Plasminogen activator inhibitor-1 (PAI-1) activity and retinal vascular calibre in type 2 diabetes

Diabetes Res Clin Pract. 2010 Feb;87(2):192-9. doi: 10.1016/j.diabres.2009.11.007. Epub 2009 Dec 16.


Objective: To describe relationships of retinal vascular calibre with plasminogen activator inhibitor-1 (PAI-1) and other cardiovascular risk factors in people with type 2 diabetes.

Methods: We recruited 112 community-based persons aged 44-83years with type 2 diabetes, photo-documented retinal status using a digital fundus camera, and measured traditional and novel vascular risk factors. Retinal arteriolar and venular calibre and the arterio-venous ratio (AVR) were determined from fundus photographs using a validated computer-assisted method.

Results: In adjusted linear regression models, PAI-1 activity was strongly associated with all measures of retinal vascular calibre: positively with arterioles (p=0.005) and AVR (p=0.001), and inversely with venules (p=0.001). In addition, wider arterioles were independently associated with waist-hip ratio (p<0.0001), HDL-C (p=0.015), and lower systolic blood pressure (p=0.042), whereas narrower venules were associated with older age and a higher albumin excretion rate. Neither arteriolar nor venular calibre was associated with plasma total homocysteine or C-reactive protein concentration.

Conclusion: Retinal vascular calibre is independently associated with PAI-1 activity in type 2 diabetes. This finding supports a role for PAI-1 activity in the microvasculature of persons with type 2 diabetes and may explain the link between retinal vascular calibre and cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arterioles / pathology
  • Blood Glucose / analysis
  • Blood Pressure
  • C-Reactive Protein / metabolism
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / pathology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / pathology
  • Diabetic Angiopathies / physiopathology
  • Diabetic Retinopathy / pathology
  • Female
  • Glycated Hemoglobin A / metabolism
  • Heart Rate
  • Homocysteine / metabolism
  • Humans
  • Male
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood*
  • Regression Analysis
  • Retinal Artery / pathology
  • Retinal Vein / pathology
  • Retinal Vessels / pathology*
  • Risk Factors
  • Venules / pathology
  • Waist-Hip Ratio


  • Blood Glucose
  • Glycated Hemoglobin A
  • Plasminogen Activator Inhibitor 1
  • Homocysteine
  • C-Reactive Protein