Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

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2018-05-04Author
Carbonell, Marc
Castelblanco Echavarría, Esmeralda
Valldeperas, Xavier
Traveset Maeso, Alicia
Vázquez, Federico
Martín, Mariona
Franch-Nadal, Josep
Puig-Domingo, Manuel
Avogaro, Angelo
Alonso, Núria
Suggested citation
Carbonell, Marc;
Castelblanco Echavarría, Esmeralda;
Valldeperas, Xavier;
Betriu i Bars, M. Àngels;
Traveset Maeso, Alicia;
Granado Casas, Minerva;
...
Mauricio Puente, Dídac.
(2018)
.
Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes.
Cardiovascular Diabetology, 2018, vol. 17, núm. 66, p. 1-10.
https://doi.org/10.1186/s12933-018-0706-z.
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Background: Cardiovascular (CV) disease due to atherosclerosis is a major cause of morbidity and mortality in adult patients with diabetes, either type 1 or type 2 diabetes. The aim of the study was to assess the association of the frequency and the burden of subclinical carotid atherosclerotic disease in patients with type 1 diabetes according to the presence and severity of diabetic retinopathy (DR). Methods: A cross-sectional study was conducted in 340 patients with type 1 diabetes (41.5% with DR), and in 304 non-diabetic individuals. All participants were free from previous CV disease and chronic kidney disease (CKD). B-mode carotid ultrasound imaging was performed in all the study subjects. Patients with type 1 diabetes underwent a full eye examination, and DR patients were divided into two groups: mild disease and advanced disease. Results: In the group of patients with type 1 diabetes, the percentage of patients with carotid plaques was higher in those with DR compared with those without DR (44.7% vs. 24.1%, p < 0.001). Patients with DR also presented a higher incidence of ≥ 2 carotid plaques (25.5% vs. 11.1%, p < 0.001). Apart from other traditional cardiovascular risk factors, the presence of advanced stages of DR was independently associated with the presence (p = 0.044) and the burden (≥ 2 carotid plaques; p = 0.009) of subclinical carotid atherosclerosis. Conclusions: In patients with type 1 diabetes without previous CV disease or established CKD, the presence of advanced stages of DR is associated with a higher atherosclerotic burden in the carotid arteries. The presence of DR identifies patients at risk for carotid atherosclerotic disease.
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Cardiovascular Diabetology, 2018, vol. 17, núm. 66, p. 1-10European research projects
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