Abstract 15930: Peripheral Vascular Function Phenotype Predicts New Diabetic Retinopathy Development in Type 2 Diabetes Patients

IntroductionStrict glycaemic control in patients with type 2 diabetes (T2D) provides debatable benefits against progression of microvascular disease. Assessment of arterial elastic properties and endothelial function could provide valuable information for the risk of microvascular disease progression in these subjects.HypothesisWe sought to study the predictive value of endothelial function and arterial stiffness for microvascular disease progression in T2D.MethodsA total of 80 T2D patients were screened for diabetic retinopathy. At baseline visit brachial artery flow mediated dilatation (FMD) and pulse wave velocity (PWV) were assessed as indices of endothelial function and arterial stiffness respectively. After 30 months, patients were re-screened for development of diabetic retinopathy (DR). FMD/PWV ratio was calculated as a composite risk biomarker of vascular function that takes into account both endothelial function and arterial stiffness.ResultsAt baseline 37 patients had established DR and 43 no DR. During follow-up 8 patients developed new DR. Interestingly, in the subgroup of patients free of DR at baseline, those that developed new DR had higher baseline HbA1c(%) levels (A). Moreover, at follow up measurements even though FMD and PWV did not differ significantly between new DR and no DR patients (p=NS for both, not shown), the composite index of FMD/PWV was significantly lower in the new DR group and comparable to patients with already established DR (B).ConclusionsIn this prospective study of T2D patients, poorer glycaemic control and increased FMD to PWV ratio at baseline were strongly associated with the development of new diabetic retinopathy. A composite vascular risk score marker based on the assessment of both endothelial function and arterial stiffness could be used for the risk stratification of microvascular disease progression in T2D patients