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Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank

AIMS/HYPOTHESIS: The aim of the study was to examine the association of retinal vessel morphometry with BP, body composition and biochemistry, and to determine whether these associations differ by diabetes status. METHODS: The UK Biobank ocular assessment included 68,550 participants aged 40-70 year...

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Autores principales: Tapp, Robyn J., Owen, Christopher G., Barman, Sarah A., Strachan, David P., Welikala, Roshan A., Foster, Paul J., Whincup, Peter H., Rudnicka, Alicja R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477904/
https://www.ncbi.nlm.nih.gov/pubmed/35852586
http://dx.doi.org/10.1007/s00125-022-05745-y
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author Tapp, Robyn J.
Owen, Christopher G.
Barman, Sarah A.
Strachan, David P.
Welikala, Roshan A.
Foster, Paul J.
Whincup, Peter H.
Rudnicka, Alicja R.
author_facet Tapp, Robyn J.
Owen, Christopher G.
Barman, Sarah A.
Strachan, David P.
Welikala, Roshan A.
Foster, Paul J.
Whincup, Peter H.
Rudnicka, Alicja R.
author_sort Tapp, Robyn J.
collection PubMed
description AIMS/HYPOTHESIS: The aim of the study was to examine the association of retinal vessel morphometry with BP, body composition and biochemistry, and to determine whether these associations differ by diabetes status. METHODS: The UK Biobank ocular assessment included 68,550 participants aged 40-70 years who underwent non-mydriatic retinal photography, BP and body composition measurements, and haematological analysis. A fully automated image analysis program provided measurements of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiometabolic risk factors by diabetes status were examined using multilevel linear regression, to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing for within-person clustering). RESULTS: A total of 50,233 participants (a reduction from 68,550) were included in these analyses. Overall, those with diabetes had significantly more tortuous venules and wider arteriolar diameters compared with those without. Associations between venular tortuosity and cardiometabolic risk factors differed according to diabetes status (p interaction <0.01) for total fat mass index, HbA(1c), C-reactive protein, white cell count and granulocyte count. For example, a unit rise in white cell count was associated with a 0.18% increase (95% CI 0.05, 0.32%) in venular tortuosity for those without diabetes and a 1.48% increase (95% CI 0.90, 2.07%) among those with diabetes. For arteriolar diameter, significant interactions were evident for systolic BP, diastolic BP, mean arterial pressure (MAP) and LDL-cholesterol. For example, a 10 mmHg rise in systolic BP was associated with a −0.92 μm difference (95% CI −0.96 to −0.88 μm) in arteriolar diameter for those without diabetes, and a −0.58 μm difference (95% CI −0.76 to −0.41 μm) among those with diabetes. No interactions were observed for arteriolar tortuosity or venular diameters. CONCLUSIONS/INTERPRETATION: We provide clear evidence of the modifying effect of diabetes on cardiometabolic risk factor associations with retinal microvascular architecture. These observations suggest the occurrence of preclinical disease processes, and may be a sign of impaired autoregulation due to hyperglycaemia, which has been suggested to play a pivotal role in the development of diabetes-related microvascular complications. DATA AVAILABILITY: The data supporting the results reported here are available through the UK Biobank (https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access). GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-022-05745-y.
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spelling pubmed-94779042022-09-17 Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank Tapp, Robyn J. Owen, Christopher G. Barman, Sarah A. Strachan, David P. Welikala, Roshan A. Foster, Paul J. Whincup, Peter H. Rudnicka, Alicja R. Diabetologia Article AIMS/HYPOTHESIS: The aim of the study was to examine the association of retinal vessel morphometry with BP, body composition and biochemistry, and to determine whether these associations differ by diabetes status. METHODS: The UK Biobank ocular assessment included 68,550 participants aged 40-70 years who underwent non-mydriatic retinal photography, BP and body composition measurements, and haematological analysis. A fully automated image analysis program provided measurements of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiometabolic risk factors by diabetes status were examined using multilevel linear regression, to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing for within-person clustering). RESULTS: A total of 50,233 participants (a reduction from 68,550) were included in these analyses. Overall, those with diabetes had significantly more tortuous venules and wider arteriolar diameters compared with those without. Associations between venular tortuosity and cardiometabolic risk factors differed according to diabetes status (p interaction <0.01) for total fat mass index, HbA(1c), C-reactive protein, white cell count and granulocyte count. For example, a unit rise in white cell count was associated with a 0.18% increase (95% CI 0.05, 0.32%) in venular tortuosity for those without diabetes and a 1.48% increase (95% CI 0.90, 2.07%) among those with diabetes. For arteriolar diameter, significant interactions were evident for systolic BP, diastolic BP, mean arterial pressure (MAP) and LDL-cholesterol. For example, a 10 mmHg rise in systolic BP was associated with a −0.92 μm difference (95% CI −0.96 to −0.88 μm) in arteriolar diameter for those without diabetes, and a −0.58 μm difference (95% CI −0.76 to −0.41 μm) among those with diabetes. No interactions were observed for arteriolar tortuosity or venular diameters. CONCLUSIONS/INTERPRETATION: We provide clear evidence of the modifying effect of diabetes on cardiometabolic risk factor associations with retinal microvascular architecture. These observations suggest the occurrence of preclinical disease processes, and may be a sign of impaired autoregulation due to hyperglycaemia, which has been suggested to play a pivotal role in the development of diabetes-related microvascular complications. DATA AVAILABILITY: The data supporting the results reported here are available through the UK Biobank (https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access). GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-022-05745-y. Springer Berlin Heidelberg 2022-07-19 2022 /pmc/articles/PMC9477904/ /pubmed/35852586 http://dx.doi.org/10.1007/s00125-022-05745-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Tapp, Robyn J.
Owen, Christopher G.
Barman, Sarah A.
Strachan, David P.
Welikala, Roshan A.
Foster, Paul J.
Whincup, Peter H.
Rudnicka, Alicja R.
Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title_full Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title_fullStr Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title_full_unstemmed Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title_short Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank
title_sort retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the uk biobank
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477904/
https://www.ncbi.nlm.nih.gov/pubmed/35852586
http://dx.doi.org/10.1007/s00125-022-05745-y
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