Blood Pressure, Lipids, and Obesity Are Associated With Retinopathy

Leiden, Hendrik A. van; Dekker, Joost; Moll, Annette C.; Nijpels, Giel; Heine, Robert J.; Bouter, Lex M.; Stehouwer, Coen D.A.; Polak, B.C.P.

doi:10.2337/diacare.25.8.1320

Cited by 363 publications

(287 citation statements)

References 22 publications

Supporting

Mentioning

234

Contrasting

Unclassified

Order By: Relevance

“…39 Several studies have examined the effects of hypertriglyceridaemia on vasomotor function of peripheral vessels, with inconsistent results. [39][40][41] Triglyceride levels were related to generalised arteriolar narrowing in the ARIC study (P ¼ 0.012) 13 and retinopathy in the Hoorn Study, 15 but not related to any retinal microvascular signs neither in the CHS 14 nor in our study. However, we found a U-shaped relationship between triglyceride levels and retinal venular diameter in the current study.…”

Section: Discussioncontrasting

confidence: 59%

“…In contrast, the Cardiovascular Health Study (CHS, n ¼ 2405, aged 69-97 years) found no association between retinal microvascular signs and any measures of serum lipid, after multivariate adjustment. 14 In the Hoorn study (n ¼ 626, age 50-74 years), 15 after adjusting for age, sex, and glucose metabolism category, retinopathy was associated with higher total cholesterol and triglyceride levels, but not associated with HDL or LDL cholesterol levels.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dyslipidaemia and microvascular disease in the retina

Leung

Wang

Rochtchina

et al. 2004

Eye

View full text Add to dashboard Cite

Purpose There are few data on the effect of serum lipids on microvascular disease. This study assessed the relationships between serum lipid levels and microvascular disease, as seen in the retina, among participants who attended a population-based study in Australia (n ¼ 3654, aged 49 þ years). Methods Diameters of retinal arterioles and venules were measured from digitised photographs of each participant to obtain an estimate of generalised arteriolar narrowing. Focal arteriolar narrowing, arteriovenous nicking, and retinopathy lesions (microaneurysms, haemorrhages, hard/soft exudates) were graded using a standard protocol. Fasting blood tests were performed in 89% of subjects. Adjusted means were calculated using general linear models. Logistic regression models were used to determine the odds ratios for retinal microvascular signs. Results After controlling for age, sex, body mass index, smoking, and mean arterial blood pressure, elevated high-density lipoprotein cholesterol was associated with narrower retinal arterioles (P trend ¼ 0.002) and venules (P trend ¼ 0.03) and with increased odds of generalised arteriolar narrowing (odds ratio 1.6, 95% confidence interval 1.1-2.2 for the highest vs the lowest quintile of high-density lipoprotein cholesterol). Serum triglyceride had a U-shaped relationship with venular diameter (P trend ¼ 0.003). We found no consistent pattern of association between serum total cholesterol or low-density lipoprotein cholesterol and any retinal microvascular signs. Conclusions These findings suggest that microvascular disease in the retina may result from processes distinct from dyslipidaemia.

show abstract

Section: Discussioncontrasting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Dyslipidaemia and microvascular disease in the retina

Leung

Wang

Rochtchina

et al. 2004

Eye

View full text Add to dashboard Cite

show abstract

“…Although the clinical trial conducted by the UK Prospective Diabetes Study Group (3,4) and the Hoorn study (16) have shown that hypertension is a serious risk factor for the onset and the progression of DR in type 2 DM, other studies have found no relationship between this complication and high blood pressure (15,17,19), as was also the case in the present study. Even if hypertension were associated with retinopathy, we would not find this association, because the two groups of patients (with and without retinopathy) presented similar mean levels of systolic and diastolic blood pressure that could be attributed to the treatment with antihypertensive drugs, since 54.1% of the patients without retinopathy use some medication to control blood pressure versus 54.6% of the patients with retinopathy.…”

Section: Kg Santos Et Alcontrasting

confidence: 28%

“…Duration of diabetes and hyperglycemia are two well-known risk factors for the development of DR (1)(2)(3)6,7,(14)(15)(16)(17). In our study, patients with retinopathy had a longer duration of diabetes and more severe diabetes than patients without it, as indicated by a lower body mass index, a higher frequency of insulin therapy, higher HbA 1 levels, lower C-peptide levels, and a higher AER.…”

