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Ding Q, Wu H, Wang W, Xiong K, Gong X, Yuan G, Li T, Li Y, Liu H, Wang L, Huang W. Association of Body Mass Index and Waist-to-Hip Ratio With Retinal Microvasculature in Healthy Chinese Adults: An Optical Coherence Tomography Angiography Study. Am J Ophthalmol 2023; 246:96-106. [PMID: 36240858 DOI: 10.1016/j.ajo.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To investigate the association of body mass index (BMI) and waist-to-hip ratio (WHR) with macular vessel density (VD) and foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA), in healthy Chinese adults. DESIGN Cross-sectional study. METHODS A total of 1555 Chinese adults aged ≥ 50 years with no history of ocular disease were recruited from communities in Guangzhou, China. The OCTA was performed with a 6 × 6 mm macular angiography model. The FAZ of the superficial capillary plexus (SCP), and VD of SCP and deep capillary plexus (DCP) were calculated. Univariable and multivariable linear regression analyses were used to evaluate the effect of BMI and WHR on VD and FAZ. RESULTS The VD of the SCP increased as BMI increased, with average measurements of 39.30 ± 2.14 for normal, 39.52 ± 2.07 for overweight, and 39.76 ± 2.03 for obesity (P = .001). The VD of the DCP also increased with increasing BMI (P = .009). Multiple regression models confirmed a positive association between generalized obesity and superficial VD in the whole image (β = 0.350, P = .008), inner circle (β = 0.431, P = .032), and outer circle (β = 0.368, P = .005). After adjusting for confounders, tertile 3 of the WHR level was positively associated with superficial VD (β = 0.472, P = .033) and deep VD (β = 0.422, P = .034) only in the inner circle. CONCLUSIONS Generalized obesity was associated with increased superficial VD, while abdominal obesity was associated with increased superficial and deep VD only in the inner circle. Different manifestations of the retinal microvasculature may reflect distinct roles of body composition on macular vessel alterations and disease occurrence.
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Affiliation(s)
- Qiong Ding
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.); The First People's Hospital of Zhaoqing, Zhaoqing City, China (Q.D., G.Y., T.L., Y.L.)
| | - Huimin Wu
- Shenzhen Children's Hospital, Shenzhen, Guangdong, China (H.W.)
| | - Wei Wang
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.)
| | - Kun Xiong
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.)
| | - Xia Gong
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.)
| | - Guiliang Yuan
- The First People's Hospital of Zhaoqing, Zhaoqing City, China (Q.D., G.Y., T.L., Y.L.)
| | - Tengchao Li
- The First People's Hospital of Zhaoqing, Zhaoqing City, China (Q.D., G.Y., T.L., Y.L.)
| | - Youjia Li
- The First People's Hospital of Zhaoqing, Zhaoqing City, China (Q.D., G.Y., T.L., Y.L.)
| | - Hua Liu
- Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China (H.L.).
| | - Lanhua Wang
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.).
| | - Wenyong Huang
- From State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (Q.D, W.W., K.X., X.G., L.W., W.H.)
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Sousa‐Sá E, Zhang Z, Pereira JR, Wright IM, Okely AD, Santos R. Systematic review on retinal microvasculature, physical activity, sedentary behaviour and adiposity in children and adolescents. Acta Paediatr 2020; 109:1956-1973. [PMID: 31998981 DOI: 10.1111/apa.15204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/16/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
AIM As retinal microvasculature (RMV) can be assessed non-invasively, it presents an opportunity to examine the health and disease of the human microcirculation, as RMV alterations have been recognised as one of the earliest signs of cardiovascular risk. This review summarises current literature on the associations between physical activity (PA), sedentary behaviour (SB) and/or adiposity and RMV in children and adolescents aged 0-18 years. METHODS Six databases were searched (MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO and CINAHL), through to December 11, 2019. English, Portuguese, French, Spanish or Dutch were the languages searched. Meta-analyses were performed using the meta-analyst software. RESULTS A total of 6796 studies were screened, and 26 studies were included, representing 24 448 participants, from 12 different countries. Studies reporting results on weight status were twenty-three, PA was assessed in six studies, and SB was assessed in three studies. Four studies examined weight status and PA/SB. Meta-analysis was performed for two studies and showed that children with obesity have smaller retinal arterioles (-2.38 µm difference, 95% CI 0.62, 4.15 µm) and larger retinal venules (2.74 µm difference, 95% CI -4.78, -0.72 µm) than children without obesity. CONCLUSION Results showed that adiposity was associated with microvascular alterations in children and adolescents. Increased adiposity, lack of PA and high levels of SB were negatively correlated with vessel width parameters.
