Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00125-015-3717-2
Title: Retinal microvascular calibre and risk of diabetes mellitus: a systematic review and participant-level meta-analysis
Authors: Sabanayagam, Charumathi 
Lye, Weng Kit 
Klein, Ronald
Klein, Barbara EK
Cotch, Mary Frances
Wang, Jie Jin 
Mitchell, Paul
Shaw, Jonathan E
Selvin, Elizabeth
Sharrett, A Richey
Wong, Tien Y 
Keywords: Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
Cohort studies
Diabetes
Meta-analysis
Retinal vessels
Systematic review
IMPAIRED FASTING GLUCOSE
LIFE-STYLE AUSDIAB
BEAVER DAM EYE
VASCULAR CALIBER
INSULIN-RESISTANCE
ENDOTHELIAL DYSFUNCTION
ATHEROSCLEROSIS RISK
VESSEL DIAMETERS
ARTERIOLAR
MUSCLE
Issue Date: 1-Nov-2015
Publisher: SPRINGER
Citation: Sabanayagam, Charumathi, Lye, Weng Kit, Klein, Ronald, Klein, Barbara EK, Cotch, Mary Frances, Wang, Jie Jin, Mitchell, Paul, Shaw, Jonathan E, Selvin, Elizabeth, Sharrett, A Richey, Wong, Tien Y (2015-11-01). Retinal microvascular calibre and risk of diabetes mellitus: a systematic review and participant-level meta-analysis. DIABETOLOGIA 58 (11) : 2476-2485. ScholarBank@NUS Repository. https://doi.org/10.1007/s00125-015-3717-2
Abstract: © 2015, Springer-Verlag Berlin Heidelberg. Aims/hypothesis: The calibre of the retinal vessels has been linked to diabetes mellitus but studies have not shown consistent results. We conducted a participant-level meta-analysis to evaluate the association between retinal arteriolar and venular calibre and diabetes. Methods: We performed a systematic review on MEDLINE and EMBASE for articles published up to December 2014. We identified five population-based prospective cohort studies that provided individual-level data on 18,771 diabetes-free participants. We used discrete time proportional hazards models to estimate pooled HRs of diabetes associated with 1 SD (20 μm) change in retinal vascular calibre. Results: We identified 2,581 incident cases of diabetes over a median follow-up period of 10 years (interquartile interval of 3.4–15.8 years). After adjustment for demographic, lifestyle and clinical factors, retinal venular calibre was significantly associated with incident diabetes (pooled HR 1.09 [95% CI 1.02, 1.15] per SD increase in venular calibre). This association persisted in analyses excluding individuals with <5 years of follow-up (1.07 [1.0, 1.12]) or those with impaired fasting glucose at baseline (1.10 [1.03, 1.17]); in subgroup analyses, the association was stronger in men than in women but was consistent across subgroups of race/ethnicity, smoking status, hypertension and BMI categories. Retinal arteriolar calibre was not associated with diabetes (0.95 [0.86, 1.06] per SD decrease in arteriolar calibre). Conclusions/interpretation: Wider retinal venules but not narrower retinal arterioles were associated with a modestly increased risk for diabetes. Knowledge of pathological mechanisms underlying wider retinal venule may provide further insights concerning microvascular alterations in diabetes.
Source Title: DIABETOLOGIA
URI: https://scholarbank.nus.edu.sg/handle/10635/169458
ISSN: 0012-186X
1432-0428
DOI: 10.1007/s00125-015-3717-2
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