title: Retinal vascular caliber and risk of retinopathy in young patients with type 1 diabetes.
abstract: OBJECTIVE
  To examine the relationship between retinal vascular caliber and incident retinopathy in children and adolescents with type 1 diabetes mellitus.
  
  
  METHODS
  Hospital-based case-control study with prospective outcomes.
  
  
  METHODS
  Cases and controls were selected from a cohort of children and adolescents 12 to 20 years old with type 1 diabetes followed up at a tertiary diabetes clinic. Cases were patients who developed incident diabetic retinopathy (n = 166) after at least 1 year of follow-up (> or =2 clinic visits), and controls were patients who had not developed retinopathy (n = 165) after > or =2 years of follow-up (> or =3 clinic visits). Baseline retinal photographs of cases and controls were digitized, and retinal vascular calibers were measured using a computer-assisted program by a grader masked to case-control status. These measurements were combined into summary indices reflecting the average arteriolar and venular calibers.
  
  
  METHODS
  Development of diabetic retinopathy.
  
  
  RESULTS
  Incident retinopathy cases had retinal arteriolar calibers (mean +/- standard deviation [SD], 206.5+/-18.4 microm) significantly larger than those of controls (200.2+/-16.5 microm) (P = 0.004) but similar retinal venular calibers (329.1+/-14.7 microm in cases vs. 326.4+/-15.1 microm in controls, P = 0.312). After adjusting for age, gender, diabetes duration, glycated hemoglobin levels, blood pressure, body mass index, and pubertal stage, larger arteriolar caliber was predictive of risk of diabetic retinopathy (odds ratio, 1.44 per SD increase in arteriolar caliber; 95% confidence interval, 1.11-1.86).
  
  
  CONCLUSIONS
  Larger retinal arteriolar caliber predicts incident retinopathy in children and adolescents with type 1 diabetes, independent of conventional risk factors for retinopathy. Measurement of retinal vascular caliber may provide prognostic information regarding the subsequent risk of diabetic retinopathy.
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Alibrahim
authors.forename: Kim C
authors.initials: KC
authors.lastname: Donaghue
authors.forename: Sophie
authors.initials: S
authors.lastname: Rogers
authors.forename: Stephen
authors.initials: S
authors.lastname: Hing
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Jenkins
authors.forename: Albert
authors.initials: A
authors.lastname: Chan
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001794:Blood Pressure; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D010781:Photography; D011446:Prospective Studies; D012161:Retinal Artery / Q000473:pathology*; D012169:Retinal Vein / Q000473:pathology*; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin