title: Retinal microvascular calibre and risk of incident diabetes: the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  To prospectively examine the association of retinal microvascular signs with incident diabetes and impaired fasting glucose (IFG) in a multi-ethnic population-based cohort.
  
  
  METHODS
  The multi-ethnic study of atherosclerosis comprised Caucasians, African-Americans, Hispanics and Chinese aged 45-84 years. Retinal vascular calibre and retinopathy were quantified from baseline retinal photographs. Incident diabetes and IFG were ascertained prospectively.
  
  
  RESULTS
  After a median follow-up of 3 years, 243 (4.9%) people developed diabetes and 565 (15.0%) developed IFG. After adjusting for known risk factors, participants with wider retinal arteriolar calibre had a higher risk of developing diabetes [HR: 1.60; 95% CI: 1.12-2.29, p=0.011 comparing highest with lowest arteriolar calibre tertile]. In ethnic subgroup analysis, the association between wider retinal arteriolar calibre and incident diabetes was stronger and statistically significant only in Caucasians [HR: 2.78; 95% CI: 1.37-5.62, p=0.005]. Retinal venular calibre and retinopathy signs were not related to risk of diabetes or IFG.
  
  
  CONCLUSIONS
  Wider retinal arteriolar calibre is independently associated with an increased risk of diabetes, supporting a possible role for early arteriolar changes in diabetes development. This effect was largely seen in Caucasians, and not in other ethnic groups, and may reflect ethnic differences in susceptibility to diabetes from microvascular pathways.
authors.affiliation: Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia. jwyau@unimelb.edu.au
authors.forename: Joanne Wen Yee
authors.initials: JW
authors.lastname: Yau
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Cotch
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000453:epidemiology / Q000208:ethnology*; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D001786:Blood Glucose
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