Retinal vascular geometry predicts incident renal dysfunction in young people with type 1 diabetes

OBJECTIVE - To examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS - This was a prospective cohort study of 511 adolescents with type 1 diabetes of at least 2 years duration, with normal albumin excretion rate (AER) and no retinopathy at baseline while attending an Australian tertiary-care hospital. AER was quantified using three overnight, timed urine specimen collections and early renal dysfunction was defined as AER >7.5 µg/min. Retinal vascular geometry (including length-to-diameter ratio [LDR] and simple tortuosity [ST]) was quantified from baseline retinal photographs. Generalized estimating equations were used to examine the relationship between incident renal dysfunction and baseline venular LDR and ST, adjusting for age, diabetes duration, glycated hemoglobin (A1C), blood pressure (BP), BMI, and cholesterol. RESULTS - Diabetes duration at baseline was 4.8 (IQR 3.3-7.5) years. After amedian 3.7 (2.3-5.7) years follow-up, 34% of participants developed incident renal dysfunction. In multivariate analysis, higher retinal venular LDR (odds ratio 1.7, 95% CI 1.2-2.4; quartile 4 vs. 1-3) and lower venular ST (1.6, 1.1-2.2; quartile 1 vs. 2-4) predicted incident renal dysfunction. CONCLUSIONS - Retinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes. These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications. Retinal venular geometry may be a useful tool to identify individuals at high risk of renal disease early in the course of diabetes. © 2012 by the American Diabetes Association.

Surface deformations as a necessary requirement for resistance switching at the surface of SrTiO3:N

Atomic force microscopy (AFM), conductive AFM and electrochemical strain microscopy were used to study the topography change at the defect surface of SrTiO3:N, breakdown in the electrical conduction of the tip/sample/electrode system and ionic motion. The IV curves show resistance switching behavior in a voltage range ±6 V < U <± 10 V and a current of maximum ±10 nA. A series of sweeping IV curves resulted in an increase in ionically polarized states (surface charging), electrochemical volume (surface deformations) and sequential formations of stable surface protrusions. The surface deformations are reversible (U <± 5 V) without IVpinched hysteresis and remained stable during the resistance switching (U >± 6 V), revealing the additional necessity (albeit insufficient due to 50% yield of working cells) of surface protrusion formation for resistance switching memory.