Cerebral small-vessel disease is associated with the severity of diabetic retinopathy in type 1 diabetes

Show full item record



Permalink

http://hdl.handle.net/10138/335182

Citation

Finndiane Study Grp , Eriksson , M , Summanen , P , Gordin , D , Forsblom , C , Shams , S , Liebkind , R , Tatlisumak , T , Putaala , J , Groop , P-H , Martola , J & Thorn , L M 2021 , ' Cerebral small-vessel disease is associated with the severity of diabetic retinopathy in type 1 diabetes ' , BMJ Open Diabetes Research & Care , vol. 9 , no. 1 , 002274 . https://doi.org/10.1136/bmjdrc-2021-002274

Title: Cerebral small-vessel disease is associated with the severity of diabetic retinopathy in type 1 diabetes
Author: Finndiane Study Grp; Eriksson, Marika; Summanen, Paula; Gordin, Daniel; Forsblom, Carol; Shams, Sara; Liebkind, Ron; Tatlisumak, Turgut; Putaala, Jukka; Groop, Per-Henrik; Martola, Juha; Thorn, Lena M.
Contributor: University of Helsinki, Nefrologian yksikkö
University of Helsinki, HUS Head and Neck Center
University of Helsinki, HUS Abdominal Center
University of Helsinki, Research Programs Unit
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Department of General Practice and Primary Health Care
Date: 2021
Language: eng
Number of pages: 7
Belongs to series: BMJ Open Diabetes Research & Care
ISSN: 2052-4897
URI: http://hdl.handle.net/10138/335182
Abstract: Introduction Cerebral small-vessel disease is common in neurologically asymptomatic individuals with type 1 diabetes. The retinal vasculature is thought to mirror the brain's vasculature, but data on this association are limited in type 1 diabetes. Our aim was to study associations between diabetic retinopathy severity and cerebral small-vessel disease in type 1 diabetes. Research design and methods For this cross-sectional study, we enrolled 189 participants with type 1 diabetes (median age 40 (33-45) years; 53% female; diabetes duration 21.6 (18.2-30.7) years) and 29 healthy age-matched and sex-matched controls as part of the Finnish Diabetic Nephropathy Study. Participants underwent a clinical investigation, brain MRI, and fundus imaging. Signs of cerebral small-vessel disease in brain MRIs were analyzed in relation to diabetic retinopathy severity (Early Treatment Diabetic Retinopathy Study (ETDRS) score). Results In type 1 diabetes, participants with cerebral small-vessel disease had higher ETDRS scores (35 (20-61) vs 20 (20-35), p=0.022) and a higher prevalence of proliferative diabetic retinopathy than those without cerebral small-vessel disease (25% vs 9%, p=0.002). In adjusted analysis, proliferative diabetic retinopathy was associated with cerebral small-vessel disease (OR 2.57 (95% CI 1.04 to 6.35)). Median ETDRS score (35 (20-65) vs 20 (20-35), p=0.024) and proliferative diabetic retinopathy prevalence were higher (29% vs 13%, p=0.002) in participants with versus without cerebral microbleeds. ETDRS scores increased by number of cerebral microbleeds (p=0.001), both ETDRS score (OR 1.05 (95% CI 1.02 to 1.09)) and proliferative diabetic retinopathy (8.52 (95% CI 1.91 to 37.94)) were associated with >2 cerebral microbleeds in separate multivariable analysis. We observed no association with white matter hyperintensities or lacunar infarcts. Conclusions Presence of cerebral small-vessel disease on brain MRI, particularly cerebral microbleeds, is associated with the severity of diabetic retinopathy.
Subject: diabetes mellitus
type 1
brain
magnetic resonance imaging
diabetic retinopathy
RETINAL MICROVASCULAR ABNORMALITIES
RISK-FACTORS
ATHEROSCLEROSIS RISK
STROKE
NEPHROPATHY
MELLITUS
3121 General medicine, internal medicine and other clinical medicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
1_s2.0_S138994572100335X_main.pdf 281.7Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record