Retinopathy in type 2 diabetes mellitus is associated with increased intima-media thickness and endothelial dysfunction

Malecki, M. T., Osmenda, G., Walus-Miarka, M., Skupien, J., Cyganek, K., Mirkiewicz-Sieradzka, B., damek-Guzik, T. A., Guzik, T.J. and Sieradzki, J. (2008) Retinopathy in type 2 diabetes mellitus is associated with increased intima-media thickness and endothelial dysfunction. European Journal of Clinical Investigation, 38(12), pp. 925-930. (doi: 10.1111/j.1365-2362.2008.02051.x) (PMID:19021717)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Guzik, Professor Tomasz
Authors: Malecki, M. T., Osmenda, G., Walus-Miarka, M., Skupien, J., Cyganek, K., Mirkiewicz-Sieradzka, B., damek-Guzik, T. A., Guzik, T.J., and Sieradzki, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Journal of Clinical Investigation
Publisher:Wiley
ISSN:0014-2972
ISSN (Online):1365-2362
Published Online:19 November 2008

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