Diabetic Retinopathy as a Predictor of Angiographic Coronary Atherosclerosis Severity in Patients with Type 2 Diabetes Mellitus

Abstract

Background Diabetic retinopathy (DR) is one of the most prevalent consequences of diabetes mellitus (DM). Much emphasis has been focused on the link between DR and cardiovascular disorders in patients with type 2 diabetes (T2DM). However, there is little information about the relation between the degree of DR and coronary atherosclerosis severity in Egyptian patients. Aim To assess the correlation between the degree of DR and the coronary atherosclerosis severity in T2DM. Patients and Methods This work included 140 diabetic patients with T2DM who underwent diagnostic coronary angiography because of suspected coronary artery disease (CAD). All participants were evaluated by history, fundus assessment, laboratory tests (lipid profile and glycated hemoglobin [HbA1c]), and selective coronary angiography. The severity of coronary artery lesion was detected by Gensini score and vessel score. Results Patients with DR had a significantly higher Gensini score (67.86± 44.56 versus 5.93± 9.02, P < 0.001) and a vessel score (2.29± 0.86 versus 0.50± 0.66, P < 0.001). There was a significant relation between the degree of DR, Gensini score (P < 0.001), and vessel score (P < 0.001), as both scores increased according to the severity of DR. The presence and degree of retinopathy were the only independent factors linked to the severity score in multivariate linear regression analyses (P < 0.001). Conclusion The presence and degree of DR are independent predictors of severe coronary atherosclerosis. Therefore, when evaluating whether a patient with T2DM is at high risk for CAD, the DR degree should be taken into consideration.

Two ferroptosis-specific expressed genes NOX4 and PARP14 are considered as potential biomarkers for the diagnosis and treatment of diabetic retinopathy and atherosclerosis

“…Atherosclerosis (AS) is also one of the common complications in diabetic patients. The association between DR and AS has attracted a large portion of research attention in recent years [ 2 – 4 ]. The American Diabetes Association (ADA) points out that DR is an independent predictor of type 2 diabetes (T2D) subclinical cardiovascular disease [ 5 ].…”

The inverse association between DNA gaps and HbA1c levels in type 2 diabetes mellitus

“…Type 2 DM patients are more likely to develop various conditions that affect elderly people, causing type 2 DM to be one of the world's most major health problems 11 – 20 . Tissue damage and multiorgan dysfunction, such as cardiovascular disease, stroke, foot ulcers, chronic kidney failure, and diabetic retinopathy, can occur in type 2 DM patients 21 – 29 . However, the mechanism underlying cellular senescence in DM needs more research.…”

Decreased Alu methylation in type 2 diabetes mellitus patients increases HbA1c levels

“…Currently, an estimated 537 million people are at an increased risk of type 2 DM, and this number is expected to increase to 592 million by 2035 and reach 783 million by 2045 1,2 . Type 2 DM patients can develop various complications, including cardiovascular disease, stroke, foot ulcers, chronic kidney failure, and diabetic retinopathy, 3–10 making it one of the world's most critical health concerns 11,12 . Type 2 DM is a multifactorial condition characterized by high blood glucose levels (hyperglycemia), 13–15 which are influenced by genetic and epigenetic factors 16–19 .…”