Retinal Vessel Tortuosity and Its Relation to Traditional and Novel Vascular Risk Markers in Persons with Diabetes

Muhammad Bayu Sasongko, Tien Yin Wong, Thanh T. Nguyen, Carol Y. Cheung, Jonathan E. Shaw, Ryo Kawasaki, Ecosse Luc Lamoureux, Jie Jin Wang

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose/Aim: To investigate the association between retinal vascular tortuosity and traditional- and vascular-related risk factors in persons with diabetes. Methods: We recruited 224 diabetic patients. Retinal vascular tortuosity was measured from fundus photographs. Association of tortuosity with the following factors was assessed after adjusting for significant co-factors: diabetes duration, HbA1c, systolic blood pressure (SBP), cholesterol and body mass index (BMI), flicker-light induced retinal vasodilatation, and markers of endothelial function and inflammation (skin microvacular responses to acetylcholine iontophoresis, soluble e-selectin, inter-cellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelin-1, total nitrite, C-reactive protein). Results: Adjusting for age and gender, longer diabetes duration was associated with more tortuous retinal arterioles (mean difference in arteriolar tortuosity 5.85 × 10−5, 95% Confidence Interval 1.44–10.3 × 10−5; p = 0.016; ≤10 versus >10 years duration). Reduced flicker-light induced retinal vasodilatation was associated with tortuous arterioles and venules (mean difference in arteriolar tortuosity 5.62 × 10−5, 4.50–6.72 × 10−5; p < 0.001 and in venules 5.94 × 10−5, 3.33–8.55 × 10−5; p < 0.001; comparing highest versus lowest tertile of flicker-light vasodilatation). These associations remained after adjusting for co-factors. Diabetes duration explained about 36% and flicker-light vasodilatation 25% of the variation in retinal arteriolar tortuosity. No associations were found between retinal arteriolar or venular tortuosity and HBA1c, SBP, cholesterol, BMI and serum markers of endothelial function. Conclusions: Increased retinal arteriolar tortuosity was related to longer diabetes duration and reduced flicker-light induced vasodilatory response, suggesting that retinal vascular tortuosity in adults with diabetes may be influenced by multiple diabetes-related physio-pathological changes.

Original languageEnglish
Pages (from-to)551-557
Number of pages7
JournalCurrent Eye Research
Volume41
Issue number4
DOIs
Publication statusPublished - 2 Apr 2016
Externally publishedYes

Keywords

  • Diabetes
  • diabetic complications
  • retinal images
  • risk markers
  • tortuosity

Cite this

Sasongko, Muhammad Bayu ; Wong, Tien Yin ; Nguyen, Thanh T. ; Cheung, Carol Y. ; Shaw, Jonathan E. ; Kawasaki, Ryo ; Lamoureux, Ecosse Luc ; Wang, Jie Jin. / Retinal Vessel Tortuosity and Its Relation to Traditional and Novel Vascular Risk Markers in Persons with Diabetes. In: Current Eye Research. 2016 ; Vol. 41, No. 4. pp. 551-557.
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title = "Retinal Vessel Tortuosity and Its Relation to Traditional and Novel Vascular Risk Markers in Persons with Diabetes",
abstract = "Purpose/Aim: To investigate the association between retinal vascular tortuosity and traditional- and vascular-related risk factors in persons with diabetes. Methods: We recruited 224 diabetic patients. Retinal vascular tortuosity was measured from fundus photographs. Association of tortuosity with the following factors was assessed after adjusting for significant co-factors: diabetes duration, HbA1c, systolic blood pressure (SBP), cholesterol and body mass index (BMI), flicker-light induced retinal vasodilatation, and markers of endothelial function and inflammation (skin microvacular responses to acetylcholine iontophoresis, soluble e-selectin, inter-cellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelin-1, total nitrite, C-reactive protein). Results: Adjusting for age and gender, longer diabetes duration was associated with more tortuous retinal arterioles (mean difference in arteriolar tortuosity 5.85 × 10−5, 95{\%} Confidence Interval 1.44–10.3 × 10−5; p = 0.016; ≤10 versus >10 years duration). Reduced flicker-light induced retinal vasodilatation was associated with tortuous arterioles and venules (mean difference in arteriolar tortuosity 5.62 × 10−5, 4.50–6.72 × 10−5; p < 0.001 and in venules 5.94 × 10−5, 3.33–8.55 × 10−5; p < 0.001; comparing highest versus lowest tertile of flicker-light vasodilatation). These associations remained after adjusting for co-factors. Diabetes duration explained about 36{\%} and flicker-light vasodilatation 25{\%} of the variation in retinal arteriolar tortuosity. No associations were found between retinal arteriolar or venular tortuosity and HBA1c, SBP, cholesterol, BMI and serum markers of endothelial function. Conclusions: Increased retinal arteriolar tortuosity was related to longer diabetes duration and reduced flicker-light induced vasodilatory response, suggesting that retinal vascular tortuosity in adults with diabetes may be influenced by multiple diabetes-related physio-pathological changes.",
keywords = "Diabetes, diabetic complications, retinal images, risk markers, tortuosity",
author = "Sasongko, {Muhammad Bayu} and Wong, {Tien Yin} and Nguyen, {Thanh T.} and Cheung, {Carol Y.} and Shaw, {Jonathan E.} and Ryo Kawasaki and Lamoureux, {Ecosse Luc} and Wang, {Jie Jin}",
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Sasongko, MB, Wong, TY, Nguyen, TT, Cheung, CY, Shaw, JE, Kawasaki, R, Lamoureux, EL & Wang, JJ 2016, 'Retinal Vessel Tortuosity and Its Relation to Traditional and Novel Vascular Risk Markers in Persons with Diabetes' Current Eye Research, vol. 41, no. 4, pp. 551-557. https://doi.org/10.3109/02713683.2015.1034371

