of any retinal lesion was 12.3% vs. 8.9% among prediabetic vs. NGR subjects. The mean MCR was 9.95±2.1 ug/g among subjects with normal retina vs. 16.6 ±9.89ug/g among those with retinal lesions. There was a strong correlation between albuminuria and presence of retinal lesions (r=0.42, P<0.0001). The index finger vibration amplitude was 0.56 ±0.31 microns in prediabetic subjects vs. 0.43±0.25 microns in NGT subjects (P=0.013). Conclusions: We here demonstrate a significant association between albuminuria and diverse retinal lesions in a biracial cohort of nondiabetic subjects, and further show relative impairment of vibration perception in prediabetic subjects (NCT02027571). Disclosure N.A. Umekwe: None. I. Owei: None. S. Dagogo-Jack: None.