Premium
Retinopathy in type 2 diabetes mellitus is associated with increased intima‐media thickness and endothelial dysfunction
Author(s) -
Malecki M. T.,
Osmenda G.,
WalusMiarka M.,
Skupien J.,
Cyganek K.,
MirkiewiczSieradzka B.,
DamekGuzik T. A.,
Guzik T. J.,
Sieradzki J.
Publication year - 2008
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2008.02051.x
Subject(s) - medicine , type 2 diabetes mellitus , microangiopathy , diabetes mellitus , von willebrand factor , retinopathy , intima media thickness , diabetic retinopathy , endothelial dysfunction , complication , type 2 diabetes , risk factor , cardiology , gastroenterology , endocrinology , carotid arteries , platelet
Background Microangioathy and macroangiopathy in type 2 diabetes mellitus (T2DM) frequently coexist. Both types of vascular complications share traditional risk factors. It is not clear whether the presence of microangiopathy, such as diabetic retinopathy (DR), constitutes a predictor of atherosclerosis in T2DM. Here we described the search for the association between DR and intima‐media thickness (IMT) in T2DM. We also compared endothelial function in subjects with and without DR. Material and methods We examined 182 consecutive patients with T2DM for at least 5 years (mean age at examination 56·3 ± 6·52 years). We assessed (i) IMT of carotid artery by ultrasound and (ii) endothelial function by flow‐mediated dilatation (FMD) method as well as by measurement of concentrations of von Willebrand factor (vWF) and s‐ICAM‐1. All patients underwent ophthalmological examination. Statistical analysis included Student's, Mann–Whitney, chi‐square, Fisher tests and multiple regression. Results DR was found in 71 (39·0%) subjects. IMT was higher in patients with DR than those without DR (0·87 mm vs. 0·79 mm, respectively, P = 0·0001). FMD was lower in the complication group than in subjects without DR (8·38% vs. 10·45%, respectively, P = 0·0023). Concentrations of s‐ICAM‐1 and vWF were not different between the groups. In multiple regression analysis, DR was among the predictors of increased IMT ( P = 0·016) and decreased FMD ( P = 0·002). We did not find a significant association of DR with vWF and s‐ICAM‐1 ( P = 0·09 and P = 0·11, respectively). Conclusions DR is associated with increased IMT and endothelial dysfunction in T2DM. Impaired endothelial function may be a common denominator of pathogenesis of microvascular complications and atherosclerosis in T2DM.