Association Between Diabetic Retinopathy and Carotid Intima-Media Thickness

Abstract

IntroductionPatients with diabetes having advanced stage of diabetic retinopathy (DR) may predict future risk of coronary artery disease. To predict cardiovascular outcomes carotid intima-media thickness (CIMT) is utilized in diabetic patients. The aim of our study was the evaluation of the relationship between retinopathy and CIMT as two valuable non-invasive methods for early detection of micro-and macrovascular complication of diabetes. MethodsThis comparative cross-sectional study was conducted in the internal medicine ward of tertiary care hospital in Pakistan from November 2020 to January 2021. Three hundred patients with type 2 diabetes mellitus and 300 control subjects were enrolled in the study after taking informed consent. Ophthalmological examination was done to screen patients for DR. CIMT was evaluated by a Doppler ultrasound for both carotid arteries. ResultsCarotid artery intimal thickness was more in patients with retinopathy compared to patients without retinopathy in both right (0.77 ± 0.16 vs. 0.66 ± 0.12; p-value: <0.0001) and left carotid artery (0.77 ± 0.15 vs. 0.65 ± 0.11; p-value: <0.0001). ConclusionIn our study, there was a correlation between DR and CIMT. Screening for DR, which may be a potential early marker for complications, may help detect patients at risk of various macro and microvascular complications.

Intima-Media Thickness and Pulsatility Index of Common Carotid Arteries in Acute Ischaemic Stroke Patients with Diabetes Mellitus

“…An association between DM and IMT was previously described in a smaller cohort [33]. In our work, diabetic stroke patients have a higher CCA PI on the initial Duplex sonography, a finding that is in line with previous observations in the carotid artery in a non-stroke population [29] and was also described in the kidney [34] and retina [33,35] of diabetic patients. PI of the CCA provides a more robust index for examining patients, as it does not rely as much on the examiner; it is independent of the angle of insonation [36].…”

Azelaic acid and guanosine in tears improve discrimination of proliferative from non-proliferative diabetic retinopathy in type-2 diabetes patients: A tear metabolomics study

“…Azelaic acid has been reported to be one of the differentially abundant metabolites between diabetic nephropathy with macroalbuminuria and diabetic patients without albuminuria [ 31 ]. The level of azelaic acid is highly correlated with the carotid intima-media thickness [ 32 ], which shows thicker in the patients with DR [ 33 ]. Yet, azelaic acid treatment could restore the levels of plasma glucose, insulin, HbA 1C , blood hemoglobin, liver glycogen, and carbohydrate metabolic key enzymes to nearly normal level in diabetic mice [ 34 ].…”