Early Signs of End‐Organ Damage in Retinal Arterioles in Patients with Type 2 Diabetes Compared to Hypertensive Patients

Jumar, Agnes; Ott, Christian; Kistner, Iris; Friedrich, Stefanie; Michelson, Georg; Harazny, Joanna; Schmieder, Roland E.

doi:10.1111/micc.12291

Cited by 14 publications

(11 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, alterations in the vascular extracellular matrix (increased collagen-to-elastin ratio) are observed in the vessel wall of people with T2DM [ 37 ], probably due to inflammatory and pro-fibrotic changes. A recent population-based study reported no difference in wall thickness and cross-sectional area of retinal arterioles between healthy, T2DM and hypertensive subjects at early stages of disease but greater wall thickness in subjects with a diabetes duration of > 60 months compared with other groups, suggesting hypertrophic remodelling in T2DM with advancing disease duration [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetes, cardiovascular disease and the microcirculation

Strain

Paldánius

2018

Cardiovasc Diabetol

427

247

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the leading cause of mortality in people with type 2 diabetes mellitus (T2DM), yet a significant proportion of the disease burden cannot be accounted for by conventional cardiovascular risk factors. Hypertension occurs in majority of people with T2DM, which is substantially more frequent than would be anticipated based on general population samples. The impact of hypertension is considerably higher in people with diabetes than it is in the general population, suggesting either an increased sensitivity to its effect or a confounding underlying aetiopathogenic mechanism of hypertension associated with CVD within diabetes. In this contribution, we aim to review the changes observed in the vascular tree in people with T2DM compared to the general population, the effects of established anti-diabetes drugs on microvascular outcomes, and explore the hypotheses to account for common causalities of the increased prevalence of CVD and hypertension in people with T2DM.

show abstract

Section: Introductionmentioning

confidence: 99%

Diabetes, cardiovascular disease and the microcirculation

Strain

Paldánius

2018

Cardiovasc Diabetol

427

247

View full text Add to dashboard Cite

show abstract

“…While no significant difference in vessel dimensions were found after the dapagliflozin period compared to baseline, the arteriole wall cross-sectional area and the WLR were both increased after the placebo period. An increased WLR and cross-sectional area are characteristic of the vascular hypertrophy seen in type 2 diabetes [ 31 ]. Our findings may, therefore, indicate a positive effect of the dapagliflozin in preventing microvascular remodelling.…”

Section: Discussionmentioning

confidence: 99%

A randomised study of the impact of the SGLT2 inhibitor dapagliflozin on microvascular and macrovascular circulation

Ott

Jumar

Striepe

et al. 2017

Cardiovasc Diabetol

Self Cite

127

View full text Add to dashboard Cite

BackgroundThe sodium–glucose cotransporter 2 inhibitor, dapagliflozin, has been shown to improve diabetic control and reduce blood pressure in patients with type 2 diabetes mellitus. Its effects on micro- and macrovascular structure and function have not yet been reported.MethodsThis was a prospective, single-centre, placebo-controlled, double-blind, randomised crossover phase IIIb study conducted between March 2014 and February 2015. After a 4-week run-in/washout phase, patients (N = 59) received 6 weeks of either dapagliflozin 10 mg or placebo once daily. They then underwent a 1-week washout before crossing over to the other treatment. Changes in retinal capillary flow (RCF) and arteriole remodelling were evaluated using scanning laser Doppler flowmetry, while micro- and macrovascular parameters in the systemic circulation were assessed using pulse wave analysis.ResultsSix weeks of dapagliflozin treatment resulted in improvements in diabetes control, including blood glucose and insulin resistance, and reduced office and 24-h ambulatory blood pressure values. RCF decreased from 324 AU at baseline to 308 AU after treatment with dapagliflozin (p = 0.028), while there was little difference after the placebo (318 AU; p = 0.334). Furthermore, the arteriole remodelling that was seen after the placebo phase was not evident after the dapagliflozin phase. Central systolic and diastolic blood pressure values were significantly lower after 6 weeks of dapagliflozin, by 3.0 and 2.2 mmHg, respectively (p = 0.035 and 0.020, respectively vs. baseline).ConclusionsSix weeks of dapagliflozin treatment resulted in numerous beneficial effects. In addition to achieving superior diabetes control and blood pressure, parameters associated with the early stages of vascular remodelling were also improved. Trial registration http://www.clinicaltrials.gov (NCT02383238)

show abstract

“…This is in accordance with previous data from our study group showing that only patients with long-term T2DM (diabetes duration of >60 month) presented retinal arteriolar hypertrophic remodeling with increased WT compared to healthy individuals and hypertensive patients. [31] Previous data from gluteal arteriolar biopsies indicated hypertrophic arteriolar remodeling, but as previously discussed by our group[31], in these patients no adjustment has been made for potentially important confounding factors such as e.g. age.…”

Section: Discussionmentioning

confidence: 99%

Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

et al. 2016

Self Cite

View full text Add to dashboard Cite

PurposeIn diabetes mellitus type 2, capillary rarefaction plays a pivotal role in the pathogenesis of end-organ damage. We investigated retinal capillary density in patients with early disease.MethodsThis cross-sectional study compares retinal capillary rarefaction determined by intercapillary distance (ICD) and capillary area (CapA), measured non-invasively and in vivo by scanning laser Doppler flowmetry, in 73 patients with type 2 diabetes, 55 healthy controls and 134 individuals with hypertension stage 1 or 2.ResultsIn diabetic patients, ICD was greater (23.2±5.5 vs 20.2±4.2, p = 0.013) and CapA smaller (1592±595 vs 1821±652, p = 0.019) than in healthy controls after adjustment for differences in cardiovascular risk factors between the groups. Compared to hypertensive patients, diabetic individuals showed no difference in ICD (23.1±5.8, p = 0.781) and CapA (1556±649, p = 0.768).ConclusionIn the early stage of diabetes type 2, patients showed capillary rarefaction compared to healthy individuals.

show abstract

Early Signs of End‐Organ Damage in Retinal Arterioles in Patients with Type 2 Diabetes Compared to Hypertensive Patients

Abstract: In the early stage of T2DM no hypertrophic remodeling was seen in retinal arterioles. However, hypertrophic remodeling was found in diabetic patients with more than 60 months duration of disease.

Cited by 14 publications

References 35 publications

Diabetes, cardiovascular disease and the microcirculation

Diabetes, cardiovascular disease and the microcirculation

A randomised study of the impact of the SGLT2 inhibitor dapagliflozin on microvascular and macrovascular circulation

Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

Contact Info

Product

Resources

About