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首页> 外文期刊>Diabetes care >Retinopathy and RAAS Activation: Results From the Canadian Study of Longevity in Type 1 Diabetes
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Retinopathy and RAAS Activation: Results From the Canadian Study of Longevity in Type 1 Diabetes

机译：视网膜病变和raas活化：加拿大糖尿病寿命研究的结果

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OBJECTIVEThe importance of renin-angiotensin-aldosterone system (RAAS) activation in retinopathy for long-standing diabetes is not well understood. We determined retinopathy stage and evaluated associations with other vascular complications before and after physiological RAAS activation in adults with long-standing (50 years duration) type 1 diabetes.RESEARCH DESIGN AND METHODSParticipants underwent retinal examination by digital funduscopic photography and optical coherence tomography and were classified as having nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), or no diabetic retinopathy (NDR) with or without diabetic macular edema (DME). Neuropathy was measured by clinical neuropathy examination scores, electrophysiologically, and by corneal confocal microscopy. Renal function was measured by inulin and para-aminohippurate clearance methods. Arterial stiffness was measured by applanation tonometry. Renal function, blood pressure, and arterial stiffness were measured before and after RAAS activation with angiotensin II (ANGII). Associations were determined using linear regression.RESULTSTwelve (16%) of the 75 participants had NDR, 24 (32%) had NPDR, and 39 (52%) had PDR. A low overall prevalence of DME (4%) was observed. Those with PDR had worse nerve function and reduced corneal nerve density, were more likely to have macrovascular disease, and had increased arterial stiffness in response to ANGII compared with those with NPDR or NDR. Prevalence of kidney disease or renal hemodynamic function did not differ by retinopathy status.CONCLUSIONSPDR was associated with neuropathy severity and cardiovascular and peripheral vascular disease. In those with PDR, RAAS activation may be linked to vascular stiffening, an effect that persists in long-standing type 1 diabetes.
机译：肾素 - 血管紧张素 - 醛固酮系统（RAAs）活化在长期糖尿病视网膜病变中的视象尚未得到很好的理解。我们在长期（50年持续时间）1型糖尿病患者之前和之后确定了视网膜病变阶段和评估了与其他血管并发症的关联，其生理RAAS活化型1型糖尿病。搜索设计和方法标准体通过数字眼底拍摄和光学相干性断层扫描进行视网膜检查并被分类与具有或没有糖尿病黄斑水肿（DME）的糖尿病性糖尿病视网膜病变（NPDR），增殖性糖尿病视网膜病变（PDR），或没有糖尿病视网膜病（NDR）。通过临床神经病变检查评分，电生理学和通过角膜共聚焦显微镜测量神经病变。肾功能通过菊粉和氨基成熟的清除方法测量。通过施施红色测量动脉僵硬度。在血管紧张素II（Angii）的Raas活化之前和之后测量肾功能，血压和动脉僵硬。使用线性回归测定的关联。75名参与者中的NDRVELVE（16％）具有NDR，24（32％）具有NPDR，39（52％）具有PDR。观察到DME（4％）的低总体患病率。那些具有PDR的神经功能较差，并且降低角膜神经密度，更有可能具有大血管疾病，并且与NPDR或NDR的那些相比，响应Angii增加了动脉僵硬度。肾病或肾血流动力学功能的患病率并未因视网膜病理学而异。链接性培养物与神经病理严重程度和心血管和外周血管疾病有关。在那些具有PDR的那些中，RAAS活化可以与血管加强相关，这是一种持续存在于长期1型糖尿病的效果。

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