title: Proliferative retinopathy in type 1 diabetes is associated with cerebral microbleeds, which is part of generalized microangiopathy.
abstract: OBJECTIVE We investigated whether proliferative diabetic retinopathy in type 1 diabetic patients can be generalized to cerebral small vessel disease and whether it is associated with impaired peripheral microvascular function. RESEARCH DESIGN AND METHODS Thirty-three patients with proliferative diabetic retinopathy (PDR+), 34 patients without proliferative diabetic retinopathy, and 33 controls underwent magnetic resonance imaging to assess cerebral microangiopathy (cerebral microbleeds) and ischemic damage (white matter hyperintensities and lacunes). Peripheral microvascular function, i.e., skin capillary density and capillary recruitment, was assessed by capillary microscopy. RESULTS Cerebral microbleeds, but not ischemic damage, were more prevalent in PDR+ patients versus the other groups (P < 0.05). A trend was found across groups for the lowest baseline capillary density in PDR+ patients (P for trend = 0.05). In individuals with microbleeds, capillary recruitment was impaired compared with those without microbleeds (P = 0.04). CONCLUSIONS In PDR+ patients, cerebral microbleed prevalence was higher and seems part of generalized microangiopathy that may affect the skin and the brain.
authors: Corresponding author: Eelco van Duinkerken, e.vanduinkerken@vumc.nl.
authors: Jorn
authors: J
authors: Woerdeman
authors: Eelco
authors: E
authors: van Duinkerken
authors: Mike P
authors: MP
authors: Wattjes
authors: Frederik
authors: F
authors: Barkhof
authors: Frank J
authors: FJ
authors: Snoek
authors: Annette C
authors: AC
authors: Moll
authors: Martin
authors: M
authors: Klein
authors: Michiel P
authors: MP
authors: de Boer
authors: Richard G
authors: RG
authors: Ijzerman
authors: Erik H
authors: EH
authors: Serné
authors: Michaela
authors: M
authors: Diamant
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged