Journal of Preventive Medicine and Public Health

Original Article

Arterial Stiffness is Associated With Diabetic Retinopathy in Korean Type 2 Diabetic Patients: Yong-Woon Yun, Min-Ho Shin, Young-Hoon Lee, Jung-Ae Rhee, Jin-Su Choi; J Prev Med Public Health. 2011;44(6):260-266. Published online November 14, 2011; DOI: https://doi.org/10.3961/jpmph.2011.44.6.260

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Objectives

We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachial-ankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients.

Methods

We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s.

Results

The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT.

Conclusions

BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.

Summary

Citations

Citations to this article as recorded by

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Author Response
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Evaluation Studies

C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans.: Mina Suh, Joo Young Lee, Song Vogue Ahn, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2009;42(1):29-34.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.29

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Abstract PDF

OBJECTIVES
This study was performed to evaluate the relationship between C-reactive protein (CRP) and carotid intima-media thickness (carotid IMT) in a population of middle-aged Koreans. METHODS: A total of 1,054 men and 1,595 women (aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause (women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. RESULTS: Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women (p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men (p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women (p for trend=0.017), but not in men (p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55 (95% CI=1.06-2.26) in women, but only 1.05 (95% CI=0.69-1.62) in men. CONCLUSIONS: CRP and carotid IMT levels appear to be directly related in women, but not in men.

Summary

Citations

Citations to this article as recorded by

Hematocrit Values Predict Carotid Intimal-Media Thickness in Obese Patients With Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study
Giovanni Tarantino, Luigi Barrea, Domenico Capone, Vincenzo Citro, Teresa Mosca, Silvia Savastano
Frontiers in Endocrinology.2018;[Epub] CrossRef
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
Journal of Preventive Medicine and Public Health.2012; 45(3): 181. CrossRef
Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex
Manuel A Gomez-Marcos, Jose I Recio-Rodríguez, Maria C Patino-Alonso, Cristina Agudo-Conde, Leticia Gomez-Sanchez, Emiliano Rodriguez-Sanchez, Marta Gomez-Sanchez, Vicente Martinez-Vizcaino, Luis Garcia-Ortiz
BMC Cardiovascular Disorders.2012;[Epub] CrossRef

English Abstract

Associations between Carotid Intima-media Thickness, Plaque and Cardiovascular Risk Factors.: Young Hoon Lee, Lian Hua Cui, Min Ho Shin, Sun Seog Kweon, Kyeong Soo Park, Seul Ki Jeong, Eun Kyung Chung, Jin Su Choi; J Prev Med Public Health. 2006;39(6):477-484.

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Abstract PDF: OBJECTIVES
This study was conducted to examine the association between the carotid artery intima-media thickness (IMT), plaque and cardiovascular risk factors according to gender and age. METHODS: The data used for this study were obtained from 1,507 subjects (691 men, 816 women), aged 20-74 years, who participated in 'Prevalence study of thyroid diseases' in two counties of Jeollanam-do Province during July and August of 2004. The body mass index (BMI) and waist hip ratio (WHR) were calculated by anthropometry. The blood pressure, pulse rate, pulse pressure, total cholesterol, triglyceride, HDL cholesterol and fasting blood sugar level were also measured. Ultrasonography was used to measure the carotid artery IMT and plaque. IMT measurements were performed at 6 sites, including both common carotid arteries, and the bulb and internal carotid arteries. The definition of the 'mean IMT' was mean value obtained from these 6 sites. RESULTS: The mean+/-standard deviation IMT values were 0.65+/-0.14 and 0.60+/-0.13 mm in men and women (p<0.001), respectively. The data were analyzed according to gender and the 50 year age groups.In a multiple linear regression analysis, age and hypertension were positively associated with the mean IMT in both men and women, aged<50 years. Age, total cholesterol and smoking (current) were positively associated with the mean IMT in men (> of =50 years). Age was positively associated with the mean IMT in women (> of =50 years), but the HDL cholesterol level was negatively associated. The prevalence of plaques was 44.2%(196/443) in men and 19.4%(89/459) in women, for those greater than 50 years of age. In a multiple logistic regression analysis, age (OR=1.090, 95%CI=1.053-1.129), HDL cholesterol (OR=0.964, 95%CI=0.944-0.984), total cholesterol (OR=1.009, 95%CI=1.002-1.017) and BMI (OR=0.896, 95%CI=0.818-0.983) were independently associated with plaques in men; whereas, age (OR=1.057, 95%CI=1.012-1.103), HDL cholesterol (OR=0.959, 95%CI=0.932-0.986), pulse pressure (OR=1.029, 95%CI=1.007-1.050) and triglycerides (OR=0.531, 95%CI=0.300-0.941) were independently associated with plaques in women. CONCLUSIONS: There were significant gender and aging differences in the association between the IMT, plaque and cardiovascular risk factors. Therefore, for the prevention of atherosclerosis, selective approaches should be considered with regard to gender and age factors.; Summary

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