Presence of retinopathy in type 1 diabetic patients is associated with subclinical macroangiopathy.

PURPOSE: The aim of the study was to assess the relationships between diabetic retinopathy, subclinical atherosclerosis and wave reflection in type 1 diabetic patients.

METHODS

The investigation involved 87 type 1 diabetic patients aged 34 years (interquartile range [IQR]: 29-43), with a disease duration of 10 years (IQR: 9-14). Of these 39 (45%) had diabetic retinopathy. Carotid intima-media thickness (CIMT) was measured using high resolution ultrasonography. Wave reflection and central hemodynamics [central (CAI(x)) and peripheral augmentation index (PAI(x))] were determined with the use of tonometry.

RESULTS

Patients with retinopathy compared to those without had increased CIMT (530 vs 480 μm, p = 0.017) and wave reflection (CAI(x) [118.90 vs 110.96 %, p = 0.03] and PAI(x) [64.95 vs 57.44 %, p = 0.029]). In logistic regression analysis, patient's age, duration of diabetes, systolic and diastolic blood pressure, postprandial glycemia, HbA1c value, CIMT (p = 0.017), CAI(x) (p = 0.03) and PAI(x) (p = 0.016) were associated with the presence of diabetic retinopathy. However, in the multivariate model, CIMT and CAI(x) did not remain predictors of retinopathy.

CONCLUSIONS

We have shown that the presence of retinopathy in type 1 diabetic patients is associated with subclinical atherosclerosis and wave reflection.