ASSOCIATIONS BETWEEN DYSGLYCEMIA, RETINAL NEURODEGENERATION, AND MICROALBUMINURIA IN PREDIABETES AND TYPE 2 DIABETES. Issue 3 (March 2022)

• Record Type: Journal Article
• Authors: Kirthi, Varo; Zuckerman, Benjamin P.; Alam, Uazman; Bunce, Catey; Hopkins, David; Jackson, Timothy L.
• Is Part Of: Retina. Volume 42:Issue 3(2022)
• Publication Date: 2022-03
• Subjects: neurodegeneration -- optical coherence tomography -- retina -- type 2 diabetes; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003337
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To explore the association between retinal neurodegeneration and metabolic parameters in progressive dysglycemia. Method: A cross-sectional study was performed on 68 participants: normal glucose tolerance (n = 23), prediabetes (n = 25), and Type 2 diabetes without diabetic retinopathy (n = 20). Anthropometric assessment and laboratory sampling for HbA1c, fasting glucose, insulin, c-peptide, lipid profile, renal function, and albumin-to-creatinine ratio were conducted. Central and pericentral macular thicknesses on spectral domain optical coherence tomography were compared with systemic parameters. Results: Baseline demographic characteristics were similar across all groups. Cuzick's trend test revealed progressive full-thickness macular thinning with increasing dysglycemia across all three groups ( P = 0.015). The urinary albumin-to-creatinine ratio was significantly correlated with full-thickness superior ( R = −0.435; P = 0.0002), inferior ( R = −0.409; P = 0.0005), temporal ( R = −0.429; P = 0.003), and nasal ( R = −0.493; P < 0.0001) pericentral macular thinning, after post hoc Bonferroni adjustment. There was no association between macular thinning and waist circumference, body mass index, blood pressure, lipid profile, or insulin resistance. Conclusion: Progressive dysglycemia is associated with macular thinning before the onset of visible retinopathy and occurs alongside microalbuminuria. Retinal neurodegenerative changes may help identify those most at risk from dysglycemic end-organ damage. Abstract : Supplemental Digital Content is Available in the Text.This study reports associations between dysglycemia, retinal neurodegeneration (detected by macular thinning on optical coherence tomography), and microalbuminuria in people with prediabetes and Type 2 diabetes.