Plasminogen activator inhibitor-1 (PAI-1) activity and retinal vascular calibre in type 2 diabetes.
OBJECTIVE
To describe relationships of retinal vascular calibre with plasminogen activator inhibitor-1 (PAI-1) and other cardiovascular risk factors in people with type 2 diabetes.


METHODS
We recruited 112 community-based persons aged 44-83years with type 2 diabetes, photo-documented retinal status using a digital fundus camera, and measured traditional and novel vascular risk factors. Retinal arteriolar and venular calibre and the arterio-venous ratio (AVR) were determined from fundus photographs using a validated computer-assisted method.


RESULTS
In adjusted linear regression models, PAI-1 activity was strongly associated with all measures of retinal vascular calibre: positively with arterioles (p=0.005) and AVR (p=0.001), and inversely with venules (p=0.001). In addition, wider arterioles were independently associated with waist-hip ratio (p<0.0001), HDL-C (p=0.015), and lower systolic blood pressure (p=0.042), whereas narrower venules were associated with older age and a higher albumin excretion rate. Neither arteriolar nor venular calibre was associated with plasma total homocysteine or C-reactive protein concentration.


CONCLUSIONS
Retinal vascular calibre is independently associated with PAI-1 activity in type 2 diabetes. This finding supports a role for PAI-1 activity in the microvasculature of persons with type 2 diabetes and may explain the link between retinal vascular calibre and cardiovascular disease.
Brazionis
L
L
Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia. laimab@medstv.unimelb.edu.au
Yau
J
J
Rowley
K
K
Itsiopoulos
C
C
O'Dea
K
K
Wong
T Y
TY
Jenkins
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012044:Regression Analysis; D012161:Retinal Artery / Q000473:pathology; D012169:Retinal Vein / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors; D014699:Venules / Q000473:pathology; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D006710:Homocysteine; D017395:Plasminogen Activator Inhibitor 1