Background: Diabetic complications (DCs) are conventionally classified as micro- or macro-angiopathies. However, in the case of diabetic neuropathy (DPN), it is thought that impairments of neurons and glial cells of the peripheral nervous system, which do not consist of the vascular system, occupy a pivotal role in the pathology. Furthermore, recent accumulated evidences indicate that diabetic retinopathy (DR) which has been mentioned as a microangiopathy, should be also considered as adisease with complex pathogenesis consist of neurodegeneration and angiopathy. Based on this fact, we hypothesized that retinal function can predict the presence or absence of early stage DCs. The current study aimed to elucidate the relationship between DCs and retinal function in diabetic patients (DM) using a handheld device of electroretinogram (ERG) RETevalTM.
Methods: Subjects: 175 hospitalized DM. Microvascular complications were assessed using urine albumin creatinine ratio (ACR) measurements, digital retinal images, and nerve conduction studies. Atherosclerosis was assessed utilizing baPWV, ABI, TBI, and carotid IMT. The Pearson’s or Spearman’s coefficient was used for data analysis.
Results: Patient background: 112 males, average 60.4±14.0 years old, mean duration of disease 10.7±11.3 years, and mean HbA1c 10.1±2.3%. Prevalence of DCs were 29.4% of DR, 32.9% of nephropathy (DN), and 43.8% of DPN. Relationships with significant correlation between indices of ERG and DCs: ERG latency (LAT) and DR (p = 0.003); ERG amplitude (AMP) and DR (p < 0.001), DN (p = 0.024), or DPN (p = 0.019). Relationships with significant correlation between indices of ERG and indices of DCs: LAT and minimal F-wave latency of the tibial nerves or sural nerve NCVs; AMP and T-Chol, LDL-C, eGFR, urinary C-peptide, ACR, IMT, baPWV, TBI, or SNAP of the sural nerves.
Conclusion: AMP and LAT were correlated with prevalence of DCs and their indices. The handheld ERG might predict DCs.
M. Kawai: None. T. Himeno: None. Y. Yamada: None. E. Asano: None. Y. Sugiura: None. H. Shimoda: None. Y. Shibata: None. M. Kondo: None. S. Tsunekawa: None. H. Kamiya: Speaker's Bureau; Self; Astellas Pharma Inc., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Novo Nordisk Oharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K. J. Nakamura: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Japan Tobacco Inc., Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Kowa Pharmaceu. Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation.