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Cited by 320Diabetes, Cardiovascular Risks, and LipoproteinsRetinal Diseases and TreatmentsRetinal Imaging and Analysis

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Retinal Arteriolar Narrowing and Risk of Diabetes Mellitus in Middle-aged Persons

Wong, Tien Yin·2002·JAMA
DOI 10.1001/jama.287.19.2528
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Abstract

CONTEXT: Microvascular processes have been hypothesized to play a role in the pathogenesis of type 2 diabetes mellitus, but prospective clinical data regarding this hypothesis are unavailable. OBJECTIVE: To examine the relation of retinal arteriolar narrowing, a marker of microvascular damage from aging, hypertension, and inflammation, to incident diabetes in healthy middle-aged persons. DESIGN, SETTING, AND PARTICIPANTS: The Atherosclerosis Risk in Communities Study, an ongoing population-based, prospective cohort study in 4 US communities that began in 1987-1989. Included in this analysis were 7993 persons aged 49 to 73 years without diabetes, of whom retinal photographs were taken during the third examination (1993-1995). MAIN OUTCOME MEASURES: Incident diabetes (defined as fasting glucose levels of > or =126 mg/dL [7.0 mmol/L], casual levels of > or =200 mg/dL [11.1 mmol/L], diabetic medications use, or physician diagnosis of diabetes at the fourth examination) by quartile of retinal arteriole-to-venule ratio (AVR). RESULTS: After a median follow-up of 3.5 years, 291 persons (3.6%) had incident diabetes. The incidence of diabetes was higher in persons with lower AVR at baseline (2.4%, 3.1%, 4.0%, and 5.2%, from highest to lowest AVR quartile; P for trend < .001). After controlling for fasting glucose and insulin levels, family history of diabetes, adiposity, physical activity, blood pressure, and other factors, persons in the lowest quartile of AVR were 71% more likely to develop diabetes than those in the highest quartile (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.13-2.57; P for trend =.002). This association persisted with different diagnostic criteria (OR, 1.92; 95% CI, 1.10-3.36; P for trend =.01, using a fasting glucose level of > or =141 mg/dL [7.8 mmol/L] as a cutoff), and was seen even in people at lower risk of diabetes, including those without a family history of diabetes, without impaired fasting glucose, and with lower measures of adiposity. CONCLUSIONS: Retinal arteriolar narrowing is independently associated with risk of diabetes, supporting a microvascular role in the development of clinical diabetes.

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Metadata

Authors
Wong, T. Y.
Affiliations
University of Wisconsin System (US)
Corresponding author
Wong, Tien Yin
ORCID
Wong, Tien Yin
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2002-05-15
Volume
287
Issue
19
Pages
2528
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.287.19.2528
OpenAlex
W2087898657
Cited by
320
References
32
Citations by year
2026: 11 · 2025: 5 · 2024: 11 · 2023: 7 · 2022: 9 · 2021: 13 · 2020: 9 · 2019: 13 · 2018: 12 · 2017: 14 · 2016: 5 · 2015: 12 · 2014: 9 · 2013: 16 · 2012: 18
FWCI
7.03
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • National University of Singapore (submittedVersion)
Funders
  • National Institutes of Health (n01hc035126-003, n01hc55021-47-0-1, n01hc55020-39-0-0, n01hc55016-37-0-0, n01hc055022-024, n01hc035125-006, n01hc55019-35-0-1, n01hc55018-38-0-1, n01hc55015-48-0-1)
  • National Heart, Lung, and Blood Institute (N01-HC55022, N01-HC-55018, N01 HC 55020, N01 HC 55019, N01 HC-35125, NN01-HC-35126, N1-HC-55021, ­N01-HC55016, N01‐HC‐55015)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords
retinal arteriolar narrowing, type 2 diabetes, incident diabetes risk, microvascular damage, middle-aged adults, Atherosclerosis Risk in Communities Study, fundus images, hypertension, aging, family history of diabetes, impaired fasting glucose, adiposity, physical activity, blood pressure, fasting blood glucose, insulin levels, diabetes prevention
MeSH terms
Aged, Aging, Diabetes Mellitus, Female, Humans, Hypertension, Inflammation, Male, Microcirculation, Middle Aged, Photography, Prospective Studies, Retinal Vessels, Risk Factors, Retinal Artery Occlusion, Logistic Models

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