Аннотация
OBJECTIVE: Flicker light-induced retinal vasodilation may reflect endothelial
function in the retinal circulation. We investigated flicker light-induced
vasodilation in individuals with diabetes and diabetic retinopathy. RESEARCH
DESIGN AND METHODS: Participants consisted of 224 individuals with diabetes and
103 nondiabetic control subjects. Flicker light-induced retinal vasodilation
(percentage increase over baseline diameter) was measured using the Dynamic
Vessel Analyzer. Diabetic retinopathy was graded from retinal photographs.
RESULTS: Mean +/- SD age was 56.5 +/- 11.8 years for those with diabetes and 48.0
+/- 16.3 years for control subjects. Mean arteriolar and venular dilation after
flicker light stimulation were reduced in participants with diabetes compared
with those in control subjects (1.43 +/- 2.10 vs. 3.46 +/- 2.36\%, P < 0.001 for
arteriolar and 2.83 +/- 2.10 vs. 3.98 +/- 1.84\%, P < 0.001 for venular dilation).
After adjustment for age, sex, diabetes duration, fasting glucose, cholesterol
and triglyceride levels, current smoking status, systolic blood pressure, and use
of antihypertensive and lipid-lowering medications, participants with reduced
flicker light-induced vasodilation were more likely to have diabetes (odds ratio
19.7 95\% CI 6.5-59.1, P < 0.001 and 8.14 3.1-21.4, P < 0.001, comparing
lowest vs. highest tertile of arteriolar and venular dilation, respectively).
Diabetic participants with reduced flicker light-induced vasodilation were more
likely to have diabetic retinopathy (2.2 1.2-4.0, P = 0.01 for arteriolar
dilation and 2.5 1.3-4.5, P = 0.004 for venular dilation). CONCLUSIONS: Reduced
retinal vasodilation after flicker light stimulation is independently associated
with diabetes status and, in individuals with diabetes, with diabetic
retinopathy. Our findings may therefore support endothelial dysfunction as a
pathophysiological mechanism underlying diabetes and its microvascular
manifestations.
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