Association of carotid intima-media thickness and arterial stiffness with diabetic retinopathy: The Chennai Urban Rural Epidemiology Study (CURES-2)

OBJECTIVE - The aim of this study was to assess the association of intima-media thickness (IMT) and arterial stiffness with diabetic retinopathy in an Asian-Indian population that has very high prevalence rates of diabetes and coronary artery disease. RESEARCH DESIGN AND METHODS - The study was conducted on 600 type 2 diabetic subjects randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), which is an ongoing population-based study of a representative population of Chennai. When present, retinopathy was graded according to a modified Early Treatment Diabetic Retinopathy Study grading system. IMT was determined using high-resolution B-mode ultrasonography. Arterial Stiffness,was measured by assessing the, augmentation index (AT) using the Sphygmocor apparatus. RESULTS - Retinopathy was diagnosed in 116 of 590 (19.6%) subjects in whom retinal photography was possible. Mean values of IMT (0.93 +/- 0.36 vs. 0.85 +/- 0.21 mm, P = 0.001) and Al (27.9 +/- 8.9 vs. 25.8 +/- 9.6%, P = 0.031) were significantly higher among diabetic subjects with retinopathy compared with those without. Both IMT (P = 0.024) and Al (P 0.050) showed a significant association to diabetic retinopathy, even after adjusting for age, duration of diabetes, HbA(1c) serum cholesterol, serum triglycerides, and microalbuminuria. CONCLUSIONS - Diabetic retinopathy is associated With IMT and Al, suggesting that common pathogenic mechanisms might predispose to diabetic micro- and macroangiopathy.