Relationship between Stage of Diabetic Retinopathy and Pulse Wave Velocity in Japanese Patients with Type 2 Diabetes

Abstract

Objectives. We investigated the relationship between the stage of diabetic retinopathy and pulse wave velocity (PWV). Methods. This was a cross-sectional study of 689 patients (406 men and 283 women) with type 2 diabetes who were admitted to our hospital from 2004 to 2007. Brachial-ankle pulse wave velocity (baPWV) was measured by an arterial pressure measurement device as PWV/ABI. Diagnosis of diabetic retinopathy was made by ophthalmologists based on the Davis classification: no diabetic retinopathy (NDR), simple retinopathy (SDR), pre-proliferative retinopathy (pre-PDR), and proliferative retinopathy (PDR). Results. There was a significant difference in PWV between patients without diabetic retinopathy (1657.0 ± 417.9 m/s (mean ± SD)) and with diabetic retinopathy (1847.1 ± 423.9 m/s) (P < 0.001). In addition, the stage of diabetic retinopathy was associated with aortic PWV (1657.0 ± 417.9 m/s in NDR (n = 420), 1819.4 ± 430.3 m/s in SDR (n = 152), 1862.1 ± 394.0 m/s in pre-PDR (n = 54), and 1901.1 ± 433.5 m/s in PDR (n = 63) (P < 0.001)). Conclusions. In patients with diabetic retinopathy, even in those with SDR, PWV was higher than that in patients without diabetic retinopathy. Physicians should therefore pay attention to the value of PWV and macroangiopathy regardless of the stage of diabetic retinopathy.

Effect of atorvastatin on diabetic rat endothelial cells and retinal lesions

“…Additionally, ILs and TNF are involved in DR lesion development, as they can directly or indirectly increase VEGF levels to promote vascular endothelial cell proliferation and are positively correlated with DR degree. In this study, VEGF, TNF-α, and IL-4 increased in the control group, which is consistent with the results of a previous study (Tanaka et al, 2013).…”

Arterial stiffness in diabetes mellitus

“…This has been confirmed in several other studies [46e48]. Furthermore, higher brachial-ankle PWV was shown to be stepwise associated with worsening stages of retinopathy [49]. Rema et al measured aortic AIx among 600 subjects with type 2 DM, approximately 20% of whom had retinopathy.…”

“…Neural involvement can manifest either as autonomic (central) or peripheral neuropathy. Autonomic dysfunction, like other microvascular complications of DM, is also an independent predictor of cardiovascular mortality [49,51,52]. Autonomic dysfunction has been associated with worse outcomes in subjects with DM, and has also been linked to other target organ dysfunction, including retinopathy and nephropathy [53e55].…”

Neutrophil–Lymphocyte ratio is associated with arterial stiffness in diabetic retinopathy in type 2 diabetes

“…Recent studies reported that increased baPWV is associated with microalbuminuria, urinary albumin excretion, neuropathy, and retinopathy in T2DM (Ogawa et al, 2008;Shin et al, 2013;Sjoblom, Nystrom, Lanne, Engvall, and Ostgren, 2014;Yokoyama et al, 2004Yokoyama et al, , 2007. In addition, PWV was positively correlated with the stage of DR (Ogawa et al, 2008;Tanaka et al, 2013). Therefore, it is considered that baPWV is a useful indicator for evaluation of complications in type 2 diabetic patients (Aso et al, 2003).…”

“…Chronic hyperglycemia causes the progression of arterial stiffness and DR (Tanaka et al, 2013). Furthermore, increased NLR is associated with elevated hemoglobin A1c (HbA1c) levels in T2DM (Sefil et al, 2014).…”