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Changes in retinal microvascular diameter in patients with diabetes.

da Silva AV, Gouvea SA, da Silva AP, Bortolon S, Rodrigues AN, Abreu GR, Herkenhoff FL - Int J Gen Med (2015)

Bottom Line: The ratio of arteriole diameter to venule diameter was calculated.The retinal microvasculature pattern was related to clinical and biochemical parameters.Therefore, the early assessment of retinal microvascular changes is possible prior to the onset of diabetic retinopathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Morphology, Federal University of Espírito Santo, Vitoria, Espirito Santo, Brazil.

ABSTRACT

Background and objectives: Diabetic retinopathy is the main microvascular complication in diabetes mellitus and needs to be diagnosed early to prevent severe sight-threatening retinopathy. The purpose of this study was to quantify the retinal microvasculature pattern and analyze the influence of blood glucose level and the duration of diabetes mellitus on the retinal microvasculature.

Methods: Two groups were analyzed: patients with diabetes (N=26) and patients without diabetes, ie, controls (N=26). A quantitative semiautomated method analyzed retinal microvasculature. The diameters of arterioles and venules were measured. The total numbers of arterioles and venules were counted. The ratio of arteriole diameter to venule diameter was calculated. The retinal microvasculature pattern was related to clinical and biochemical parameters.

Results: Patients with diabetes exhibited larger venule diameters in the upper temporal quadrant of the retina compared to the lower temporal quadrant (124.85±38.03 µm vs 102.92±15.69 µm; P<0.01). Patients with diabetes for 5 or more years had larger venule diameters in the upper temporal quadrant than patients without diabetes (141.62±44.44 vs 112.58±32.11 µm; P<0.05). The degree of venodilation in the upper temporal quadrant was positively correlated with blood glucose level and the estimated duration of diabetes mellitus.

Interpretation and conclusion: The employed quantitative method demonstrated that patients with diabetes exhibited venule dilation in the upper temporal quadrant, and the duration of diabetes mellitus was positively correlated with blood glucose level. Therefore, the early assessment of retinal microvascular changes is possible prior to the onset of diabetic retinopathy.

No MeSH data available.


Related in: MedlinePlus

Linear regression between blood glucose level and VDUT (A) and ADUT (B).Abbreviations: ADUT, arteriole diameter in the upped temporal quadrant; VDUT, venule diameter in the upper temporal quadrant.
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f2-ijgm-8-267: Linear regression between blood glucose level and VDUT (A) and ADUT (B).Abbreviations: ADUT, arteriole diameter in the upped temporal quadrant; VDUT, venule diameter in the upper temporal quadrant.

Mentions: The clinical and biochemical characteristics of the sample are shown in Table 1. The groups did not differ in age, sex, SAP, DAP, PP, MAP, or HR. The biochemical data in Table 1 indicate that fasting glucose, VLDL (very-low-density lipoprotein) cholesterol, and triglycerides were significantly higher in patients with diabetes than patients without diabetes (controls). The groups did not differ in mean values for total cholesterol, HDL (high-density lipoprotein) cholesterol, LDL (low-density lipoprotein) cholesterol, hematocrit, erythrocyte number, or hemoglobin. The microvascular features of the retina were distinct in the various quadrants. Table 2 shows significant differences among patients with diabetes in the mean ADUN vs ADLN, VDUT vs VDLT, and VDUN vs VDLN. The remaining microvascular features of the retina were not significantly different. The mean VDUT was ~22% greater in patients with diabetes for 5 or more years than in patients with diabetes for less than 5 years and in patients without diabetes (controls) (Table 3). The differences for the group with diabetes described in Table 3 remained when the distribution of diabetes duration was considered, and the means for VDUT vs VDLT and VDUN vs VDLN differed significantly among patients with diabetes for 5 or more years. Quantitative changes in the retinal microvasculature in the upper temporal quadrant of patients with diabetes were more evident when associated with blood plasma glucose levels (Figure 2). Significant positive correlations were observed between blood glucose level and VDUT (r=0.37, P<0.01) and blood glucose level and ADUT (r=0.31, P<0.05). The TAD, ADLT, ADUN, ADLN, TVD, VDLT, VDUN, VDLN, AD/VD ratio, TNA, and TNV were not correlated with blood glucose level. A positive correlation was observed between VDUT and duration of diabetes (Figure 3). The duration of diabetes exhibited an r2 of 0.23 (P<0.05) and explained 23% of VDUT dilation. The partial correlation coefficient was adjusted for SAP, and a positive correlation was observed between blood glucose level and VDUT (r=0.37 vs r=0.37 after adjusting for SAP, P<0.01) and blood glucose level and ADUT (r=0.31 vs r=0.30 after adjusting for SAP, P<0.05), independent of SAP. The remaining retinal microvascular parameters (TAD, ADLT, ADUN, ADLN, TVD, VDLT, VDUN, VDLN, AD/VD Ratio, TNA, and TNV) were not correlated with blood glucose level (Table 4). The partial correlation with adjustment for SAP was calculated between DM duration and VDUT. SAP did not affect this correlation (r=0.33 vs r=0.33 after adjusting for SAP, P<0.01). The remaining retinal microvascular parameters were not correlated with DM duration after adjusting for SAP (Table 5).