Retinal Vessel Tortuosity and Its Relation to Traditional and Novel Vascular Risk Markers in Persons with Diabetes. / Sasongko, Muhammad Bayu; Wong, Tien Yin; Nguyen, Thanh T.; Cheung, Carol Y.; Shaw, Jonathan E.; Kawasaki, Ryo; Lamoureux, Ecosse Luc; Wang, Jie Jin.

In: Current Eye Research, Vol. 41, No. 4, 02.04.2016, p. 551-557.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Sasongko, Muhammad Bayu

AU - Wong, Tien Yin

AU - Nguyen, Thanh T.

AU - Cheung, Carol Y.

AU - Shaw, Jonathan E.

AU - Kawasaki, Ryo

AU - Lamoureux, Ecosse Luc

AU - Wang, Jie Jin

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N2 - Purpose/Aim: To investigate the association between retinal vascular tortuosity and traditional- and vascular-related risk factors in persons with diabetes. Methods: We recruited 224 diabetic patients. Retinal vascular tortuosity was measured from fundus photographs. Association of tortuosity with the following factors was assessed after adjusting for significant co-factors: diabetes duration, HbA1c, systolic blood pressure (SBP), cholesterol and body mass index (BMI), flicker-light induced retinal vasodilatation, and markers of endothelial function and inflammation (skin microvacular responses to acetylcholine iontophoresis, soluble e-selectin, inter-cellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelin-1, total nitrite, C-reactive protein). Results: Adjusting for age and gender, longer diabetes duration was associated with more tortuous retinal arterioles (mean difference in arteriolar tortuosity 5.85 × 10−5, 95% Confidence Interval 1.44–10.3 × 10−5; p = 0.016; ≤10 versus >10 years duration). Reduced flicker-light induced retinal vasodilatation was associated with tortuous arterioles and venules (mean difference in arteriolar tortuosity 5.62 × 10−5, 4.50–6.72 × 10−5; p < 0.001 and in venules 5.94 × 10−5, 3.33–8.55 × 10−5; p < 0.001; comparing highest versus lowest tertile of flicker-light vasodilatation). These associations remained after adjusting for co-factors. Diabetes duration explained about 36% and flicker-light vasodilatation 25% of the variation in retinal arteriolar tortuosity. No associations were found between retinal arteriolar or venular tortuosity and HBA1c, SBP, cholesterol, BMI and serum markers of endothelial function. Conclusions: Increased retinal arteriolar tortuosity was related to longer diabetes duration and reduced flicker-light induced vasodilatory response, suggesting that retinal vascular tortuosity in adults with diabetes may be influenced by multiple diabetes-related physio-pathological changes.

AB - Purpose/Aim: To investigate the association between retinal vascular tortuosity and traditional- and vascular-related risk factors in persons with diabetes. Methods: We recruited 224 diabetic patients. Retinal vascular tortuosity was measured from fundus photographs. Association of tortuosity with the following factors was assessed after adjusting for significant co-factors: diabetes duration, HbA1c, systolic blood pressure (SBP), cholesterol and body mass index (BMI), flicker-light induced retinal vasodilatation, and markers of endothelial function and inflammation (skin microvacular responses to acetylcholine iontophoresis, soluble e-selectin, inter-cellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelin-1, total nitrite, C-reactive protein). Results: Adjusting for age and gender, longer diabetes duration was associated with more tortuous retinal arterioles (mean difference in arteriolar tortuosity 5.85 × 10−5, 95% Confidence Interval 1.44–10.3 × 10−5; p = 0.016; ≤10 versus >10 years duration). Reduced flicker-light induced retinal vasodilatation was associated with tortuous arterioles and venules (mean difference in arteriolar tortuosity 5.62 × 10−5, 4.50–6.72 × 10−5; p < 0.001 and in venules 5.94 × 10−5, 3.33–8.55 × 10−5; p < 0.001; comparing highest versus lowest tertile of flicker-light vasodilatation). These associations remained after adjusting for co-factors. Diabetes duration explained about 36% and flicker-light vasodilatation 25% of the variation in retinal arteriolar tortuosity. No associations were found between retinal arteriolar or venular tortuosity and HBA1c, SBP, cholesterol, BMI and serum markers of endothelial function. Conclusions: Increased retinal arteriolar tortuosity was related to longer diabetes duration and reduced flicker-light induced vasodilatory response, suggesting that retinal vascular tortuosity in adults with diabetes may be influenced by multiple diabetes-related physio-pathological changes.

KW - Diabetes

KW - diabetic complications

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