Retinal Vessel Diameters and Risk of Impaired Fasting Glucose or Diabetes Mellitus: The Rotterdam Study

Abstract

Purpose: : To investigate associations between baseline retinal vessel diameters and risk of impaired fasting glucose (IFG) or diabetes mellitus (DM) in a population–based cohort (≥55 years). To investigate associations between baseline retinal vessel diameters and risk of impaired fasting glucose (IFG) or diabetes mellitus (DM) in a population–based cohort (≥55 years).

Methods: : Baseline retinal vessel diameters (1990–1993) were measured on digitized images of 2309 persons with a normal glucose tolerance test (post–load glucose <7.8 mmol/l) at baseline, defined as arteriolar or venular summary diameters or the arterio/venous ratio (AVR). The outcome at follow–up (1997–1999) was IFG (defined as 6.1–7.0 mmol/l), or DM (defined as ≥7.0 mmol/l and/or anti–diabetic medication use).

Results: : Odds ratios (ORs) per standard deviation (SD) increase in venular diameters were 1.13 (95% confidence interval: 1.00–1.29) for IFG and 1.09 (0.90–1.33) for DM. Odds ratios per SD decrease in arteriolar diameters were 1.12 (0.98–1.27) for IFG and 1.08 (0.89–1.31) for DM, and similarly per SD decrease in AVR 1.29 (1.13–1.46) and 1.19 (0.98–1.45). After adjustment for cardiovascular risk factors, these associations were similar for venules and disappeared for arterioles. Stratification on age showed that associations between venular dilatation and IFG (OR: 1.23; 1.02–1.47) or DM (OR: 1.18; 0.89–1.56) were stronger in participants below 70 years.

Conclusions: : In our study the risk of IFG and DM with AVR was explained by venular dilatation rather than arteriolar narrowing warranting more focus on the causes of this dilatation.

Keywords: diabetes • retina • vascular occlusion/vascular occlusive disease