Vascular risk factors are associated with retinal arteriolar narrowing and venular widening in children and adolescents with type 1 diabetes

J Pediatr Endocrinol Metab. 2017 Mar 1;30(3):301-309. doi: 10.1515/jpem-2016-0398.

Abstract

Background: The aim of the study was to describe the relationship of retinal arteriolar and venular calibre with vascular risk factors in children and adolescents with type 1 diabetes.

Methods: In this hospital-based cross-sectional study, the medical files of 483 children and adolescents with type 1 diabetes were audited to collect retinal images and relevant clinical data. Retinal vascular calibre was measured using standardised protocols.

Results: After multivariable adjustments, a vascular risk profile that included: older age, higher serum creatinine, higher systolic blood pressure (SBP), higher body mass index (BMI), abnormal estimated glomerular filtration rate (eGFR), lower high-density lipoproteins (HDL) cholesterol, longer duration of diabetes and higher serum sodium was associated with narrower central retinal artery equivalent (CRAE) (95% CI=-4.10/-0.76, p=0.004). A specific risk profile, including higher total cholesterol level, higher BMI, lower physical activity level, higher HbA1c, higher triglyceride levels, female gender and lower socio-economic status, was associated with wider central retinal vein equivalent (CRVE) (95% CI=1.14/5.62, p=0.003).

Conclusions: In summary, these findings support evidence that cardiovascular disease may have its origins early in life. Prospective and/or intervention studies are required to confirm whether the observed associations are involved in the causal pathway for retinal vascular calibre.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / analysis
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / pathology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Retinopathy / etiology*
  • Diabetic Retinopathy / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prognosis
  • Retinal Artery / pathology*
  • Retinal Vein / pathology*
  • Risk Factors
  • Young Adult

Substances

  • Biomarkers