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Mingguang He, Yin Hu; The Impact of 5-Year Longitudinal Trends of Fasting Plasma Glucose Levels on Retinal Microvasculature. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5358.
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To explore the impacts of five-year longitudinal changes in fasting plasma glucose (FPG) on retinal vascular caliber in middle-aged and elderly Chinese with or without established diabetes.
A prospective cohort study was conducted in Guangzhou, southern China. Subjects aged 40 years or older, with or without established diabetes mellitus, were recruited. FPG were measured annually between 2008 and 2012 using the same standardized protocols and equipment. Retinal vascular caliber was measured, in the images collected in 2012, as the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) using standard fundus photographs and validated software. Participants with at least three FPG measurements were included for statistical analysis. Associations of retinal vascular caliber with the longitudinal trend (slope on linear regression-FPG) and fluctuation (measured as the root mean square error and standard deviation of FPG) in FPG, were examined using a linear regression model.
A total of 4062 subjects (417 diabetes and 3645 non-diabetes) at baseline were included in the analysis. In a multivariate regression model, the FPG longitudinal trend with a 10% annual rise in FPG was associated with a 2.04 μm reduction in CRAE (P=0.016) and a 3.21 μm increment in CRVE (P=0.002), in the non-diabetes. The association was not statistically significant in the diabetes (P>0.05). In the diabetes but not the non-diabetes, RMSE-FPG was positively associated with CRVE (β=25.4, P=0.037).
An annual rising trend in FPG was associated with narrowed retinal arteriole and widened venule in the non-diabetes, while FPG fluctuation was associated with widened retinal venule in the diabetes. This result indicates the importance of maintaining glucose stability to protect vascular damages.
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