Presence of retinopathy in type 1 diabetic patients is associated with subclinical macroangiopathy

Abstract

Purpose. The aim of the study was to assess the relationships between diabetic retinopathy, subclinical atherosclerosis and wave reflection in type 1 diabetic patients. Methods. The investigation involved 87 type 1 diabetic patients aged 34 years (interquartile range [IQR]: 29–43), with a disease duration of 10 years (IQR: 9–14). Of these 39 (45%) had diabetic retinopathy. Carotid intima-media thickness (CIMT) was measured using high resolution ultrasonography. Wave reflection and central hemodynamics [central (CAI_x) and peripheral augmentation index (PAI_x)] were determined with the use of tonometry. Results. Patients with retinopathy compared to those without had increased CIMT (530 vs 480 μm, p = 0.017) and wave reflection (CAI_x [118.90 vs 110.96 %, p = 0.03] and PAI_x [64.95 vs 57.44 %, p = 0.029]). In logistic regression analysis, patient's age, duration of diabetes, systolic and diastolic blood pressure, postprandial glycemia, HbA1c value, CIMT (p = 0.017), CAI_x (p = 0.03) and PAI_x (p = 0.016) were associated with the presence of diabetic retinopathy. However, in the multivariate model, CIMT and CAI_x did not remain predictors of retinopathy. Conclusions. We have shown that the presence of retinopathy in type 1 diabetic patients is associated with subclinical atherosclerosis and wave reflection.

Key Words::

• Diabetic retinopathy
• type 1 diabetes mellitus
• carotid intima-media thickness
• wave reflection
• diabetic vascular complications

Acknowledgements

The authors are indebted to Professor Geoffrey Shaw for his editorial assistance and to Dr M. Meller for his clinical cooperation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.