Artery Research (Nov 2015)

3.1 PREDIABETES IS ASSOCIATED WITH IMPAIRED RETINAL VASODILATION: THE MAASTRICHT STUDY

  • Ben Sörensen*,
  • Boy Houben,
  • Tos Berendschot,
  • Jan Schouten,
  • Bram Kroon,
  • Carla van der Kallen,
  • Ronald Henry,
  • Annemarie Koster,
  • Pieter Dagnelie,
  • Nicolaas Schaper,
  • Miranda Schram,
  • Coen Stehouwer

DOI
https://doi.org/10.1016/j.artres.2015.10.014
Journal volume & issue
Vol. 12

Abstract

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Aim: Type 2 diabetes (DM2) causes microvascular dysfunction (MVD). In addition, MVD can contribute to insulin resistance, predisposing to DM2. This hypothesis predicts that MVD should be present in impaired glucose metabolism (IGM; prediabetes). However, population-based studies of MVD and glucose metabolism are not available. We investigated this using the retinal arteriolar dilator response to flicker light. Methods: In a population-based study (n = 2205), we determined retinal %-dilation (Dynamic Vessel Analyzer; Imedos, Germany) and glucose metabolism status (OGTT; classified as normal (NGM), IGM or DM2). Differences were compared with multivariable regression adjusted for age, sex, BMI, smoking, systolic-BP, lipid profile, retinopathy, (micro)albuminuria, the use of lipid-modifying and/or blood-pressure-lowering medication and prior cardiovascular disease. Results: 1263 individuals had NGM (42% men, aged 58 ± 8 years (mean ± SD)), 336 IGM (61% men, aged 61 ± 7 years) and 606 (due to oversampling) DM2 (69% men, aged 63 ± 8 years). Arteriolar %-dilation was median 3.51, IQR 1.47 to 5.95, range −5.69 to +19.71. %-dilation (mean ± SD) was 4.42 ± 3.45 in NGM, 3.77 ± 3.06 in IGM, and 3.26 ± 3.27 in DM2. Adjusted analyses showed decreased %-dilation in IGM (β = −0.461, p = 0.03) and DM2 (β = 0.559, p = 0.01) vs NGM. Conclusion: IGM and DM2 are associated with reduced flicker-light-induced retinal arteriolar dilation, independently of major cardiovascular risk factors. These findings support the concept that MVD precedes and thus may contribute to DM2.