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Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.
Ophthalmology 2007; 114(10):1884-92O

Abstract

OBJECTIVE

To describe the relationship of retinal arteriolar and venular calibers to the long-term incidence of microvascular and macrovascular complications in people with type 2 diabetes.

DESIGN

Population-based prospective study.

PARTICIPANTS

One thousand three hundred seventy persons diagnosed to have diabetes at > or =30 years of age in south central Wisconsin participated in the baseline examination from 1980 to 1982, 987 in the 4-year follow-up, and 533 in the 10-year follow-up.

METHODS

Computer-assisted grading was used to determine the average caliber of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and retinal venules (central retinal venular equivalent [CRVE]) at all examinations.

MAIN OUTCOME MEASURES

Incidence and progression of diabetic retinopathy; incidence of proliferative diabetic retinopathy and macular edema; incidence of nephropathy, neuropathy, and lower extremity amputation; and ischemic heart disease, stroke, and overall mortality.

RESULTS

While adjusting for other factors, smaller CRAE was associated with the 14-year cumulative incidence of lower extremity amputation (odds ratio [OR], first vs. second to fourth quartiles, 2.20; 95% confidence interval [CI], 1.14-4.24; P = 0.02), 22-year all-cause mortality (hazard ratio [HR], 1.18; 95% CI, 1.02-1.38; P = 0.03), and 22-year stroke mortality (HR, 1.47; 95% CI, 1.04-2.07; P = 0.03) but not with the other end points. Larger CRVE was associated with the 14-year incidence of diabetic nephropathy (OR, fourth vs. first to third quartiles, 2.08; 95% CI, 1.47-2.94; P<0.001) and 22-year stroke mortality (HR, 1.71; 95% CI, 1.20-2.44; P = 0.003) but with none of the other end points.

CONCLUSIONS

Retinal vessel caliber is independently associated with risk of incident nephropathy, lower extremity amputation, and stroke mortality in persons with type 2 diabetes. Measurement of retinal vessel caliber from photographs may provide additional information for the prediction of these events.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726-2336, USA. Kleinr@epi.ophth.wisc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17540447

Citation

Klein, Ronald, et al. "Retinal Vessel Caliber and Microvascular and Macrovascular Disease in Type 2 Diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy." Ophthalmology, vol. 114, no. 10, 2007, pp. 1884-92.
Klein R, Klein BE, Moss SE, et al. Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology. 2007;114(10):1884-92.
Klein, R., Klein, B. E., Moss, S. E., & Wong, T. Y. (2007). Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology, 114(10), pp. 1884-92.
Klein R, et al. Retinal Vessel Caliber and Microvascular and Macrovascular Disease in Type 2 Diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology. 2007;114(10):1884-92. PubMed PMID: 17540447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. AU - Klein,Ronald, AU - Klein,Barbara E K, AU - Moss,Scot E, AU - Wong,Tien Y, Y1 - 2007/05/30/ PY - 2006/09/14/received PY - 2007/02/19/revised PY - 2007/02/20/accepted PY - 2007/6/2/pubmed PY - 2007/10/19/medline PY - 2007/6/2/entrez SP - 1884 EP - 92 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 10 N2 - OBJECTIVE: To describe the relationship of retinal arteriolar and venular calibers to the long-term incidence of microvascular and macrovascular complications in people with type 2 diabetes. DESIGN: Population-based prospective study. PARTICIPANTS: One thousand three hundred seventy persons diagnosed to have diabetes at > or =30 years of age in south central Wisconsin participated in the baseline examination from 1980 to 1982, 987 in the 4-year follow-up, and 533 in the 10-year follow-up. METHODS: Computer-assisted grading was used to determine the average caliber of retinal arterioles (central retinal arteriolar equivalent [CRAE]) and retinal venules (central retinal venular equivalent [CRVE]) at all examinations. MAIN OUTCOME MEASURES: Incidence and progression of diabetic retinopathy; incidence of proliferative diabetic retinopathy and macular edema; incidence of nephropathy, neuropathy, and lower extremity amputation; and ischemic heart disease, stroke, and overall mortality. RESULTS: While adjusting for other factors, smaller CRAE was associated with the 14-year cumulative incidence of lower extremity amputation (odds ratio [OR], first vs. second to fourth quartiles, 2.20; 95% confidence interval [CI], 1.14-4.24; P = 0.02), 22-year all-cause mortality (hazard ratio [HR], 1.18; 95% CI, 1.02-1.38; P = 0.03), and 22-year stroke mortality (HR, 1.47; 95% CI, 1.04-2.07; P = 0.03) but not with the other end points. Larger CRVE was associated with the 14-year incidence of diabetic nephropathy (OR, fourth vs. first to third quartiles, 2.08; 95% CI, 1.47-2.94; P<0.001) and 22-year stroke mortality (HR, 1.71; 95% CI, 1.20-2.44; P = 0.003) but with none of the other end points. CONCLUSIONS: Retinal vessel caliber is independently associated with risk of incident nephropathy, lower extremity amputation, and stroke mortality in persons with type 2 diabetes. Measurement of retinal vessel caliber from photographs may provide additional information for the prediction of these events. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17540447/Retinal_vessel_caliber_and_microvascular_and_macrovascular_disease_in_type_2_diabetes:_XXI:_the_Wisconsin_Epidemiologic_Study_of_Diabetic_Retinopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00206-0 DB - PRIME DP - Unbound Medicine ER -