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Retinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons.

TitleRetinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons.
Publication TypeJournal Article
Year of Publication2002
AuthorsWong T Y, Klein R, A Sharrett R, Schmidt MI, Pankow JS, Couper DJ, Klein BEK, Hubbard LD, Duncan BB
Corporate AuthorsARIC Investigators
JournalJAMA
Volume287
Issue19
Pagination2528-33
Date Published2002 May 15
ISSN0098-7484
KeywordsAged, Aging, Diabetes Mellitus, Female, Humans, Hypertension, Inflammation, Logistic Models, Male, Microcirculation, Middle Aged, Photography, Prospective Studies, Retinal Artery Occlusion, Retinal Vessels, Risk Factors
Abstract

CONTEXT: Microvascular processes have been hypothesized to play a role in the pathogenesis of type 2 diabetes mellitus, but prospective clinical data regarding this hypothesis are unavailable.

OBJECTIVE: To examine the relation of retinal arteriolar narrowing, a marker of microvascular damage from aging, hypertension, and inflammation, to incident diabetes in healthy middle-aged persons.

DESIGN, SETTING, AND PARTICIPANTS: The Atherosclerosis Risk in Communities Study, an ongoing population-based, prospective cohort study in 4 US communities that began in 1987-1989. Included in this analysis were 7993 persons aged 49 to 73 years without diabetes, of whom retinal photographs were taken during the third examination (1993-1995).

MAIN OUTCOME MEASURES: Incident diabetes (defined as fasting glucose levels of > or =126 mg/dL [7.0 mmol/L], casual levels of > or =200 mg/dL [11.1 mmol/L], diabetic medications use, or physician diagnosis of diabetes at the fourth examination) by quartile of retinal arteriole-to-venule ratio (AVR).

RESULTS: After a median follow-up of 3.5 years, 291 persons (3.6%) had incident diabetes. The incidence of diabetes was higher in persons with lower AVR at baseline (2.4%, 3.1%, 4.0%, and 5.2%, from highest to lowest AVR quartile; P for trend or =141 mg/dL [7.8 mmol/L] as a cutoff), and was seen even in people at lower risk of diabetes, including those without a family history of diabetes, without impaired fasting glucose, and with lower measures of adiposity.

CONCLUSIONS: Retinal arteriolar narrowing is independently associated with risk of diabetes, supporting a microvascular role in the development of clinical diabetes.

DOI10.1001/jama.287.19.2528
Alternate JournalJAMA
PubMed ID12020333
Grant ListN01-HC-35125 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N1-HC-55021 / HC / NHLBI NIH HHS / United States
NN01-HC-35126 / HC / NHLBI NIH HHS / United States