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Early atherosclerosis is associated with retinal microvascular changes in adolescents with type 1 diabetes
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Early atherosclerosis is associated with retinal microvascular changes in adolescents with type 1 diabetes
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Journal Article
Early atherosclerosis is associated with retinal microvascular changes in adolescents with type 1 diabetes
2018
Overview
Background/Objective Adolescents with type 1 diabetes have early macrovascular changes (increased intima‐media thickness [IMT]) and early retinal changes that predict clinical disease in adulthood. We hypothesized that early changes in the macrovascular and retinal microvascular beds develop in parallel before retinopathy develops. We therefore aimed to investigate the relationship between changes in atherosclerosis (carotid and aortic IMT) and retinal vascular geometry cross‐sectionally and longitudinally in adolescents with type 1 diabetes. Methods Ninety adolescents with type 1 diabetes (41 boys, aged 13.6 ± 3.5 years) who were enrolled in a randomized controlled trial had evaluations at baseline; 41 randomized to placebo were also investigated at 12 months for carotid and aortic IMT using ultrasound and retinal vascular geometry was measured from retinal photographs. Results There were significant associations between thicker mean/maximum carotid IMT and wider retinal arteriolar and venular calibers; for every 0.1 mm increase in mean carotid IMT, retinal arteriolar caliber increased by 7.90 μm (95% confidence interval [CI] 4.50, 11.30, P < 0.0001) and venular caliber by 9.61 μm (95% CI 4.16, 15.06, P = 0.0008). Increased mean aortic IMT was associated with increased arteriolar tortuosity (2.61, 95% CI 0.50, 4.71, P = 0.02). Conclusions The early changes of atherosclerosis are associated with retinal microvascular changes in adolescents with type 1 diabetes. This supports parallel adverse changes in the macro and microvascular circulations from early adolescence in type 1 diabetes, and highlights the importance of early intervention.
Publisher
John Wiley & Sons A/S,John Wiley & Sons, Inc
Subject
/ Aorta
/ Atherosclerosis - drug therapy
/ Atherosclerosis - epidemiology
/ Child
/ Diabetes
/ Diabetes mellitus (insulin dependent)
/ Diabetes Mellitus, Type 1 - complications
/ Diabetes Mellitus, Type 1 - drug therapy
/ Diabetes Mellitus, Type 1 - epidemiology
/ Diabetic Retinopathy - diagnosis
/ Diabetic Retinopathy - drug therapy
/ Diabetic Retinopathy - epidemiology
/ Female
/ Humans
/ Male
/ Placebos
/ Retina
/ Retinal Diseases - diagnosis
/ Retinal Diseases - drug therapy
/ Retinal Diseases - epidemiology
/ Retinal Vessels - diagnostic imaging
