Background Diabetes, a health crisis afflicting millions worldwide, is increasing rapidly in prevalence. The microvascular complications triggered by diabetes have emerged as the principal cause of renal disease and blindness. The retinal microvascular network may be sensitive to early systemic vascular structural and functional changes. Therefore, this research endeavored to discern the systemic determinants influencing the retinal microvascular network in patients with and without diabetes. Methods The Kailuan Eye Study is a cross-sectional study based on the community-based cohort Kailuan Study. Participants underwent optical coherence tomography angiography (OCTA) (Zeiss Cirrus 5000; Carl Zeiss Meditec) and comprehensive systemic examination. Metrics such as perfusion density (PD), vascular density (VD), foveal avascular zone (FAZ) parameters of the superficial capillary plexus (SCP) in the macula were assessed. Results This study included 860 eligible participants (average age = 62.75 +/- 6.52 years; 21.9% female), of which 449 were diabetics. People with diabetes had diminished PD and VD in the entire macular and parafoveal regions compared to people without diabetes. Reduced PD in the whole macular region was correlated with higher fasting plasma glucose (FPG, mmol/L) concentration (Beta = -0.19, 95% CI = -0.42 to -0.36, P < 0.001), longer axial length (AL, mm) (Beta = -0.13, 95%CI = -0.48 to -0.25, P = 0.002), and elevated heart rate (Beta = -0.10, 95%CI = -0.14 to -0.19, P = 0.014), after adjusting for younger age (Beta = -0.18, 95%CI = -0.24 to -0.35, P < 0.001), consistent with VD of the whole macular region. A higher FPG level was significantly correlated with lower SCP density of both PD and VD in the macular and parafoveal region (P < 0.05 for all), as well as increased systolic blood pressure and low-density lipoprotein cholesterol concentration (P < 0.01 for all). Conclusions In this large-sample cross-sectional study, OCTA evaluation revealed that high prevalence of diabetes and elevated FPG levels were correlated with reduced retinal VD and PD. Hypertension and hyperlipidemia are important risk factors for the development of atherosclerotic cardiovascular disease but have no significant effect on retinal microvascular abnormalities.
基金:
National Natural Science Foundation of China [82220108017, 82141128, 82101146]; Capital Health Research and Development of Special [2024-1-2052, 2024-4-20510]; Science & Technology Project of Beijing Municipal Science & Technology Commission [Z201100005520045, Z181100001818003]; Natural Science Foundation of Beijing [7232024]; Sanming Project of Medicine in Shenzhen [SZSM202311018]
第一作者机构:[1]Capital Med Univ, Beijing Tongren Hosp,Ophthalmol & Visual Sci Key L, Beijing Tongren Eye Ctr,Med Artificial Intelligenc, Lab Intraocular Tumor Diag & Treatment, Beijing 100730, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Yao Yao,Wang Qian,Yang Jingyan,et al.Associations of retinal microvascular alterations with diabetes mellitus: an OCTA-based cross-sectional study[J].BMC OPHTHALMOLOGY.2024,24(1):doi:10.1186/s12886-024-03492-9.
APA:
Yao, Yao,Wang, Qian,Yang, Jingyan,Yan, Yanni&Wei, Wenbin.(2024).Associations of retinal microvascular alterations with diabetes mellitus: an OCTA-based cross-sectional study.BMC OPHTHALMOLOGY,24,(1)
MLA:
Yao, Yao,et al."Associations of retinal microvascular alterations with diabetes mellitus: an OCTA-based cross-sectional study".BMC OPHTHALMOLOGY 24..1(2024)