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. 2021 Sep 23:2021:9124656.
doi: 10.1155/2021/9124656. eCollection 2021.

Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Yaxin An  1 , Yuxian Yang  1 , Bin Cao  1 , Huan Dong  1 , Aihua Li  1 , Wenying Zhao  1 , Jing Ke  1 , Dong Zhao  1   2
Affiliations

Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Yaxin An et al. J Diabetes Res. .

Abstract

Introduction: Brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, has been demonstrated to be associated with type 2 diabetes mellitus (T2DM) and its vascular complications. This study was aimed at investigating the correlations of baPWV with both the presence and severity of diabetic retinopathy (DR) at baseline and at exploring the predictive role of baPWV in the new onset/progression of DR in the follow-up analysis.

Methods: The prospective cohort study recruited 2,473 Chinese patients with T2DM, of whom 663 participants were finally included in the follow-up analysis. The presence and grading of DR were performed by the modified Early Treatment Diabetic Retinopathy Study. Uni- or multivariate linear and logistic regression models and Cox proportional-hazards regression analysis were conducted.

Results: Of 2,473 patients with T2DM at baseline, 734 individuals were assessed to have DR and further categorized into 630 with non-sight-threatening DR (NSTDR) and 104 with STDR. In addition to the positive relationship between increased baPWV and the presence of DR, multinominal logistic regression analysis revealed that higher tertiles of baPWV were significantly related to the NSTDR (T2: OR = 1.62 (1.22, 2.15), p < 0.001, and T3: OR = 2.58 (1.86, 3.58), p < 0.001) and STDR group (T3: OR = 3.87 (1.87, 8.02), p < 0.001). During a follow-up (mean period of 16.4 months), 111 participants had new onset/progression of DR. The cox regressions showed that high baseline baPWV was correlated with increased risk of development/progression of DR (HR = 2.24, 95% CI (1.24, 4.03), p = 0.007, for T2 baPWV and HR = 2.90, 95% CI (1.49, 5.64), p = 0.002, for T3 baPWV) after adjustments for multiple factors.

Conclusions: Our results demonstrated that baseline baPWV might be an independent predictor in new onset/worsening of DR, suggesting that increased arterial stiffness might be involved in the development of DR. Follow-up studies with a longer duration are needed.

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Conflict of interest statement

The authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
The associations of baPWV with the presence and severity of DR. Differences in baPWV according to the presence of DR (a) and severity of DR (c) were presented by boxplots. Stacked bar plots (b) showing percentages of the presence (bluish-green bar) and absence of DR (orange bar) stratified by tertiles of baPWV, while similar plots (d) displaying differences in the proportions of severe DR (dark green) and mild DR (medium green) among tertiles of baPWV.
Figure 2
Figure 2
The relationships between baPWV and new onset/progression of DR: (a) boxplots showing distributions of baPWV between the group without and with new onset/progression of DR; (b) comparisons of the group with (dark orange) and without onset/progression of DR (light orange) based on the tertiles of baPWV were illustrated by stacked bar plots.
See this image and copyright information in PMC

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