Gestational diabetes mellitus and retinal microvasculature

BMC Ophthalmology

Research Article

Yin Bun Cheung¹  Ngee Lek²  Michael Kramer³  Kok Hian Tan⁴  Fabian Yap⁴  Jia Yu Koh⁵  Robyn J. Tapp⁵  Ryan E. K. Man⁵  Ling-Jun Li⁶  Tien Yin Wong⁶  Seang Mei Saw⁷  Shirong Cai⁸  Peter Gluckman⁸  Yap Seng Chong⁹ 

[1] Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore, Singapore;Department for International Health, University of Tampere, Tampere, Finland;Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore, Singapore;KK Women’s and Children’s Hospital, Singapore, Singapore;Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada;KK Women’s and Children’s Hospital, Singapore, Singapore;Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, 168751, Singapore, Singapore;Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, 168751, Singapore, Singapore;Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore, Singapore;Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, 168751, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore;Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore;Singapore Institute for Clinical Sciences, Growth, Development & Metabolism, Singapore, Singapore;

关键词: Retinal microvasculature;    Gestational diabetes mellitus;    Pregnancy outcomes;    Retinal imaging;    Retinal microvascular measures;   

DOI  :  10.1186/s12886-016-0398-7

 received in 2016-08-10, accepted in 2016-12-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSmall-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.MethodsA 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.ResultsIn 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°).ConclusionsGDM 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.

【 授权许可】

CC BY   
© The Author(s). 2017