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Proliferative diabetic retinopathy linked to coronary artery calcium
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Risk factors that link diabetic retinopathy in type 2 diabetes to coronary atherosclerosis should be identified and treated, according to results of recent data.
To determine the relationship between retinopathy and macrovascular disease, researchers from various sites across the United States conducted a cross-sectional study on a Veteran Affairs Diabetes Trial cohort of 204 patients with type 2 diabetes (mean duration of 12.3 years).
The researchers reported a link between retinopathy and coronary artery calcium (r=0.19; P=.006). In patients with no retinopathy, median coronary artery calcium increased by 197. Additional increases included 229 in those with microaneurysms only, 364 in those with mild nonproliferative diabetic retinopathy, 300 in those with moderate to severe NPDR and 981 in those with proliferative diabetic retinopathy.
A strong correlation between proliferative diabetic retinopathy and coronary artery calcium was reported. Compared with patients with no proliferative diabetic retinopathy, those with proliferative diabetic retinopathy were about six times more likely to have coronary artery calcium >400, despite adjustments for other CVD risk factors. – by Stacey L. Adams
Diabetes Care. 2008;31:952-957.
This is an interesting paper which extends epidemiologic data on coronary heart disease to a measure of coronary artery calcium. Nowadays, people are very in love with things like intravascular ultrasound. However, most of the time with intravascular ultrasound, retinopathy is not measured. This study is elegant because they use stereo-retinal photographs, which makes it a wonderful paper for the assessment of retinopathy. The measure of atherosclerosis, however, might not be so good. But, the paper reinforces the idea that to some degree a common set of risk factors underlie both micro- and macro-vascular disease.
– Stephen M. Haffner, MD
Professor of Medicine-Epidemiology, University of Texas Health Science Center