J Prev Med Public Health.  2011 Nov;44(6):260-266. 10.3961/jpmph.2011.44.6.260.

Arterial Stiffness is Associated With Diabetic Retinopathy in Korean Type 2 Diabetic Patients

• Yun YW
• Shin MH
• Lee YH
• Rhee JA
• Choi JS

• KMID: 1031141
• DOI: http://doi.org/10.3961/jpmph.2011.44.6.260

Abstract

OBJECTIVES
We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachial-ankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients.
METHODS
We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s.
RESULTS
The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT.
CONCLUSIONS
BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.

Keyword

Carotid plaque; Diabetes mellitus; Diabetic retinopathy; Intima-media thickness; Peripheral arterial disease; Pulse wave velocity

MeSH Terms

Aged
Aged, 80 and over
Ankle Brachial Index
Carotid Artery Diseases/epidemiology/*pathology
Confidence Intervals
Diabetes Mellitus, Type 2/epidemiology/*pathology
Diabetic Retinopathy/epidemiology/*pathology
Female
Humans
Logistic Models
Male
Odds Ratio
Peripheral Arterial Disease/epidemiology/*pathology
Republic of Korea/epidemiology
Risk Assessment
Tunica Intima/pathology
Tunica Media/pathology