Impaired retinal vasodilator responses in prediabetes and type 2 diabetes

Mary E.J. Lott, Julia E. Slocomb, Vikram Shivkumar, Bruce Smith, David Quillen, Robert A. Gabbay, Thomas W. Gardner, Kerstin Bettermann

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: In diabetes, endothelial dysfunction and subsequent structural damage to blood vessels can lead to heart attacks, retinopathy and strokes. However, it is unclear whether prediabetic subjects exhibit microvascular dysfunction indicating early stages of arteriosclerosis and vascular risk. The purpose of this study was to examine whether retinal reactivity may be impaired early in the hyperglycaemic continuum and may be associated with markers of inflammation. Methods: Individuals with prediabetes (n = 22), type 2 diabetes (n = 25) and healthy age and body composition matched controls (n = 19) were studied. We used the Dynamic Vessel Analyzer to assess retinal vasoreactivity (percentage change in vessel diameter) during a flickering light stimulation. Fasting highly sensitive c-reactive protein (hs-CRP), a marker of inflammation, was measured in blood plasma. Results: Prediabetic and diabetic individuals had attenuated peak vasodilator and relative amplitude changes in retinal vein diameters to the flickering light stimulus compared with healthy controls (peak dilation: prediabetic subjects 3.3 ± 1.8%, diabetic subjects 3.3 ± 2.1% and controls 5.6 ± 2.6%, p = 0.001; relative amplitude: prediabetic subjects 4.3 ± 2.2%, diabetic subjects 5.0 ± 2.6% and control subjects 7.2 ± 3.2%, p = 0.003). Similar findings were observed in retinal arteries. Levels of hs-CRP were not associated with either retinal vessel response parameters. Conclusion: Retinal reactivity was impaired in prediabetic and type 2 diabetic individuals in parallel with reduced insulin sensitivity but not associated with levels of hs-CRP. Retinal vasoreactivity measurements may be a sensitive tool to assess early vascular risk.

Original languageEnglish (US)
Pages (from-to)e462-e469
JournalActa Ophthalmologica
Volume91
Issue number6
DOIs
StatePublished - Sep 1 2013

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Prediabetic State
Vasodilator Agents
Type 2 Diabetes Mellitus
Blood Vessels
Retinal Artery
Inflammation
Retinal Vein
Light
Retinal Vessels
Proteins
Arteriosclerosis
Body Composition
Insulin Resistance
Dilatation
Fasting
Stroke
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Lott, Mary E.J. ; Slocomb, Julia E. ; Shivkumar, Vikram ; Smith, Bruce ; Quillen, David ; Gabbay, Robert A. ; Gardner, Thomas W. ; Bettermann, Kerstin. / Impaired retinal vasodilator responses in prediabetes and type 2 diabetes. In: Acta Ophthalmologica. 2013 ; Vol. 91, No. 6. pp. e462-e469.
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abstract = "Purpose: In diabetes, endothelial dysfunction and subsequent structural damage to blood vessels can lead to heart attacks, retinopathy and strokes. However, it is unclear whether prediabetic subjects exhibit microvascular dysfunction indicating early stages of arteriosclerosis and vascular risk. The purpose of this study was to examine whether retinal reactivity may be impaired early in the hyperglycaemic continuum and may be associated with markers of inflammation. Methods: Individuals with prediabetes (n = 22), type 2 diabetes (n = 25) and healthy age and body composition matched controls (n = 19) were studied. We used the Dynamic Vessel Analyzer to assess retinal vasoreactivity (percentage change in vessel diameter) during a flickering light stimulation. Fasting highly sensitive c-reactive protein (hs-CRP), a marker of inflammation, was measured in blood plasma. Results: Prediabetic and diabetic individuals had attenuated peak vasodilator and relative amplitude changes in retinal vein diameters to the flickering light stimulus compared with healthy controls (peak dilation: prediabetic subjects 3.3 ± 1.8{\%}, diabetic subjects 3.3 ± 2.1{\%} and controls 5.6 ± 2.6{\%}, p = 0.001; relative amplitude: prediabetic subjects 4.3 ± 2.2{\%}, diabetic subjects 5.0 ± 2.6{\%} and control subjects 7.2 ± 3.2{\%}, p = 0.003). Similar findings were observed in retinal arteries. Levels of hs-CRP were not associated with either retinal vessel response parameters. Conclusion: Retinal reactivity was impaired in prediabetic and type 2 diabetic individuals in parallel with reduced insulin sensitivity but not associated with levels of hs-CRP. Retinal vasoreactivity measurements may be a sensitive tool to assess early vascular risk.",
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Lott, MEJ, Slocomb, JE, Shivkumar, V, Smith, B, Quillen, D, Gabbay, RA, Gardner, TW & Bettermann, K 2013, 'Impaired retinal vasodilator responses in prediabetes and type 2 diabetes', Acta Ophthalmologica, vol. 91, no. 6, pp. e462-e469. https://doi.org/10.1111/aos.12129

Impaired retinal vasodilator responses in prediabetes and type 2 diabetes. / Lott, Mary E.J.; Slocomb, Julia E.; Shivkumar, Vikram; Smith, Bruce; Quillen, David; Gabbay, Robert A.; Gardner, Thomas W.; Bettermann, Kerstin.

In: Acta Ophthalmologica, Vol. 91, No. 6, 01.09.2013, p. e462-e469.

Research output: Contribution to journalArticle

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N2 - Purpose: In diabetes, endothelial dysfunction and subsequent structural damage to blood vessels can lead to heart attacks, retinopathy and strokes. However, it is unclear whether prediabetic subjects exhibit microvascular dysfunction indicating early stages of arteriosclerosis and vascular risk. The purpose of this study was to examine whether retinal reactivity may be impaired early in the hyperglycaemic continuum and may be associated with markers of inflammation. Methods: Individuals with prediabetes (n = 22), type 2 diabetes (n = 25) and healthy age and body composition matched controls (n = 19) were studied. We used the Dynamic Vessel Analyzer to assess retinal vasoreactivity (percentage change in vessel diameter) during a flickering light stimulation. Fasting highly sensitive c-reactive protein (hs-CRP), a marker of inflammation, was measured in blood plasma. Results: Prediabetic and diabetic individuals had attenuated peak vasodilator and relative amplitude changes in retinal vein diameters to the flickering light stimulus compared with healthy controls (peak dilation: prediabetic subjects 3.3 ± 1.8%, diabetic subjects 3.3 ± 2.1% and controls 5.6 ± 2.6%, p = 0.001; relative amplitude: prediabetic subjects 4.3 ± 2.2%, diabetic subjects 5.0 ± 2.6% and control subjects 7.2 ± 3.2%, p = 0.003). Similar findings were observed in retinal arteries. Levels of hs-CRP were not associated with either retinal vessel response parameters. Conclusion: Retinal reactivity was impaired in prediabetic and type 2 diabetic individuals in parallel with reduced insulin sensitivity but not associated with levels of hs-CRP. Retinal vasoreactivity measurements may be a sensitive tool to assess early vascular risk.

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Lott MEJ, Slocomb JE, Shivkumar V, Smith B, Quillen D, Gabbay RA et al. Impaired retinal vasodilator responses in prediabetes and type 2 diabetes. Acta Ophthalmologica. 2013 Sep 1;91(6):e462-e469. https://doi.org/10.1111/aos.12129