Journal Article
Research Support, U.S. Gov't, P.H.S.
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Retinal and gingival hemorrhaging and chronic hyperglycemia.

Diabetes Care 2011 January
OBJECTIVE: To assess the hypothesis that retinopathies are indicative of systemic microvascular injury.

RESEARCH DESIGN AND METHODS: The only U.S. national survey assessing microvascular hemorrhaging at two distinct anatomical sites was the National Health and Nutrition Examination Survey (1988-1994). The systemic microvascular injury hypothesis was assessed by modeling the association of retinal and gingival hemorrhaging and the factors that explain this association.

RESULTS: Individuals in whom one or more in five gingival sites was hemorrhaging had a 57% increased odds for retinal hemorrhaging (95% CI: 1.26-1.94). This association between retinal and gingival hemorrhaging was 51% explained by A1C concentrations. Retinal and gingival hemorrhaging exhibited the signature J-shaped prevalence patterns when plotted as a function of A1C concentrations.

CONCLUSIONS: Gingival hemorrhaging reflected on retinal hemorrhaging, and both shared chronic hyperglycemia as an explanatory marker. These epidemiological findings support the hypothesis that retinopathies are reflective of systemic microvascular injury.

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