Glycemic Control and Retinal Microvascular Changes in Type 2 Diabetes Mellitus Patients without Clinical Retinopathy.

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & Metabolism Journal Pub Date : 2024-09-01 Epub Date: 2024-03-13 DOI:10.4093/dmj.2023.0149
Kangmin Lee, Ga Hye Lee, Seung Eun Lee, Jee Myung Yang, Kunho Bae
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Abstract

Backgruound: To investigate the association of glycemic control and retinal microvascular changes in patients with type 2 diabetes mellitus (T2DM) without diabetic retinopathy (DR).

Methods: This retrospective, observational, cohort study included patients with T2DM without DR. The patients were categorized into intensive control (IC; mean glycosylated hemoglobin [HbA1c] ≤7.0%) and moderate control (MC; mean HbA1c >7.0%) groups. Optical coherence tomography (OCT) and swept-source OCT angiography (OCTA) image parameters were compared between three groups, including healthy controls.

Results: In total, 259 eyes of 259 participants (88 IC, 81 MC, and 90 controls) were included. The foveal avascular zone area was significantly larger in the MC group than IC and control groups (all P<0.05). The IC group had lower vessel density in the superficial retinal layer and deep retinal layer than the controls (all P<0.05). The choriocapillaris (CC) flow deficit (FD) was significantly greater in the MC group than in the IC and control groups (18.2%, 16.7%, and 14.2%, respectively; all P<0.01). In multivariate regression analysis, CC-FD was associated with the mean HbA1c level (P=0.008). There were no significant differences in OCT parameters among the groups.

Conclusion: OCTA revealed that early CC impairment is associated with HbA1c levels; the CC changes precede clinically apparent DR. The OCTA parameters differed among the groups according to the degree of glycemic control. Our results suggest that microvascular changes precede DR and are closely related to glycemic control.

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无临床视网膜病变的 2 型糖尿病患者的血糖控制和视网膜微血管变化。
背景:研究无糖尿病视网膜病变(DR)的2型糖尿病(T2DM)患者血糖控制与视网膜微血管变化的关系:研究无糖尿病视网膜病变(DR)的 2 型糖尿病(T2DM)患者的血糖控制与视网膜微血管变化之间的关系:这项回顾性、观察性、队列研究纳入了无糖尿病视网膜病变的 T2DM 患者。患者被分为强化控制组(IC;平均糖化血红蛋白 [HbA1c] ≤7.0%)和中度控制组(MC;平均 HbA1c >7.0%)。比较了三组(包括健康对照组)之间的光学相干断层扫描(OCT)和扫源 OCT 血管造影(OCTA)图像参数:共纳入 259 名参与者的 259 只眼睛(88 名 IC 组、81 名 MC 组和 90 名对照组)。MC 组的眼窝无血管区面积明显大于 IC 组和对照组(均为 PC):OCTA 显示,早期 CC 损伤与 HbA1c 水平有关;CC 变化先于临床上明显的 DR。血糖控制程度不同,各组的 OCTA 参数也不同。我们的研究结果表明,微血管变化先于 DR 发生,且与血糖控制密切相关。
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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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