title: Retinal arteriolar tortuosity is associated with retinopathy and early kidney dysfunction in type 1 diabetes.
abstract: OBJECTIVE
  To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early kidney dysfunction was defined as AER ≥7.5 μg/min.
  
  
  RESULTS
  Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early kidney dysfunction only, and 85 (9.0%) had both retinopathy and early kidney dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early kidney dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles).
  
  
  CONCLUSIONS
  Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
authors: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
authors: Muhammad Bayu
authors: MB
authors: Sasongko
authors: Tien Yin
authors: TY
authors: Wong
authors: Kim C
authors: KC
authors: Donaghue
authors: Ning
authors: N
authors: Cheung
authors: Alicia J
authors: AJ
authors: Jenkins
authors: Paul
authors: P
authors: Benitez-Aguirre
authors: Jie Jin
authors: JJ
authors: Wang
mesh_terms: D000293:Adolescent; D001160:Arterioles / Q000473:pathology; D001794:Blood Pressure; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis*; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D012161:Retinal Artery / Q000473:pathology*; D055815:Young Adult
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human