Microvascular endothelial dysfunction (smallest quartile of retinal dilation) was associated with 1.168 times greater albuminuria (95% CI 1.046-1.303) compared to the greatest dilation.
Cross-Sectional (n=2,095)
Is microvascular endothelial dysfunction associated with albuminuria in a population-based cohort?
Microvascular endothelial dysfunction is independently associated with albuminuria, particularly in individuals with type 2 diabetes.
Effect estimate: 1.168 times greater (95% CI 1.046-1.303)
OBJECTIVE: Albuminuria is thought to be a biomarker of microvascular and macrovascular endothelial dysfunction. However, direct evidence for an association of microvascular endothelial dysfunction with albuminuria is limited. In addition, experimental data suggest a stronger association of microvascular endothelial dysfunction with albuminuria in individuals with than in those without diabetes. METHODS: We examined cross-sectional associations of flicker light-induced retinal arteriolar dilation (n = 2095) and heat-induced skin hyperemia (n = 1508) with 24-h albuminuria in the population-based, diabetes-enriched Maastricht Study. We used linear regression analyses to adjust for age, sex, type 2 diabetes, and cardiovascular disease risk factors. In addition, we tested for statistical interaction with type 2 diabetes. RESULTS: Median interquartile range albuminuria was 6.5 3.9-11.6 mg/24 h and 8.2% had albuminuria at least 30 mg/24 h. After adjustment, albuminuria was 1.168 (95% confidence interval, 1.046-1.303) times greater in participants in the quartile with the smallest flicker light-induced retinal arteriolar dilation relative to those with the greatest dilation, and this association was stronger in participants with type 2 diabetes (Pinteraction < 0.10). Further, each 100 percentage points lower heat-induced skin hyperemia was associated with a 1.022 (1.010-1.035) times greater albuminuria in participants with type 2 diabetes, whereas it was not associated with albuminuria in nondiabetic participants (Pinteraction < 0.10). CONCLUSION: This is the first population-based study that provides direct evidence that microvascular endothelial dysfunction is associated with albuminuria, and that this association is stronger in individuals with than in those without type 2 diabetes.
Martens et al. (2018) conducted a cross-sectional in Albuminuria (n=2,095). Microvascular endothelial dysfunction (smallest quartile of retinal arteriolar dilation) vs. Greatest quartile of retinal arteriolar dilation was evaluated on 24-h albuminuria (1.168 times greater, 95% CI 1.046-1.303). Microvascular endothelial dysfunction (smallest quartile of retinal dilation) was associated with 1.168 times greater albuminuria (95% CI 1.046-1.303) compared to the greatest dilation.