Background/Aim The aim of this study was to evaluate the effect of prediabetes and diabetes on macular thickness and retinal vascular calibres in our population-based cohort (Northern Finland Birth Cohort). Methods The population of 2005 individuals was divided into diabetes (n=57), prediabetes (n=1638) and normal glucose metabolism (NGM) groups (n=310). Total thickness of the macula was measured using Cirrus HD-OCT 4000. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) calibres were measured from the fundus images. The diagnosis of diabetes and prediabetes was made according to WHO 2006 diagnostic standards. Results Significant macular thinning was observed in subjects with prediabetes (−2.69 μm (95% CI −4.29 to −1.09), p<0.05 and −0.10 mm3 (95% CI −0.16 to −0.04), p<0.05 for macular cube average thickness and cube volume, respectively) and it was greatest in the pericentral area. Macular cube average thickness and macular cube volume decreased significantly by worsening glucose metabolism. Furthermore, CRAE was decreased by increases in 2-hour post-load glucose, glucose area under the curve and increase in Matsuda index (p<0.001, 0.019 and <0.001, respectively). In mediation analysis, macular thickness had significant average causal mediation effect (ACME) on CRVE and CRAE in subjects with prediabetes. Conclusion We detected significant thinning of the macula in subjects with prediabetes. The diameters of retinal arteries were decreased by impaired glucose metabolism. This study provides a new perspective since it revealed that the early and subtle changes caused by prediabetes as macular thinning had significant ACME on retinal vessels, therefore supporting the neurodegenerative theory of diabetes-induced changes in the retina.

中文翻译：

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前驱糖尿病影响黄斑的结构：芬兰北部出生队列中黄斑变薄

背景/目的 本研究的目的是在我们基于人群的队列（芬兰北部出生队列）中评估前驱糖尿病和糖尿病对黄斑厚度和视网膜血管口径的影响。方法将2005人分为糖尿病组（n=57）、前驱糖尿病组（n=1638）和糖代谢正常组（n=310）。使用 Cirrus HD-OCT 4000 测量黄斑的总厚度。从眼底图像测量视网膜中央小动脉当量 (CRAE) 和视网膜中央小静脉当量 (CRVE) 口径。根据世界卫生组织 2006 年诊断标准进行糖尿病和前驱糖尿病的诊断。结果 在糖尿病前期患者中观察到显着的黄斑变薄（-2.69 μm（95% CI -4.29 至 -1.09），p<0.05 和 -0.10 mm3（95% CI -0.16 至 -0.04），p<0。05 为黄斑立方体的平均厚度和立方体体积，分别），并且在中心周围区域最大。由于葡萄糖代谢恶化，黄斑块平均厚度和黄斑块体积显着降低。此外，负荷后 2 小时葡萄糖、曲线下葡萄糖面积的增加和松田指数的增加降低了 CRAE（分别为 p<0.001、0.019 和 <0.001）。在中介分析中，黄斑厚度对糖尿病前期受试者的 CRVE 和 CRAE 具有显着的平均因果中介效应 (ACME)。结论 我们检测到糖尿病前期受试者的黄斑明显变薄。视网膜动脉的直径因葡萄糖代谢受损而减小。