Department of Ophthalmology, Odense University Hospital, Odense, Denmark Clinical Research Institute, University of Southern Denmark, Odense, Denmark OPEN (Odense Patient data Explorative Network), Odense University Hospital, Odense, Denmark
Department of Ophthalmology, Odense University Hospital, Odense, Denmark Clinical Research Institute, University of Southern Denmark, Odense, Denmark.
Diabetes. 2014 Nov;63(11):3906-14. doi: 10.2337/db14-0227. Epub 2014 Jun 9.
Diabetic neuropathy, nephropathy, and retinopathy cause significant morbidity in patients with type 1 diabetes, even though improvements in treatment modalities delay the appearance and reduce the severity of these complications. To prevent or further delay the onset, it is necessary to better understand common underlying pathogenesis and to discover preclinical biomarkers of these complications. Retinal vessel calibers have been associated with the presence of microvascular complications, but their long-term predictive value has only been sparsely investigated. We examined retinal vessel calibers as 16-year predictors of diabetic nephropathy, neuropathy, and proliferative retinopathy in a young population-based Danish cohort with type 1 diabetes. We used semiautomated computer software to analyze vessel diameters on baseline retinal photos. Calibers of all vessels coursing through a zone 0.5-1 disc diameter from the disc margin were measured and summarized as the central artery and vein equivalents. In multiple regression analyses, we found wider venular diameters and smaller arteriolar diameters were both predictive of the 16-year development of nephropathy, neuropathy, and proliferative retinopathy. Early retinal vessel caliber changes are seemingly early markers of microvascular processes, precede the development of microvascular complications, and are a potential noninvasive predictive test on future risk of diabetic retinopathy, neuropathy, and nephropathy.
糖尿病性神经病、肾病和视网膜病变会给 1 型糖尿病患者带来严重的发病率，尽管治疗方式的改进延迟了这些并发症的出现并降低了其严重程度。为了预防或进一步延迟发病，有必要更好地了解常见的潜在发病机制，并发现这些并发症的临床前生物标志物。视网膜血管直径与微血管并发症的存在有关，但它们的长期预测价值仅得到了稀疏的研究。我们在一个基于人群的丹麦 1 型糖尿病年轻队列中，将视网膜血管直径作为糖尿病肾病、神经病和增殖性视网膜病变的 16 年预测指标进行了研究。我们使用半自动计算机软件分析了基线视网膜照片上的血管直径。测量并总结了通过距视盘边缘 0.5-1 个视盘直径区域的所有血管的直径，作为中央动脉和静脉等效物。在多元回归分析中，我们发现静脉直径变宽和小动脉直径变小都与 16 年肾病、神经病和增殖性视网膜病变的发展有关。早期视网膜血管口径变化似乎是微血管过程的早期标志物，先于微血管并发症的发生，是糖尿病性视网膜病变、神经病和肾病未来风险的潜在非侵入性预测测试。
