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Resting heart rate is associated with nonproliferative retinopathy in normoalbuminuric type 1 diabetic patients

Previous studies have reported that retinopathy might be present already in normoalbuminuric state in type 1 diabetic patients. The aim of this study was to evaluate the prevalence and predictors of nonproliferative retinopathy in normoalbuminuric type 1 diabetic patients. Study included 312 normoalbuminuric type 1 diabetic patients with normal renal function and before any interventions with statins, ACE inhibitors or angiotensin II receptor blockers. Diagnosis of nonproliferative retinopathy was made by fundoscopy after pupillary dilatation. Urinary albumin excretion rate (UAE) was measured from at least two 24-h urine samples. Nonproliferative retinopathy was present in 36% of normoalbuminuric patients. Patients with nonproliferative retinopathy were older, had longer duration of diabetes, higher HbA1c, daily insulin dose and higher resting heart rate (RHR) (p≤0.01 for all). Subjects in the 4th quartile of RHR were older, had longer duration of diabetes, higher HbA1c, daily insulin dose, serum creatinine, UAE, and had significantly higher prevalence of nonproliferative retinopathy compared to subjects in 2nd, 3rd and 4th quartiles (p<0.05). In logistic regression analysis, after adjustment for risk factors, higher RHR was significantly associated with risk of nonproliferative retinopathy in our subjects (p<0.001), with odds ratios of 1.02 to 1.08. These data suggest that RHR is independently associated with nonproliferative retinopathy in normoalbuminuric type 1 diabetic patients.

type 1 diabetes; heart rate; retinopathy; microvascular complications; albuminuria

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