Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia.
Diabetes Res Clin Pract. 2010 Feb;87(2):192-9. doi: 10.1016/j.diabres.2009.11.007. Epub 2009 Dec 16.
To describe relationships of retinal vascular calibre with plasminogen activator inhibitor-1 (PAI-1) and other cardiovascular risk factors in people with type 2 diabetes.
We recruited 112 community-based persons aged 44-83years with type 2 diabetes, photo-documented retinal status using a digital fundus camera, and measured traditional and novel vascular risk factors. Retinal arteriolar and venular calibre and the arterio-venous ratio (AVR) were determined from fundus photographs using a validated computer-assisted method.
In adjusted linear regression models, PAI-1 activity was strongly associated with all measures of retinal vascular calibre: positively with arterioles (p=0.005) and AVR (p=0.001), and inversely with venules (p=0.001). In addition, wider arterioles were independently associated with waist-hip ratio (p<0.0001), HDL-C (p=0.015), and lower systolic blood pressure (p=0.042), whereas narrower venules were associated with older age and a higher albumin excretion rate. Neither arteriolar nor venular calibre was associated with plasma total homocysteine or C-reactive protein concentration.
Retinal vascular calibre is independently associated with PAI-1 activity in type 2 diabetes. This finding supports a role for PAI-1 activity in the microvasculature of persons with type 2 diabetes and may explain the link between retinal vascular calibre and cardiovascular disease.
描述 2 型糖尿病患者视网膜血管口径与纤溶酶原激活物抑制剂-1（PAI-1）和其他心血管危险因素的关系。
我们招募了 112 名年龄在 44-83 岁之间的、以社区为基础的 2 型糖尿病患者，使用数字眼底相机对视网膜状况进行了照片记录，并测量了传统和新型血管危险因素。使用经过验证的计算机辅助方法从眼底照片中确定视网膜动脉和静脉的口径以及动静脉比（AVR）。
在调整后的线性回归模型中，PAI-1 活性与所有视网膜血管口径测量值均呈强烈相关：与小动脉（p=0.005）和 AVR（p=0.001）呈正相关，与小静脉（p=0.001）呈负相关。此外，更宽的小动脉与腰围-臀围比（p<0.0001）、HDL-C（p=0.015）和较低的收缩压（p=0.042）独立相关，而更窄的小静脉与年龄较大和更高的白蛋白排泄率相关。小动脉或小静脉的口径均与血浆总同型半胱氨酸或 C 反应蛋白浓度无关。
视网膜血管口径与 2 型糖尿病患者的 PAI-1 活性独立相关。这一发现支持 PAI-1 活性在 2 型糖尿病患者的微血管中的作用，并可能解释视网膜血管口径与心血管疾病之间的联系。
