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Relations between Cardiac and Visual Phenotypes in Diabetes: A Multivariate Approach.

Oliveiros B, Sanches M, Quendera B, Graça B, Guelho D, Gomes L, Carrilho F, Caseiro-Alves F, Castelo-Branco M - PLoS ONE (2016)

Bottom Line: We found moderate to strong correlation between left ventricle function and the eye constructs: minimum correlation was found for psychophysical motion thresholds (DA: 0.734; LR: 0.666), while the maximum correlation was achieved with structural volume density in the neural retina (DA: 0.786; LR: 0.788).Controlling the effect of pairwise correlated visual constructs, the parameters that were most correlated to left ventricle function were volume density in retina and thickness of the retinal nerve fiber layers (adjusted multiple R2 is 0.819 and 0.730 for DA and LR), with additional contribution of psychophysical loss in achromatic contrast discrimination.We conclude that visual structural and functional changes in type 2 diabetes are related to heart dysfunction, when the effects of clinical, demographic and associated risk factors are taken into account, revealing a genuine relation between cardiac and retinal diabetic phenotypes.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

ABSTRACT
Cardiovascular disease and diabetes represent a major public health concern. The former is the most frequent cause of death and disability in patients with type 2 diabetes, where left ventricular dysfunction is highly prevalent. Moreover, diabetic retinopathy is becoming a dominant cause of visual impairment and blindness. The complex relation between cardiovascular disease and diabetic retinopathy as a function of ageing, obesity and hypertension remains to be clarified. Here, we investigated such relations in patients with diabetes type 2, in subjects with neither overt heart disease nor advanced proliferative diabetic retinopathy. We studied 47 patients and 50 controls, aged between 45 and 65 years, equally distributed according to gender. From the 36 measures regarding visual structure and function, and the 11 measures concerning left ventricle function, we performed data reduction to obtain eight new derived variables, seven of which related to the eye, adjusted for age, gender, body mass index and high blood pressure using both discriminant analysis (DA) and logistic regression (LR). We found moderate to strong correlation between left ventricle function and the eye constructs: minimum correlation was found for psychophysical motion thresholds (DA: 0.734; LR: 0.666), while the maximum correlation was achieved with structural volume density in the neural retina (DA: 0.786; LR: 0.788). Controlling the effect of pairwise correlated visual constructs, the parameters that were most correlated to left ventricle function were volume density in retina and thickness of the retinal nerve fiber layers (adjusted multiple R2 is 0.819 and 0.730 for DA and LR), with additional contribution of psychophysical loss in achromatic contrast discrimination. We conclude that visual structural and functional changes in type 2 diabetes are related to heart dysfunction, when the effects of clinical, demographic and associated risk factors are taken into account, revealing a genuine relation between cardiac and retinal diabetic phenotypes.

No MeSH data available.


Related in: MedlinePlus

Graphical abstract highlighting our main results.Prediction of left ventricular dysfunction in type 2 diabetes (T2DM) based on independent visual dysfunction, moderated by common risk factors such as age, gender, body mass index (BMI) and presence/absence of drug controlled arterial hypertension (HBP).
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pone.0153772.g003: Graphical abstract highlighting our main results.Prediction of left ventricular dysfunction in type 2 diabetes (T2DM) based on independent visual dysfunction, moderated by common risk factors such as age, gender, body mass index (BMI) and presence/absence of drug controlled arterial hypertension (HBP).

Mentions: Therefore, the loss of density in the neuro-retina and increased thickness of the retinal nerve fiber layers, naturally related to diabetic retinopathy and its impact on visual dysfunction, is correlated to left ventricle dysfunction in this type of patients. Such relation is described on Fig 3, showing that type 2 diabetes may be predicted either through visual or cardiac phenotype, both closely related when natural risk factors to type 2 diabetes are taken into account.


Relations between Cardiac and Visual Phenotypes in Diabetes: A Multivariate Approach.

Oliveiros B, Sanches M, Quendera B, Graça B, Guelho D, Gomes L, Carrilho F, Caseiro-Alves F, Castelo-Branco M - PLoS ONE (2016)

Graphical abstract highlighting our main results.Prediction of left ventricular dysfunction in type 2 diabetes (T2DM) based on independent visual dysfunction, moderated by common risk factors such as age, gender, body mass index (BMI) and presence/absence of drug controlled arterial hypertension (HBP).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835099&req=5

pone.0153772.g003: Graphical abstract highlighting our main results.Prediction of left ventricular dysfunction in type 2 diabetes (T2DM) based on independent visual dysfunction, moderated by common risk factors such as age, gender, body mass index (BMI) and presence/absence of drug controlled arterial hypertension (HBP).
Mentions: Therefore, the loss of density in the neuro-retina and increased thickness of the retinal nerve fiber layers, naturally related to diabetic retinopathy and its impact on visual dysfunction, is correlated to left ventricle dysfunction in this type of patients. Such relation is described on Fig 3, showing that type 2 diabetes may be predicted either through visual or cardiac phenotype, both closely related when natural risk factors to type 2 diabetes are taken into account.

Bottom Line: We found moderate to strong correlation between left ventricle function and the eye constructs: minimum correlation was found for psychophysical motion thresholds (DA: 0.734; LR: 0.666), while the maximum correlation was achieved with structural volume density in the neural retina (DA: 0.786; LR: 0.788).Controlling the effect of pairwise correlated visual constructs, the parameters that were most correlated to left ventricle function were volume density in retina and thickness of the retinal nerve fiber layers (adjusted multiple R2 is 0.819 and 0.730 for DA and LR), with additional contribution of psychophysical loss in achromatic contrast discrimination.We conclude that visual structural and functional changes in type 2 diabetes are related to heart dysfunction, when the effects of clinical, demographic and associated risk factors are taken into account, revealing a genuine relation between cardiac and retinal diabetic phenotypes.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

ABSTRACT
Cardiovascular disease and diabetes represent a major public health concern. The former is the most frequent cause of death and disability in patients with type 2 diabetes, where left ventricular dysfunction is highly prevalent. Moreover, diabetic retinopathy is becoming a dominant cause of visual impairment and blindness. The complex relation between cardiovascular disease and diabetic retinopathy as a function of ageing, obesity and hypertension remains to be clarified. Here, we investigated such relations in patients with diabetes type 2, in subjects with neither overt heart disease nor advanced proliferative diabetic retinopathy. We studied 47 patients and 50 controls, aged between 45 and 65 years, equally distributed according to gender. From the 36 measures regarding visual structure and function, and the 11 measures concerning left ventricle function, we performed data reduction to obtain eight new derived variables, seven of which related to the eye, adjusted for age, gender, body mass index and high blood pressure using both discriminant analysis (DA) and logistic regression (LR). We found moderate to strong correlation between left ventricle function and the eye constructs: minimum correlation was found for psychophysical motion thresholds (DA: 0.734; LR: 0.666), while the maximum correlation was achieved with structural volume density in the neural retina (DA: 0.786; LR: 0.788). Controlling the effect of pairwise correlated visual constructs, the parameters that were most correlated to left ventricle function were volume density in retina and thickness of the retinal nerve fiber layers (adjusted multiple R2 is 0.819 and 0.730 for DA and LR), with additional contribution of psychophysical loss in achromatic contrast discrimination. We conclude that visual structural and functional changes in type 2 diabetes are related to heart dysfunction, when the effects of clinical, demographic and associated risk factors are taken into account, revealing a genuine relation between cardiac and retinal diabetic phenotypes.

No MeSH data available.


Related in: MedlinePlus