Retinal arteriolar narrowing predicts incidence of diabetes: the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study.
OBJECTIVE
To examine the relationship of retinal vascular caliber to incident diabetes in a population-based cohort.


METHODS
The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study recruited adults aged 25+ years across Australia in 1999-2000, with a follow-up 5 years later in 2004-2005. Participants' glycemic status was classified using fasting plasma glucose (FPG) and 2-h oral glucose tolerance (2-h plasma glucose [2hPG]) tests. Diabetes was diagnosed if FPG was >or=7.0 mmol/l or 2hPG was >or=11.1 mmol/l. Retinal vascular caliber was measured from baseline retinal photographs using a computer-assisted program.


RESULTS
Of the 803 participants without diabetes at baseline, 108 (13.4%) developed diabetes at follow-up: 7 (2.8%) of 246 participants with normal glucose tolerance, 9 (13.6%) of 66 participants with impaired fasting glucose, and 92 (18.7%) of 491 participants with impaired glucose tolerance. After multivariate analysis, participants with narrower retinal arteriolar caliber had a higher risk of diabetes (odds ratio 2.21 [95% CI 1.02-4.80], comparing smallest versus highest arteriolar caliber tertiles, P = 0.04 for trend). There was no association between retinal venular caliber and incident diabetes.


CONCLUSIONS
Narrower retinal arteriolar caliber predicted risk of diabetes. These data provide further evidence that microvascular changes may contribute to the pathogenesis of diabetes.
Nguyen
Thanh T
TT
Centre for Eye Research Australia, University of Melbourne, 32 Gisborne St., East Melbourne 3002, Australia.
Wang
Jie Jin
JJ
Islam
F M Amirul
FM
Mitchell
Paul
P
Tapp
Robyn J
RJ
Zimmet
Paul Z
PZ
Simpson
Richard
R
Shaw
Jonathan
J
Wong
Tien Y
TY
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D015356:Retinal Artery Occlusion / Q000150:complications*; D012307:Risk Factors