Changes in retinal microvascular diameter in patients with diabetes.

da Silva AV, Gouvea SA, da Silva AP, Bortolon S, Rodrigues AN, Abreu GR, Herkenhoff FL - Int J Gen Med (2015)

Linear regression between blood glucose level and VDUT (A) and ADUT (B).Abbreviations: ADUT, arteriole diameter in the upped temporal quadrant; VDUT, venule diameter in the upper temporal quadrant.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554448&req=5

f2-ijgm-8-267: Linear regression between blood glucose level and VDUT (A) and ADUT (B).Abbreviations: ADUT, arteriole diameter in the upped temporal quadrant; VDUT, venule diameter in the upper temporal quadrant.
Mentions: The clinical and biochemical characteristics of the sample are shown in Table 1. The groups did not differ in age, sex, SAP, DAP, PP, MAP, or HR. The biochemical data in Table 1 indicate that fasting glucose, VLDL (very-low-density lipoprotein) cholesterol, and triglycerides were significantly higher in patients with diabetes than patients without diabetes (controls). The groups did not differ in mean values for total cholesterol, HDL (high-density lipoprotein) cholesterol, LDL (low-density lipoprotein) cholesterol, hematocrit, erythrocyte number, or hemoglobin. The microvascular features of the retina were distinct in the various quadrants. Table 2 shows significant differences among patients with diabetes in the mean ADUN vs ADLN, VDUT vs VDLT, and VDUN vs VDLN. The remaining microvascular features of the retina were not significantly different. The mean VDUT was ~22% greater in patients with diabetes for 5 or more years than in patients with diabetes for less than 5 years and in patients without diabetes (controls) (Table 3). The differences for the group with diabetes described in Table 3 remained when the distribution of diabetes duration was considered, and the means for VDUT vs VDLT and VDUN vs VDLN differed significantly among patients with diabetes for 5 or more years. Quantitative changes in the retinal microvasculature in the upper temporal quadrant of patients with diabetes were more evident when associated with blood plasma glucose levels (Figure 2). Significant positive correlations were observed between blood glucose level and VDUT (r=0.37, P<0.01) and blood glucose level and ADUT (r=0.31, P<0.05). The TAD, ADLT, ADUN, ADLN, TVD, VDLT, VDUN, VDLN, AD/VD ratio, TNA, and TNV were not correlated with blood glucose level. A positive correlation was observed between VDUT and duration of diabetes (Figure 3). The duration of diabetes exhibited an r2 of 0.23 (P<0.05) and explained 23% of VDUT dilation. The partial correlation coefficient was adjusted for SAP, and a positive correlation was observed between blood glucose level and VDUT (r=0.37 vs r=0.37 after adjusting for SAP, P<0.01) and blood glucose level and ADUT (r=0.31 vs r=0.30 after adjusting for SAP, P<0.05), independent of SAP. The remaining retinal microvascular parameters (TAD, ADLT, ADUN, ADLN, TVD, VDLT, VDUN, VDLN, AD/VD Ratio, TNA, and TNV) were not correlated with blood glucose level (Table 4). The partial correlation with adjustment for SAP was calculated between DM duration and VDUT. SAP did not affect this correlation (r=0.33 vs r=0.33 after adjusting for SAP, P<0.01). The remaining retinal microvascular parameters were not correlated with DM duration after adjusting for SAP (Table 5).

Bottom Line: The ratio of arteriole diameter to venule diameter was calculated.The retinal microvasculature pattern was related to clinical and biochemical parameters.Therefore, the early assessment of retinal microvascular changes is possible prior to the onset of diabetic retinopathy.

View Article: PubMed Central - PubMed

Affiliation: Department of Morphology, Federal University of Espírito Santo, Vitoria, Espirito Santo, Brazil.

ABSTRACT

Background and objectives: Diabetic retinopathy is the main microvascular complication in diabetes mellitus and needs to be diagnosed early to prevent severe sight-threatening retinopathy. The purpose of this study was to quantify the retinal microvasculature pattern and analyze the influence of blood glucose level and the duration of diabetes mellitus on the retinal microvasculature.

Methods: Two groups were analyzed: patients with diabetes (N=26) and patients without diabetes, ie, controls (N=26). A quantitative semiautomated method analyzed retinal microvasculature. The diameters of arterioles and venules were measured. The total numbers of arterioles and venules were counted. The ratio of arteriole diameter to venule diameter was calculated. The retinal microvasculature pattern was related to clinical and biochemical parameters.

Results: Patients with diabetes exhibited larger venule diameters in the upper temporal quadrant of the retina compared to the lower temporal quadrant (124.85±38.03 µm vs 102.92±15.69 µm; P<0.01). Patients with diabetes for 5 or more years had larger venule diameters in the upper temporal quadrant than patients without diabetes (141.62±44.44 vs 112.58±32.11 µm; P<0.05). The degree of venodilation in the upper temporal quadrant was positively correlated with blood glucose level and the estimated duration of diabetes mellitus.

Interpretation and conclusion: The employed quantitative method demonstrated that patients with diabetes exhibited venule dilation in the upper temporal quadrant, and the duration of diabetes mellitus was positively correlated with blood glucose level. Therefore, the early assessment of retinal microvascular changes is possible prior to the onset of diabetic retinopathy.

No MeSH data available.


Related in: MedlinePlus