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Diabetes Publish Ahead of Print published online ahead of print December 17, 2007
DOI: 10.2337/db07-1376
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Original Research

Retinal Arteriolar Narrowing Predicts Incidence of Diabetes: The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study

Thanh T. Nguyen, MBBS1, Jie Jin Wang, PhD1,,2, FM Amirul Islam, PhD1, Paul Mitchell, PhD2, Robyn J. Tapp, PhD3,,4, Paul Z. Zimmet, PhD3, Richard Simpson, FRACP4, Jonathan Shaw, FRACP3, and Tien Y. Wong, PhD1,,3,,5

1Centre for Eye Research Australia, University of Melbourne
2Centre for Vision Research, University of Sydney
3International Diabetes Institute, Melbourne
4Department of Epidemiology and Preventive Medicine, Monash University, Melbourne
5Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore

Objective: To examine the relationship of retinal vascular caliber to incident diabetes in a population-based cohort.

Research Design and Methods: The Australian Diabetes, Obesity and Lifestyle Study recruited adults aged 25+ years across Australia in 1999-2000, with a follow up 5 years later in 2004-2005. Participants' glycemic status was classified using fasting plasma glucose (FPG) and 2-hour oral glucose tolerance (2hPG) tests. Diabetes was diagnosed if FPG ≥7.0 mmol/l or 2hPG ≥11.1mmol/l. Retinal vascular caliber was measured from baseline retinal photographs using a computer-assisted program.

Results: Of the 803 participants without diabetes at baseline, 108 (13.4%) developed diabetes at follow up: 7 (2.8%) from 246 participants with normal glucose tolerance, 9 (13.6%) from 66 participants with impaired fasting glucose, and 92 (18.7%) from 491 participants with impaired glucose tolerance. After multivariate analysis, participants with narrower retinal arteriolar caliber had higher risk of diabetes (odds ratio 2.21, 95% confidence interval 1.02-4.80, comparing smallest vs. highest arteriolar caliber tertiles, p=0.04 for trend). There was no association between retinal venular caliber and incident diabetes.

Conclusions: Narrower retinal arteriolar caliber predicted risk of diabetes. These data provide further evidence that microvascular changes may contribute to the pathogenesis of diabetes.

Correspondence: twong{at}unimelb.edu.au


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