PS 17-52 EARLY SIGNS OF END-ORGAN DAMAGE IN RETINAL ARTERIOLES IN HYPERTENSIVE IN COMPARISON WITH TYPE 2 DIABETIC PATIENTS

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Abstract

Objective:

Eutrophic and hypertrophic remodeling are major vascular hallmarks for hypertension and diabetes associated microvascular end-organ damage in peripheral arterioles. Retinal microvascular arterioles can nowadays be easily analyzed by non-invasive tools. The aim of this study is to compare retinal arterioles of hypertensive with those of diabetic patients and healthy individuals to identify disease specific early signs of microvascular end-organ damage.

Design and method:

Retinal parameters were assessed in 158 stage 1 and 2 hypertensive individuals (mean age 52 years), 107 patients with non-insulin-dependent type-2 diabetes mellitus (T2DM) (mean age 61 years, median disease duration 60 months) and 86 healthy individuals. Wall thickness (WT), wall-to-lumen-ratio (WLR) and cross-sectional area (CA) of retinal arterioles (80–140 μm) were measured non-invasively and in vivo by scanning-laser-Doppler-flowmetry (Heidelberg Engineering, Germany).

Results:

Hypertensive patients showed no significant difference in WT (13.3 ± 4 vs 14.2 ± 3, p = 0.151), WLR (0.347 ± 0.094 vs. 0.375 ± 0.086, p = 0.664) and CA (3862 ± 1546 vs. 4192 ± 1093, p = 0.108) in comparison with diabetic patients. Compared to the healthy control group patients with T2DM showed greater WT (13.3 ± 4 vs 12.9 ± 3.1, p = 0.011) and WLR (0.347 ± 0.094 vs 0.314 ± 0.078, p = 0.001). In the diabetic group there was a correlation between both WT (r = 0.196, p = 0.050) and CA with diabetes duration (r = 0.204, p = 0.040). Consistently the subgroup of patients with diabetes duration of more than 60 month showed greater WT (14.9 ± 4, p < 0.001) and CA (4526 ± 1127, p = 0.003) compared to the hypertensive group.

Conclusions:

Eutrophic remodeling was seen in retinal arterioles of hypertensive patients and patients with T2DM in the early stage of disease. However, hypertrophic remodeling was found in diabetic patients with more than 60 month duration of disease.

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