title: The association between regional arterial stiffness and diabetic retinopathy in type 2 diabetes.
abstract: OBJECTIVE
  Although several studies have reported that PWV is associated with diabetic retinopathy, it remains controversial as to which segment provides the PWV that might best reflect the presence of retinopathy. The aim of this study was to determine the pulse wave velocity (PWV) of arterial segments that is most closely associated with diabetic retinopathy in subjects without a history of macrovascular complications.
  
  
  METHODS
  After excluding subjects with a history of ischemic heart disease, peripheral artery disease, ischemic stroke, renal insufficiency, overt proteinuria, and other nondiabetic ophthalmic lesions or insufficient retinal examinations, a total of 494 subjects were analyzed by cross-sectional study. The central PWVs, including the heart-femoral (hf), heart-carotid (hc), heart-ankle (ha), and carotid-brachial (cb) segments, and the peripheral PWVs, including brachial-ankle (ba) and femoral-ankle (fa), were measured for each subject.
  
  
  RESULTS
  The group with diabetic retinopathy exhibited significantly higher hfPWV, hcPWV, haPWV and baPWV, but notcbPWV, faPWV or augmentation index (AI). Age, duration of diabetes, systolic and diastolic BP and pulse pressure were all positively associated with hfPWV, hcPWV, haPWV and baPWV. Quartiles of hfPWV were significantly associated with diabetic retinopathy after adjustment for covariates and known risk factors of diabetic retinopathy (P for trend = 0.023). Conversely, all quartiles of haPWV, hcPWV and baPWV lost significance after adjustment.
  
  
  CONCLUSIONS
  We found that diabetic retinopathy was most closely associated with hfPWV, suggesting the most reliable index of regional arterial stiffness index in retinopathy.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Kim
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Rhee
authors.forename: Won Young
authors.initials: WY
authors.lastname: Lee
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Oh
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Sun Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Sujeong
authors.initials: S
authors.lastname: Song
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D001916:Brachial Artery / Q000503:physiopathology; D002339:Carotid Arteries / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness