Qiu Chengxuan, Cotch Mary Frances, Sigurdsson Sigurdur, Garcia Melissa, Klein Ronald, Jonasson Fridbert, Klein Barbara E K, Eiriksdottir Gudny, Harris Tamara B, van Buchem Mark A, Gudnason Vilmundur, Launer Lenore J
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health (NIH), Bethesda, Maryland 20892, USA.
Diabetes. 2008 Jun;57(6):1645-50. doi: 10.2337/db07-1455. Epub 2008 Mar 10.
Diabetes increases the risk for microvascular disease. The retina and the brain both have intricate microvascular systems that are developmentally similar. We sought to examine whether microvascular lesions in the retina and in the brain are associated and whether this association differs among people with and without diabetes.
The analysis included 4,218 participants of the Icelandic population-based Age, Gene/Environment Susceptibility-Reykjavik Study who were born in 1907-1935 and who were previously followed as a part of the Reykjavik Study. Retinal focal arteriolar narrowing, arteriovenous (AV) nicking, and microaneurysms/hemorrhages were evaluated on digital retinal images of both eyes. Cerebral microbleeds (CMBs) were evaluated from magnetic resonance images. Data were analyzed with logistic and multinomial logistic regression models controlling for demographics, major cardiovascular risk factors, cerebral infarcts, and white matter lesions.
Evidence of brain microbleeds was found in 485 (11.5%) people, including 192 with multiple (>or=2) microbleeds. Subjects with signs of retinal microvascular lesions were at a significantly increased likelihood for having multiple CMBs. People with diabetes in combination with the presence of either retinal AV nicking (odds ratio [OR] 2.47 [95% CI 1.42-4.31]) or retinal microaneurysms/hemorrhages (2.28 [1.24-4.18]) were significantly more likely to have multiple CMBs.
Retinal microvascular abnormalities and brain microbleeds may occur together in older adults. People with both diabetes and signs of retinal microvascular lesions (AV nicking and microaneurysms/hemorrhages) are more likely to have multiple microbleeds in the brain. Microvascular disease in diabetes extends to the brain.
糖尿病会增加微血管疾病的风险。视网膜和大脑都有复杂的微血管系统，在发育上相似。我们试图研究视网膜和大脑中的微血管病变是否相关，以及这种关联在糖尿病患者和非糖尿病患者中是否存在差异。
分析纳入了冰岛基于人群的年龄、基因/环境易感性-雷克雅未克研究中的4218名参与者，他们出生于1907年至1935年，之前作为雷克雅未克研究的一部分接受随访。通过双眼的数字视网膜图像评估视网膜局灶性小动脉狭窄、动静脉交叉压迫和微动脉瘤/出血。从磁共振图像评估脑微出血（CMB）。使用逻辑回归和多项逻辑回归模型分析数据，控制人口统计学、主要心血管危险因素、脑梗死和白质病变。
在485人（11.5%）中发现了脑微出血的证据，其中192人有多处（≥2处）微出血。有视网膜微血管病变迹象的受试者发生多处CMB的可能性显著增加。糖尿病患者同时存在视网膜动静脉交叉压迫（比值比[OR]2.47[95%CI 1.42 - 4.31]）或视网膜微动脉瘤/出血（2.28[1.24 - 4.18]）时，发生多处CMB的可能性显著更高。
视网膜微血管异常和脑微出血可能在老年人中共同出现。患有糖尿病且有视网膜微血管病变迹象（动静脉交叉压迫和微动脉瘤/出血）的人更有可能在大脑中出现多处微出血。糖尿病中的微血管疾病扩展到了大脑。
