title: The association of longitudinal trend of fasting plasma glucose with retinal microvasculature in people without established diabetes.
abstract: OBJECTIVE
  Structural changes of retinal vasculature, such as altered retinal vascular calibers, are considered as early signs of systemic vascular damage. We examined the associations of 5-year mean level, longitudinal trend, and fluctuation in fasting plasma glucose (FPG) with retinal vascular caliber in people without established diabetes.
  
  
  METHODS
  A prospective study was conducted in a cohort of Chinese people age ≥40 years in Guangzhou, southern China. The FPG was measured at baseline in 2008 and annually until 2012. In 2012, retinal vascular caliber was assessed using standard fundus photographs and validated software. A total of 3645 baseline nondiabetic participants with baseline and follow-up data on FPG for 3 or more visits was included for statistical analysis. The associations of retinal vascular caliber with 5-year mean FPG level, longitudinal FPG trend (slope of linear regression-FPG), and fluctuation (standard deviation and root mean square error of FPG) were analyzed using multivariable linear regression analyses.
  
  
  RESULTS
  Multivariate regression models adjusted for baseline FPG and other potential confounders showed that a 10% annual increase in FPG was associated independently with a 2.65-μm narrowing in retinal arterioles (P = 0.008) and a 3.47-μm widening in venules (P = 0. 0.004). Associations with mean FPG level and fluctuation were not statistically significant.
  
  
  CONCLUSIONS
  Annual rising trend in FPG, but not its mean level or fluctuation, is associated with altered retinal vasculature in nondiabetic people.
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Guangzhou No.11 People's Hospital, Guangzhou, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Niu
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia.
authors.forename: Brien A
authors.initials: BA
authors.lastname: Holden
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000097:blood*; D018450:Disease Progression; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012171:Retinal Vessels / Q000473:pathology*; D013997:Time Factors
chemical_list: D001786:Blood Glucose
keywords: glycemic trend; nondiabetic; retinal vasculature