3.1 PREDIABETES IS ASSOCIATED WITH IMPAIRED RETINAL VASODILATION: THE MAASTRICHT STUDY

• Main Authors: Ben Sörensen*, Boy Houben, Tos Berendschot, Jan Schouten, Bram Kroon, Carla van der Kallen, Ronald Henry, Annemarie Koster, Pieter Dagnelie, Nicolaas Schaper, Miranda Schram, Coen Stehouwer
• Format: Article
• Language: English
• Published: Atlantis Press 2015-11-01
• Series: Artery Research
• Online Access: https://www.atlantis-press.com/article/125930713/view

Aim: Type 2 diabetes (DM2) causes microvascular dysfunction (MVD). In addition, MVD can contribute to insulin resistance, predisposing to DM2. This hypothesis predicts that MVD should be present in impaired glucose metabolism (IGM; prediabetes). However, population-based studies of MVD and glucose metabolism are not available. We investigated this using the retinal arteriolar dilator response to flicker light. Methods: In a population-based study (n = 2205), we determined retinal %-dilation (Dynamic Vessel Analyzer; Imedos, Germany) and glucose metabolism status (OGTT; classified as normal (NGM), IGM or DM2). Differences were compared with multivariable regression adjusted for age, sex, BMI, smoking, systolic-BP, lipid profile, retinopathy, (micro)albuminuria, the use of lipid-modifying and/or blood-pressure-lowering medication and prior cardiovascular disease. Results: 1263 individuals had NGM (42% men, aged 58 ± 8 years (mean ± SD)), 336 IGM (61% men, aged 61 ± 7 years) and 606 (due to oversampling) DM2 (69% men, aged 63 ± 8 years). Arteriolar %-dilation was median 3.51, IQR 1.47 to 5.95, range −5.69 to +19.71. %-dilation (mean ± SD) was 4.42 ± 3.45 in NGM, 3.77 ± 3.06 in IGM, and 3.26 ± 3.27 in DM2. Adjusted analyses showed decreased %-dilation in IGM (β = −0.461, p = 0.03) and DM2 (β = 0.559, p = 0.01) vs NGM. Conclusion: IGM and DM2 are associated with reduced flicker-light-induced retinal arteriolar dilation, independently of major cardiovascular risk factors. These findings support the concept that MVD precedes and thus may contribute to DM2.