Section: Kg Santos Et Almentioning

confidence: 56%

Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

Santos

Tschiedel

Schneider

et al. 2005

Braz J Med Biol Res

View full text Add to dashboard Cite

Diabetic retinopathy (DR) is a sight-threatening chronic complication of diabetes mellitus and is the leading cause of acquired blindness in adults. In this cross-sectional study, we investigated the prevalence of and the factors associated with DR in an analysis of 210 consecutive and unrelated Brazilian Caucasians with type 2 diabetes mellitus. Retinopathy was evaluated by ophthalmoscopy and/or biomicroscopy through dilated pupils. The relationship between clinical and metabolic variables and the presence of DR was assessed by logistic regression analysis. DR was detected in 99 of the 210 patients (47%). In the univariate logistic regression analyses, male sex, duration of diabetes, body mass index, glycated hemoglobin, C-peptide, LDL cholesterol, smoking, and albumin excretion rate were found to be associated with the presence of DR. However, the multiple logistic regression analysis showed that only duration of diabetes (odds ratio (OR) = 1.15, 95% CI = 1.09-1.22; P < 0.001), glycated hemoglobin (OR = 1.21, 95% CI = 1.01-1.46; P = 0.047) and albumin excretion rate >100 µg/min (OR = 12.72, 95% CI = 3.89-41.56; P < 0.001) were independently associated with DR. Although DR was found to be frequent among Brazilian type 2 diabetic patients, its prevalence was within the range observed in other Caucasian populations. Our findings emphasize the need for good glycemic control in order to prevent or delay the onset of DR, since the most well-known risk factors for the development of this complication in type 2 diabetes mellitus, such as duration of diabetes, glycated hemoglobin and albumin excretion rate were independently related to DR.

show abstract

“…Laser photocoagulation and vitrectomy have improved the quality of life for patients with diabetic retinopathy and prevented the visual loss [71]. In the 1970s and 1980s, randomized controlled clinical trials (RCTs) in diabetic retinopathy began to evaluate the effects of laser photocoagulation [72,73]. The Early Treatment Diabetic Retinopathy Study (ETDRS) (1979-1990) also elucidated the natural history of diabetic retinopathy and provided new insights into the optimization of scatter laser photocoagulation for diabetic retinopathy [74].…”

Section: Secondary Preventionmentioning

confidence: 99%

Molecular mechanisms of Diabetic Retinopathy, general preventive strategies and novel therapeutic targets

Safi¹,

Qvist²,

Kumar³

et al. 2013

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

The growing number of people with diabetes worldwide suggests that diabetic retinopathy (DR) and diabetic macular edema (DME) will continue to be sight threatening factors. The pathogenesis of diabetic retinopathy is a widespread cause of visual impairment in the world and a range of hyperglycemia-linked pathways have been implicated in the initiation and progression of this condition. Despite understanding the polyol pathway flux, activation of protein kinase C (KPC) isoforms, increased hexosamine pathway flux, and increased advanced glycation end-product (AGE) formation, pathogenic mechanisms underlying diabetes induced vision loss are not fully understood. The purpose of this paper is to review molecular mechanisms that regulate cell survival and apoptosis of retinal cells and discuss new and exciting therapeutic targets with comparison to the old and inefficient preventive strategies. This review highlights the recent advancements in understanding hyperglycemia-induced biochemical and molecular alterations, systemic metabolic factors, and aberrant activation of signaling cascades that ultimately lead to activation of a number of transcription factors causing functional and structural damage to retinal cells. It also reviews the established interventions and emerging molecular targets to avert diabetic retinopathy and its associated risk factors.

show abstract

Blood Pressure, Lipids, and Obesity Are Associated With Retinopathy

Cited by 363 publications

References 22 publications

Dyslipidaemia and microvascular disease in the retina

Dyslipidaemia and microvascular disease in the retina

Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

Molecular mechanisms of Diabetic Retinopathy, general preventive strategies and novel therapeutic targets

Contact Info

Product

Resources

About