Gestational diabetes mellitus and retinal microvasculature
AuthorLi, L-J; Kramer, M; Tapp, RJ; Man, REK; Lek, N; Cai, S; Yap, F; Gluckman, P; Tan, KH; Chong, YS; ...
Source TitleBMC Ophthalmology
AffiliationOphthalmology (Eye & Ear Hospital)
Melbourne School of Population and Global Health
Document TypeJournal Article
CitationsLi, L. -J., Kramer, M., Tapp, R. J., Man, R. E. K., Lek, N., Cai, S., Yap, F., Gluckman, P., Tan, K. H., Chong, Y. S., Koh, J. Y., Saw, S. M., Cheung, Y. B. & Wong, T. Y. (2017). Gestational diabetes mellitus and retinal microvasculature. BMC OPHTHALMOLOGY, 17 (1), https://doi.org/10.1186/s12886-016-0398-7.
Access StatusOpen Access
BACKGROUND: Small-vessel dysfunction may be an important consequence of chronic hyperglycemia. We examined the association between gestational diabetes mellitus (GDM), a state of transient hyperglycemia during pregnancy, and retinal microvascular changes in pregnant women at 26-28 weeks of pregnancy. METHODS: A total of 1136 pregnant women with singleton pregnancies were recruited during their first trimester at two major Singapore maternity hospitals in an on-going birth cohort study. Participants underwent an oral glucose tolerance test and retinal imaging at 26-28 weeks gestation (n = 542). We used the 1999 World Health Organization (WHO) criteria to define GDM: ≥7.0 mmol/L for fasting glucose and/or ≥7.8 mmol/L for 2-h post-glucose. Retinal microvasculature was measured using computer software (Singapore I Vessel Analyzer, SIVA version 3.0, Singapore Eye Research Institute, Singapore) from the retinal photographs. RESULTS: In a multiple linear regression model adjusting for age, ethnicity and maternal education, mothers with GDM had narrower arteriolar caliber (-1.6 μm; 95% Confidence Interval [CI]: -3.1 μm, -0.2 μm), reduced arteriolar fractal dimension (-0.01 Df; 95% CI: -0.02 Df, -0.001 Df;), and larger arteriolar branching angle (1.8°; 95% CI: 0.3°, 3.3°) than mothers without GDM. After further adjusting for traditional risks of GDM, arteriolar branching angle remained significantly larger in mothers with GDM than those without GDM (2.0°; 95% CI: 0.5°, 3.6°). CONCLUSIONS: GDM was associated with a series of retinal arteriolar abnormalities, including narrower caliber, reduced fractal dimension and larger branching angle, suggesting that transient hyperglycemia during pregnancy may cause small-vessel dysfunction.
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