PDF(Pubmed)
Abstract：
UNASSIGNED: Both hypertension and diabetes are known to increase the wall-to-lumen ratio (WLR) of retinal arterioles, but the differential effects are unknown. Here, we study the timing and relative impact of hypertension versus diabetes on the WLR in diabetic retinopathy (DR) to address this unresolved question.
UNASSIGNED: This prospective cross-sectional study compared the retinal arteriolar WLR in 17 healthy eyes, 15 with diabetes but no apparent DR (DM no DR), and 8 with diabetic macular edema (DME) and either nonproliferative or proliferative DR. We imaged each arteriole using adaptive optics scanning laser ophthalmoscopy and measured the WLR using ImageJ. Multiple linear regression (MLR) was performed to estimate the effects of hypertension, diabetes, and age on the WLR.
UNASSIGNED: Both subjects with DM no DR and subjects with DME had significantly higher WLR than healthy subjects (0.36 ± 0.08 and 0.42 ± 0.08 vs. 0.29 ± 0.07, 1-way ANOVA P = 0.0009). MLR in healthy subjects and subjects with DM no DR showed hypertension had the strongest effect (regression coefficient = 0.08, P = 0.009), whereas age and diabetes were not significantly correlated with WLR. MLR in all three groups together (healthy, DM no DR, and DME) showed diabetes had the strongest effect (regression coefficient = 0.05, P = 0.02), whereas age and hypertension were not significantly correlated with WLR.
UNASSIGNED: Hypertension may be an early driver of retinal arteriolar wall thickening in preclinical DR, independent of age or diabetes, whereas changes specific to DR may drive wall thickening in DME and later DR stages.
UNASSIGNED: We offer a framework for understanding the relative contributions of hypertension and diabetes on the vascular wall, and emphasize the importance of hypertension control early in diabetes even before DR onset.
UNASSIGNED: This prospective cross-sectional study compared the retinal arteriolar WLR in 17 healthy eyes, 15 with diabetes but no apparent DR (DM no DR), and 8 with diabetic macular edema (DME) and either nonproliferative or proliferative DR. We imaged each arteriole using adaptive optics scanning laser ophthalmoscopy and measured the WLR using ImageJ. Multiple linear regression (MLR) was performed to estimate the effects of hypertension, diabetes, and age on the WLR.
UNASSIGNED: Both subjects with DM no DR and subjects with DME had significantly higher WLR than healthy subjects (0.36 ± 0.08 and 0.42 ± 0.08 vs. 0.29 ± 0.07, 1-way ANOVA P = 0.0009). MLR in healthy subjects and subjects with DM no DR showed hypertension had the strongest effect (regression coefficient = 0.08, P = 0.009), whereas age and diabetes were not significantly correlated with WLR. MLR in all three groups together (healthy, DM no DR, and DME) showed diabetes had the strongest effect (regression coefficient = 0.05, P = 0.02), whereas age and hypertension were not significantly correlated with WLR.
UNASSIGNED: Hypertension may be an early driver of retinal arteriolar wall thickening in preclinical DR, independent of age or diabetes, whereas changes specific to DR may drive wall thickening in DME and later DR stages.
UNASSIGNED: We offer a framework for understanding the relative contributions of hypertension and diabetes on the vascular wall, and emphasize the importance of hypertension control early in diabetes even before DR onset.
摘要：
■已知高血压和糖尿病都会增加视网膜小动脉的腔壁比（WLR），但不同的影响是未知的。这里,我们研究了糖尿病性视网膜病变(DR)中高血压与糖尿病对WLR的时间和相对影响,以解决这个尚未解决的问题.
■这项前瞻性横断面研究比较了17只健康眼睛的视网膜小动脉WLR，15患有糖尿病但无明显DR（DM无DR），和8伴有糖尿病性黄斑水肿（DME）和非增生性或增生性DR。我们使用自适应光学扫描激光检眼镜对每个小动脉成像，并使用ImageJ测量WLR。进行多元线性回归（MLR）以估计高血压的影响，糖尿病,WLR上的年龄。
■无DR的DM受试者和DME受试者的WLR均明显高于健康受试者（0.36±0.08和0.42±0.08vs.0.29±0.07，单因素方差分析P=0.0009）。MLR在健康受试者和无DRDM受试者中显示高血压的影响最强(回归系数=0.08,P=0.009),而年龄和糖尿病与WLR无显著相关。所有三组的MLR（健康，DM无DR,和DME）显示糖尿病的影响最强（回归系数=0.05，P=0.02），而年龄和高血压与WLR无显著相关。
■高血压可能是临床前DR中视网膜小动脉壁增厚的早期驱动因素，独立于年龄或糖尿病，而特定于DR的变化可能会导致DME和后期DR阶段的壁增厚。
■我们提供了一个框架来了解高血压和糖尿病对血管壁的相对贡献，并强调在糖尿病早期甚至在DR发病之前控制高血压的重要性。
■这项前瞻性横断面研究比较了17只健康眼睛的视网膜小动脉WLR，15患有糖尿病但无明显DR（DM无DR），和8伴有糖尿病性黄斑水肿（DME）和非增生性或增生性DR。我们使用自适应光学扫描激光检眼镜对每个小动脉成像，并使用ImageJ测量WLR。进行多元线性回归（MLR）以估计高血压的影响，糖尿病,WLR上的年龄。
■无DR的DM受试者和DME受试者的WLR均明显高于健康受试者（0.36±0.08和0.42±0.08vs.0.29±0.07，单因素方差分析P=0.0009）。MLR在健康受试者和无DRDM受试者中显示高血压的影响最强(回归系数=0.08,P=0.009),而年龄和糖尿病与WLR无显著相关。所有三组的MLR（健康，DM无DR,和DME）显示糖尿病的影响最强（回归系数=0.05，P=0.02），而年龄和高血压与WLR无显著相关。
■高血压可能是临床前DR中视网膜小动脉壁增厚的早期驱动因素，独立于年龄或糖尿病，而特定于DR的变化可能会导致DME和后期DR阶段的壁增厚。
■我们提供了一个框架来了解高血压和糖尿病对血管壁的相对贡献，并强调在糖尿病早期甚至在DR发病之前控制高血压的重要性。
