Purpose: The aim of the study was to assess the relationships between diabetic retinopathy, subclinical atherosclerosis and wave reflection in type 1 diabetic patients.
Methods: The investigation involved 87 type 1 diabetic patients aged 34 years (interquartile range [IQR]: 29-43), with a disease duration of 10 years (IQR: 9-14). Of these 39 (45%) had diabetic retinopathy. Carotid intima-media thickness (CIMT) was measured using high resolution ultrasonography. Wave reflection and central hemodynamics [central (CAI(x)) and peripheral augmentation index (PAI(x))] were determined with the use of tonometry.
Results: Patients with retinopathy compared to those without had increased CIMT (530 vs 480 μm, p = 0.017) and wave reflection (CAI(x) [118.90 vs 110.96 %, p = 0.03] and PAI(x) [64.95 vs 57.44 %, p = 0.029]). In logistic regression analysis, patient's age, duration of diabetes, systolic and diastolic blood pressure, postprandial glycemia, HbA1c value, CIMT (p = 0.017), CAI(x) (p = 0.03) and PAI(x) (p = 0.016) were associated with the presence of diabetic retinopathy. However, in the multivariate model, CIMT and CAI(x) did not remain predictors of retinopathy.
Conclusions: We have shown that the presence of retinopathy in type 1 diabetic patients is associated with subclinical atherosclerosis and wave reflection.