Plasminogen activator inhibitor-1 (PAI-1) activity and retinal vascular calibre in type 2 diabetes

Brazionis, L.; Yau, J.; Rowley, K.; Itsiopoulos, C.; O’Dea, K.; Wong, T.Y.; Jenkins, A.

doi:10.1016/j.diabres.2009.11.007

« Previous Next »Diabetes Research and Clinical Practice
Volume 87, Issue 2 , Pages 192-199, February 2010

Plasminogen activator inhibitor-1 (PAI-1) activity and retinal vascular calibre in type 2 diabetes

L. Brazionis
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia
- These authors contributed equally.
- Corresponding author at: The University of Melbourne, Department of Medicine, St Vincent's Hospital, P.O. BOX 2900, Fitzroy, VIC 3065, Australia. Tel.: +61 3 92882665; fax: +61 3 92882581.
J. Yau
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia
- Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
- These authors contributed equally.
K. Rowley
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, University of Melbourne, Australia
C. Itsiopoulos
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia
K. O’Dea
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia
T.Y. Wong
- Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
A. Jenkins
- Department of Medicine, University of Melbourne, St Vincent's Hospital, Australia

Received 16 July 2009; received in revised form 9 November 2009; accepted 9 November 2009. published online 14 December 2009.

Abstract

Objective

To describe relationships of retinal vascular calibre with plasminogen activator inhibitor-1 (PAI-1) and other cardiovascular risk factors in people with type 2 diabetes.

Methods

We recruited 112 community-based persons aged 44–83years with type 2 diabetes, photo-documented retinal status using a digital fundus camera, and measured traditional and novel vascular risk factors. Retinal arteriolar and venular calibre and the arterio–venous ratio (AVR) were determined from fundus photographs using a validated computer-assisted method.

Results

In adjusted linear regression models, PAI-1 activity was strongly associated with all measures of retinal vascular calibre: positively with arterioles (p=0.005) and AVR (p=0.001), and inversely with venules (p=0.001). In addition, wider arterioles were independently associated with waist-hip ratio (p<0.0001), HDL-C (p=0.015), and lower systolic blood pressure (p=0.042), whereas narrower venules were associated with older age and a higher albumin excretion rate. Neither arteriolar nor venular calibre was associated with plasma total homocysteine or C-reactive protein concentration.

Conclusion

Retinal vascular calibre is independently associated with PAI-1 activity in type 2 diabetes. This finding supports a role for PAI-1 activity in the microvasculature of persons with type 2 diabetes and may explain the link between retinal vascular calibre and cardiovascular disease.

Keywords: Retinal vascular calibre, Cardiovascular risk factors, PAI-1, Diabetes