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- Title
Alterations in Retinal Microvascular Geometry in Young Type 1 Diabetes.
- Authors
Sasongko, Muhammad Bayu; Wang, Jie Jin; Donaghue, Kim C.; Cheung, Ning; Benitez-Aguirre, Paul; Jenkins, Alicia; Hsu, Wynne; Lee, Mong-Li; Wong, Tien Y.
- Abstract
OBJECTIVE -- To describe retinal microvascular geometric parameters in young patients with type 1 diabetes. RESEARCH DESIGN AND METHODS -- Patients with type 1 diabetes (aged 12-20 years) had clinical assessments and retinal photography following standardized protocol at a tertiary-care hospital in Sydney. Retinal microvascular geometry, including arteriolar and venular tortuosity, branching angles, optimality deviation, and length-to-diameter ratio (LDR), were measured from digitized photographs. Associations of these geometric characteristics with diabetes duration, A1C level, systolic blood pressure (SBP), and other risk factors were assessed. RESULTS -- Of 1,159 patients enrolled, 944 (81.4%) had gradable photographs and 170 (14.7%) had retinopathy. Older age was associated with decreased arteriolar (P = 0.024) and venular (P = 0.002) tortuosity, and female subjects had larger arteriolar branching angle than male subjects (P = 0.03). After adjusting for age and sex, longer diabetes duration was associated with larger arteriolar branching angle (P ≤ 0.001) and increased arteriolar optimality deviation (P = 0.018), higher A1C was associated with increased arteriolar tortuosity (>8.5 vs. ≤8.5%, P = 0.008), higher SBP was associated with decreased arteriolar LDR (P = 0.002), and higher total cholesterol levels were associated with increased arteriolar LDR (P = 0.044) and decreased venular optimality deviation (P = 0.044). These associations remained after controlling for A1C, retinal vessel caliber, and retinopathy status and were seen in subjects without retinopathy. CONCLUSIONS -- Key diabetes-related factors affect retinal microvascular geometry in young type 1 diabetes, even in those without evidence of retinopathy. These early retinal alterations may be markers of diabetes microvascular complications.
- Subjects
SYDNEY (N.S.W.); NEW South Wales; DIABETES complications; RETINAL diseases; MICROCIRCULATION disorders; BLOOD pressure; DIABETES
- Publication
Diabetes Care, 2010, Vol 33, Issue 6, p1331
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc10-0055