1 型糖尿病急性高血糖期间视网膜血管直径的动态变化。
Dynamic changes in retinal vessel diameter during acute hyperglycemia in type 1 diabetes.
机构信息
Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States; Department of Medicine, Division of Nephrology, University of Colorado Denver, Aurora, CO 80045, United States; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, United States; Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94305, United States.
出版信息
J Diabetes Complications. 2018 Feb;32(2):234-239. doi: 10.1016/j.jdiacomp.2017.10.001. Epub 2017 Oct 24.
AIMS
To investigate changes in retinal vessel diameter during acute hyperglycemia in patients with type 1 diabetes.
METHODS
We conducted a study on 11 subjects with type 1 diabetes. Euglycemia was maintained for 3h followed by induction of hyperglycemia and simultaneous bolus of rapid acting insulin. Two fundus photos were captured during euglycemia and five fundus photos, blood glucose and blood pressure were taken every 30min for 2.5h post-prandial. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured over the study visit and examined using generalized linear mixed models.
RESULTS
In a multivariate mixed model, mean CRAE and CRVE were reduced at 90min post-prandial in both zones B and C. In repeated measures analysis, arterioles exhibited a significant association with change in vessel caliber per change in blood glucose. Inconsistent effects of blood pressure on vessel diameter were also measured.
CONCLUSIONS
We document a change in retinal vessel diameter during acute hyperglycemia in persons with type 1 diabetes. Larger controlled studies are required to further investigate this phenomenon and to more accurately assess if hyperglycemia has direct effects on retinal vessel diameter.
目的
研究 1 型糖尿病患者急性高血糖期间视网膜血管直径的变化。
方法
我们对 11 名 1 型糖尿病患者进行了研究。先维持 3 小时的正常血糖，然后诱导高血糖，并同时给予速效胰岛素推注。在正常血糖期间拍摄了 2 张眼底照片，在餐后 2.5 小时内每 30 分钟测量 5 张眼底照片、血糖和血压。在研究期间测量中心视网膜动脉等效直径（CRAE）和中心视网膜静脉等效直径（CRVE），并使用广义线性混合模型进行检查。
结果
在多变量混合模型中，B 区和 C 区的 CRAE 和 CRVE 在餐后 90 分钟时均降低。在重复测量分析中，小动脉与血糖变化引起的血管口径变化之间存在显著关联。还测量了血压对血管直径的不一致影响。
结论
我们记录了 1 型糖尿病患者急性高血糖期间视网膜血管直径的变化。需要更大规模的对照研究来进一步研究这一现象，并更准确地评估高血糖是否对视网膜血管直径有直接影响。
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