title: Arterial stiffness is associated with diabetic retinopathy in Korean type 2 diabetic patients.
abstract: OBJECTIVE
  We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachial-ankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients.
  
  
  METHODS
  We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s.
  
  
  RESULTS
  The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT.
  
  
  CONCLUSIONS
  BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.
authors.affiliation: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Yong Woon
authors.initials: YW
authors.lastname: Yun
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Shin
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Lee
authors.forename: Jung Ae
authors.initials: JA
authors.lastname: Rhee
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000473:pathology*; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology