The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes
Abstract Individuals with Type 2 Diabetes (T2D) are at high risk of subclinical cardiovascular disease (CVD), potentially detectable through retinal alterations. In this single-centre, prospective cohort study, 255 asymptomatic adults with T2D and no prior history of CVD underwent echocardiography,...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-13468-4 |
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| author | Abbas S. Alatrany Kishan Lakhani Alice C. Cowley Jian L. Yeo Abhishek Dattani Sarah L. Ayton Aparna Deshpande Matthew P.M. Graham-Brown Melanie J. Davies Kamlesh Khunti Thomas Yates Stephanie L. Sellers Huiyu Zhou Emer M. Brady Jayanth R. Arnold James Deane Rebecca J. McLean Frank A. Proudlock Gerry P. McCann Gaurav S. Gulsin |
| author_facet | Abbas S. Alatrany Kishan Lakhani Alice C. Cowley Jian L. Yeo Abhishek Dattani Sarah L. Ayton Aparna Deshpande Matthew P.M. Graham-Brown Melanie J. Davies Kamlesh Khunti Thomas Yates Stephanie L. Sellers Huiyu Zhou Emer M. Brady Jayanth R. Arnold James Deane Rebecca J. McLean Frank A. Proudlock Gerry P. McCann Gaurav S. Gulsin |
| author_sort | Abbas S. Alatrany |
| collection | DOAJ |
| description | Abstract Individuals with Type 2 Diabetes (T2D) are at high risk of subclinical cardiovascular disease (CVD), potentially detectable through retinal alterations. In this single-centre, prospective cohort study, 255 asymptomatic adults with T2D and no prior history of CVD underwent echocardiography, non-contrast coronary computed tomography and cardiovascular magnetic resonance. Retinal photographs were evaluated for diabetic retinopathy grade and microvascular geometric characteristics using deep learning (DL) tools. Associations with cardiac imaging markers of subclinical CVD were explored. Of the participants (aged 64 ± 7 years, 62% males); 200 (78%) had no diabetic retinopathy and 55 (22%) had mild background retinopathy. Groups were well-matched for age, sex, ethnicity, CV risk factors, urine microalbuminuria, and serum natriuretic peptide and high-sensitivity troponin levels. Presence of retinopathy was associated with a greater burden of coronary atherosclerosis (coronary artery calcium score ≥ 100; OR 2.63; 95% CI 1.29–5.36; P = 0.008), more concentric left ventricular remodelling (OR 3.11; 95% CI 1.50–6.45; P = 0.002), and worse global longitudinal strain (OR 2.32; 95% CI 1.18–4.59; P = 0.015), independent of key co-variables. Early diabetic retinopathy is associated with a high burden of coronary atherosclerosis and markers of early heart failure. Routine diabetic eye screening may serve as an effective alternative to currently advocated screening tests for detecting subclinical CVD in T2D, presenting opportunities for earlier detection and intervention. |
| format | Article |
| id | doaj-art-45a39e8a206448e69be725f19ebfc627 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-45a39e8a206448e69be725f19ebfc6272025-08-20T03:42:33ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-13468-4The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetesAbbas S. Alatrany0Kishan Lakhani1Alice C. Cowley2Jian L. Yeo3Abhishek Dattani4Sarah L. Ayton5Aparna Deshpande6Matthew P.M. Graham-Brown7Melanie J. Davies8Kamlesh Khunti9Thomas Yates10Stephanie L. Sellers11Huiyu Zhou12Emer M. Brady13Jayanth R. Arnold14James Deane15Rebecca J. McLean16Frank A. Proudlock17Gerry P. McCann18Gaurav S. Gulsin19Department of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Imaging Services, University Hospitals of Leicester NHS TrustDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterLeicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research CentreLeicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research CentreLeicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research CentreCardiovascular Translational Laboratory, St Paul’s Hospital, University of British Columbia Centre for Heart Lung InnovationSchool of Computing and Mathematical Sciences, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterThe University of Leicester Ulverscroft Eye Unit, Leicester Royal InfirmaryThe University of Leicester Ulverscroft Eye Unit, Leicester Royal InfirmaryThe University of Leicester Ulverscroft Eye Unit, Leicester Royal InfirmaryDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterDepartment of Cardiovascular Sciences, National Institute for Health Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, University of LeicesterAbstract Individuals with Type 2 Diabetes (T2D) are at high risk of subclinical cardiovascular disease (CVD), potentially detectable through retinal alterations. In this single-centre, prospective cohort study, 255 asymptomatic adults with T2D and no prior history of CVD underwent echocardiography, non-contrast coronary computed tomography and cardiovascular magnetic resonance. Retinal photographs were evaluated for diabetic retinopathy grade and microvascular geometric characteristics using deep learning (DL) tools. Associations with cardiac imaging markers of subclinical CVD were explored. Of the participants (aged 64 ± 7 years, 62% males); 200 (78%) had no diabetic retinopathy and 55 (22%) had mild background retinopathy. Groups were well-matched for age, sex, ethnicity, CV risk factors, urine microalbuminuria, and serum natriuretic peptide and high-sensitivity troponin levels. Presence of retinopathy was associated with a greater burden of coronary atherosclerosis (coronary artery calcium score ≥ 100; OR 2.63; 95% CI 1.29–5.36; P = 0.008), more concentric left ventricular remodelling (OR 3.11; 95% CI 1.50–6.45; P = 0.002), and worse global longitudinal strain (OR 2.32; 95% CI 1.18–4.59; P = 0.015), independent of key co-variables. Early diabetic retinopathy is associated with a high burden of coronary atherosclerosis and markers of early heart failure. Routine diabetic eye screening may serve as an effective alternative to currently advocated screening tests for detecting subclinical CVD in T2D, presenting opportunities for earlier detection and intervention.https://doi.org/10.1038/s41598-025-13468-4Cardiovascular diseaseType 2 diabetesDigital retinal photographyDiabetic cardiomyopathyAtherosclerotic coronary artery diseaseHeart failure. |
| spellingShingle | Abbas S. Alatrany Kishan Lakhani Alice C. Cowley Jian L. Yeo Abhishek Dattani Sarah L. Ayton Aparna Deshpande Matthew P.M. Graham-Brown Melanie J. Davies Kamlesh Khunti Thomas Yates Stephanie L. Sellers Huiyu Zhou Emer M. Brady Jayanth R. Arnold James Deane Rebecca J. McLean Frank A. Proudlock Gerry P. McCann Gaurav S. Gulsin The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes Scientific Reports Cardiovascular disease Type 2 diabetes Digital retinal photography Diabetic cardiomyopathy Atherosclerotic coronary artery disease Heart failure. |
| title | The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| title_full | The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| title_fullStr | The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| title_full_unstemmed | The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| title_short | The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| title_sort | retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes |
| topic | Cardiovascular disease Type 2 diabetes Digital retinal photography Diabetic cardiomyopathy Atherosclerotic coronary artery disease Heart failure. |
| url | https://doi.org/10.1038/s41598-025-13468-4 |
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