Cardiovascular Diabetology (May 2018)

Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

  • Marc Carbonell,
  • Esmeralda Castelblanco,
  • Xavier Valldeperas,
  • Àngels Betriu,
  • Alícia Traveset,
  • Minerva Granado-Casas,
  • Marta Hernández,
  • Federico Vázquez,
  • Mariona Martín,
  • Esther Rubinat,
  • Albert Lecube,
  • Josep Franch-Nadal,
  • Elvira Fernández,
  • Manel Puig-Domingo,
  • Angelo Avogaro,
  • Núria Alonso,
  • Dídac Mauricio

DOI
https://doi.org/10.1186/s12933-018-0706-z
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 10

Abstract

Read online

Abstract Background Cardiovascular (CV) disease due to atherosclerosis is a major cause of morbidity and mortality in adult patients with diabetes, either type 1 or type 2 diabetes. The aim of the study was to assess the association of the frequency and the burden of subclinical carotid atherosclerotic disease in patients with type 1 diabetes according to the presence and severity of diabetic retinopathy (DR). Methods A cross-sectional study was conducted in 340 patients with type 1 diabetes (41.5% with DR), and in 304 non-diabetic individuals. All participants were free from previous CV disease and chronic kidney disease (CKD). B-mode carotid ultrasound imaging was performed in all the study subjects. Patients with type 1 diabetes underwent a full eye examination, and DR patients were divided into two groups: mild disease and advanced disease. Results In the group of patients with type 1 diabetes, the percentage of patients with carotid plaques was higher in those with DR compared with those without DR (44.7% vs. 24.1%, p < 0.001). Patients with DR also presented a higher incidence of ≥ 2 carotid plaques (25.5% vs. 11.1%, p < 0.001). Apart from other traditional cardiovascular risk factors, the presence of advanced stages of DR was independently associated with the presence (p = 0.044) and the burden (≥ 2 carotid plaques; p = 0.009) of subclinical carotid atherosclerosis. Conclusions In patients with type 1 diabetes without previous CV disease or established CKD, the presence of advanced stages of DR is associated with a higher atherosclerotic burden in the carotid arteries. The presence of DR identifies patients at risk for carotid atherosclerotic disease.

Keywords