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The relationship between retinal hemodynamics and systemic markers of endothelial function and inflammation in type 2 diabetes
Author(s) -
HUDSON C,
KHUU LA,
PALKA E,
FLANAGAN JG,
WONG T,
LAM WC,
MARKOWITZ SN,
BRENT M,
MANDELCORN M,
DEVENYI RG
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.4215.x
Subject(s) - medicine , von willebrand factor , hemodynamics , diabetic retinopathy , endothelial dysfunction , diabetes mellitus , inflammation , blood flow , type 2 diabetes , systemic inflammation , retinal , ophthalmology , cardiology , gastroenterology , endocrinology , platelet
Purpose The aim of the study was to investigate the associations, if any, between retinal hemodynamics and systemic markers of endothelial function and inflammation in patients with type 2 diabetes and non‐proliferative diabetic retinopathy (NPDR). Methods Retinal blood flow measurements and blood serum samples were obtained from 9 healthy controls (Group 1, mean age 53.8 yrs, SD 11.7), 23 patients with mild‐to‐moderate NPDR (Group 2, mean age 61.4 yrs, SD 8.5; duration 9.9 yrs, SD 8.8) and 14 patients with moderate‐to‐severe NPDR (Group 3, mean age 60.3 yrs, SD 9.9; duration 17.0 yrs, SD 9.4). Retinal blood flow was measured in the supero‐temporal arteriole using the Canon Laser Blood Flowmeter. Blood samples were collected to derive levels of intercellular adhesion molecule (ICAM‐1), vascular adhesion molecule (VCAM‐1), E‐selectin and von Willebrand factor (vWF). Results Diameter, velocity, maximum‐to‐minimum velocity ratio and flow were the same across the groups and did not change over a 6 month follow‐up. A1c and ICAM‐1 were significantly elevated across the groups (p=0.001 and p=0.030, resp., ANOVA). VCAM‐1 (r =0.325, p=0.046) and vWF (r =0.334, p=0.050) showed relatively weak associations with baseline max:min velocity ratio. vWF showed moderate associations with change in velocity (r = 0.571, p=0.007) and change blood flow (r = 0.455, p=0.038). Conclusion The relationship between endothelial dysfunction and inflammation markers and retinal hemodynamics in type 2 diabetes is complex since not all markers show an association. This work is on‐going.