The relationship of retinal vascular calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

Tikellis, Gabriella; Wang, J J; Tapp, Robyn J.; Simpson, Richard; Mitchell, Paul; Zimmet, Paul; Shaw, Jonathan E.; Wong, Tien Yin

doi:10.1007/s00125-007-0822-x

Cited by 68 publications

(61 citation statements)

References 34 publications

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“…20 Our study now clearly shows that in Asian Malays, as in white population, wider retinal arterioles are associated with diabetes. The association of wider retinal venules with diabetic retinopathy signs in our study is also consistent with clinical experience, as well as with findings from white population from BMES, 10 AusDiab, 8 MESA, 7 and Wisconsin Epidemiological Study of Diabetic Retinopathy (WESDR). 6,9 The mechanisms underlying wider retinal arterioles with diabetes are uncertain, but multiple aetiologies have been suggested, including impaired autoreguation of small vessels caused by hyperglycaemia and hypoxia.…”

Section: Discussionsupporting

confidence: 91%

“…8 Data from MESA study suggest that there may be racial variation of the effect of diabetes on the retinal vascular calibre. However, due to the small number of Asian participants, such an observation would need confirmation by other studies.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Several studies have shown that subtle variations in retinal vascular calibre are related to prediabetes, diabetes development, and diabetic retinopathy. [5][6][7][8][9][10][11] The Blue Mountain Eye Study (BMES) 10 and the Australian Diabetes, Obesity, and Lifestyle (AusDiab) 8 reported that wider retinal arterioles are associated with diabetes, whereas wider retinal venules are associated with diabetic retinopathy. However, most earlier studies examined only white populations.…”

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confidence: 99%

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Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Islam

Nguyen

Wang

et al. 2008

Eye

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Purpose To describe the relationship of retinal vascular calibre with diabetes and diabetic retinopathy in an Asian population. Methods A total of 3280 (78.7% response) subjects, aged 40-80 years, of Malay ethnicity residing in Singapore participated in this population-based, cross-sectional study. Retinal vascular calibre was measured and summarized using a validated computer programme from digital retinal photographs. Diabetic retinopathy signs were graded from photographs using the modified Airlie House classification. Results Of the 3004 subjects with data for this analysis, 682 (22.7%) had diabetes, of whom 194 (28.4%) had retinopathy. After multivariable adjustment, retinal arteriolar calibre was significantly wider in persons with diabetes (141 vs 139 lm, Po0.001); venular calibre was not associated with diabetes (P ¼ 0.93). Among participants with diabetes, venular calibre increased from 218.7 lm in those without retinopathy to 231.1 lm in those with moderate and 231.4 lm in those with severe retinopathy (P for trend ¼ o0.001); arteriolar calibre was not associated with diabetic retinopathy. Conclusions This study shows wider retinal arterioles in diabetes and wider venules in those with diabetic retinopathy in an Asian population. These findings confirm earlier data on white population, supporting the concept that a quantitative assessment of retinal vasculature may provide further insights into early diabetic microvascular damage.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Islam

Nguyen

Wang

et al. 2008

Eye

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“…Nonmydriatic digital retinal photographs were taken at baseline (14). Retinal vascular caliber was measured using a validated computer-based program by trained graders masked to participant characteristics (16). If retinal vascular caliber could not be measured from photographs of the right eye, the left was used.…”

Section: Methodsmentioning

confidence: 99%

Retinal Arteriolar Narrowing Predicts Incidence of Diabetes

et al. 2008

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OBJECTIVE—To examine the relationship of retinal vascular caliber to incident diabetes in a population-based cohort. RESEARCH DESIGN AND METHODS—The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study recruited adults aged 25+ years across Australia in 1999–2000, with a follow-up 5 years later in 2004–2005. Participants' glycemic status was classified using fasting plasma glucose (FPG) and 2-h oral glucose tolerance (2-h plasma glucose [2hPG]) tests. Diabetes was diagnosed if FPG was ≥7.0 mmol/l or 2hPG was ≥11.1 mmol/l. Retinal vascular caliber was measured from baseline retinal photographs using a computer-assisted program. RESULTS—Of the 803 participants without diabetes at baseline, 108 (13.4%) developed diabetes at follow-up: 7 (2.8%) of 246 participants with normal glucose tolerance, 9 (13.6%) of 66 participants with impaired fasting glucose, and 92 (18.7%) of 491 participants with impaired glucose tolerance. After multivariate analysis, participants with narrower retinal arteriolar caliber had a higher risk of diabetes (odds ratio 2.21 [95% CI 1.02–4.80], comparing smallest versus highest arteriolar caliber tertiles, P = 0.04 for trend). There was no association between retinal venular caliber and incident diabetes. CONCLUSIONS—Narrower retinal arteriolar caliber predicted risk of diabetes. These data provide further evidence that microvascular changes may contribute to the pathogenesis of diabetes.

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“…Recent studies have shown that alterations in the retinal architecture, as reflected by variations in retinal vascular calibre, may be a marker of prediabetes, diabetes and its microvascular complications [1][2][3] measurements, however, offer information on a single specific variable of the retinal vascular network.…”

Section: Introductionmentioning

confidence: 99%

Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

et al. 2010

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Aims/hypothesis The fractal dimension (D f ) of the retinal vasculature is a global measure of its branching pattern complexity. We examined the relationship of retinal D f with diabetes. Methods We conducted a cross-sectional study of 1,577 participants with diabetes and impaired glucose metabolism and normal controls from the population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Retinal D f was quantified from fundus photographs using a computerbased programme and diabetes status was determined by oral glucose tolerance test based on the WHO criteria. Results After adjustment for age, sex and vascular risk factors, persons with higher retinal D f were more likely to have diabetes (OR 1.56; 95% CI 1.14-2.14, highest vs lowest fractal tertile). This relationship remained with further adjustment for retinal arteriolar calibre and presence of retinopathy (OR 1.64; 95% CI 1.19-2.27), and after excluding participants with retinopathy (OR 1.60; 95% CI 1.16-2.21). Retinal D f was not related to impaired glucose tolerance or impaired fasting glucose (OR 1.19; 95% CI 0.85-1.67). Conclusions/interpretation Individuals with diabetes, but not with impaired glucose metabolism, have greater retinal D f , reflecting greater complexity of the retinal vasculature. Our findings suggest the presence of early microvascular changes in the retinal vasculature of persons with diabetes, even in the absence of overt retinopathy.

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The relationship of retinal vascular calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

Cited by 68 publications

References 34 publications

Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study

Retinal Arteriolar Narrowing Predicts Incidence of Diabetes

Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

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