Association Between Atherosclerosis and Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes Mellitus

Aim: To explore the association between the atherosclerosis and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes mellitus (T2DM). Methods: This hospital-based cross-sectional study included 949 patients (700 males and 249 females) with T2DM. The atherosclerotic parameters were assessed using the cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), and carotid plaque. DR was assessed and graded using digital retinal photography and fundus fluorescein angiography as either nonproliferative DR (NPDR) or proliferative DR (PDR). Multiple logistic regression analysis was performed to identify the associations between the atherosclerotic parameters and DR status. Results: The prevalence of DR was 23.6% in total patients, including 167 (17.6%) patients with NPDR and 57 (6.0%) patients with PDR. Patients with NPDR and PDR were more likely to have higher prevalence of increased CAVI, increased ABI, and carotid plaque than those without DR. In multivariable adjusted logistic regression analysis, patients with NPDR showed an odds ratio (OR) of 2.59 [95% confidence interval (CI), 1.61-4.19] for increased CAVI, 1.99 (0.62-6.34) for increased ABI, and 1.75 (1.13-2.71) for carotid plaque. Patients with PDR showed an OR of 7.83 (3.52-17.41) for increased CAVI, 10.65 (3.33-34.04) for increased ABI, and 11.40 (2.67-48.63) for carotid plaque. Conclusion: Both NPDR and PDR were independently associated with increased CAVI and presence of carotid plaque in Chinese patients with T2DM.