title: Differential association of retinal arteriolar and venular caliber with diabetes and retinopathy.
abstract: OBJECTIVE
  To describe the relationship of retinal arteriolar and venular caliber with diabetes, retinopathy and hyperglycemia, in an Asian Indian population.
  
  
  METHODS
  This was a population-based cross-sectional study of 3400 (75.6% response rate) Singapore ethnic Indians aged 40-80 years. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were obtained using a validated computer-assisted program. Diabetes mellitus was identified using standardized criteria. Diabetic retinopathy was graded based on the modified Airlie House Classification System.
  
  
  RESULTS
  There were 980 (32.2%) participants with diabetes. Of these, 327 (33.4%) had diabetic retinopathy. After multivariate adjustment, diabetic persons had a wider CRAE (145.23μm vs 142.38μm, P<0.001). This relationship was stronger in persons without hyperlipidemia (P-interaction<0.1). Among diabetic participants, wider CRVE was related to increasing severity of retinopathy (P for trend<0.05) and this association may be altered by hypertensive status. Retinal arteriolar caliber widened with increasing glucose (P<0.001) and HbA1C (P<0.001) levels.
  
  
  CONCLUSIONS
  In Indian adults, wider retinal arteriolar caliber is associated with diabetes and hyperglycemia, while wider retinal venular caliber is associated with diabetic retinopathy. This is consistent with white populations and confirms the differential systemic association of retinal vascular caliber in Asian Indians.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore.
authors.forename: Andrew S H
authors.initials: AS
authors.lastname: Tsai
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Raghavan
authors.initials: R
authors.lastname: Lavanya
authors.forename: Rongli
authors.initials: R
authors.lastname: Zhang
authors.forename: Haslina
authors.initials: H
authors.lastname: Hamzah
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001160:Arterioles / Q000473:pathology; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000208:ethnology / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012171:Retinal Vessels / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014699:Venules / Q000473:pathology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human