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Affiliation(s)
- Eduarda Sousa‐Sá
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Zhiguang Zhang
- Early Start University of Wollongong Wollongong NSW Australia
| | - João R. Pereira
- Early Start University of Wollongong Wollongong NSW Australia
- Research Unit for Sport and Physical Activity University of Coimbra Coimbra Portugal
| | - Ian M. Wright
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Anthony D. Okely
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Rute Santos
- Early Start University of Wollongong Wollongong NSW Australia
- Research Centre in Physical Activity, Health and Leisure University of Porto Porto Portugal
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Tapp RJ, Owen CG, Barman SA, Welikala RA, Foster PJ, Whincup PH, Strachan DP, Rudnicka AR. Retinal Vascular Tortuosity and Diameter Associations with Adiposity and Components of Body Composition. Obesity (Silver Spring) 2020; 28:1750-1760. [PMID: 32725961 PMCID: PMC7116641 DOI: 10.1002/oby.22885] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/18/2020] [Accepted: 05/06/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether adiposity or body composition relates to microvascular characteristics of the retina, indicative of cardiometabolic function. METHODS A fully automated QUARTZ software processed retinal images from 68,550 UK Biobank participants (aged 40-69 years). Differences in retinal vessel diameter and tortuosity with body composition measures from the Tanita analyzer were obtained by using multilevel regression analyses adjusted for age, sex, ethnicity, clinic, smoking, and Townsend deprivation index. RESULTS Venular tortuosity and diameter increased by approximately 2% (P < 10-300 ) and 0.6 μm (P < 10-6 ), respectively, per SD increase in BMI, waist circumference index, waist-hip ratio, total body fat mass index, and fat-free mass index (FFMI). Venular associations with adiposity persisted after adjustment for FFMI, whereas associations with FFMI were weakened by FMI adjustment. Arteriolar diameter (not tortuosity) narrowing with FFMI was independent of adiposity (-0.6 μm; -0.7 to -0.4 μm per SD increment of FFMI), while adiposity associations with arteriolar diameter were largely nonsignificant after adjustment for FFMI. CONCLUSIONS This demonstrates, on an unprecedented scale, that venular tortuosity and diameter are more strongly associated with adiposity, whereas arteriolar diameter relates more strongly to fat-free mass. Different attributes of the retinal microvasculature may reflect distinct roles of body composition and fatness on the cardiometabolic system.
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Affiliation(s)
- Robyn J Tapp
- Population Health Research Institute, St George's, University of London, London, UK
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sarah A Barman
- Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - Roshan A Welikala
- Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - Paul J Foster
- Integrative Epidemiology Research Group, UCL Institute of Ophthalmology, London, UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospital, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - David P Strachan
- Population Health Research Institute, St George's, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George's, University of London, London, UK
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Tapp RJ, Owen CG, Barman SA, Welikala RA, Foster PJ, Whincup PH, Strachan DP, Rudnicka AR. Associations of Retinal Microvascular Diameters and Tortuosity With Blood Pressure and Arterial Stiffness: United Kingdom Biobank. Hypertension 2019; 74:1383-1390. [PMID: 31661987 PMCID: PMC7069386 DOI: 10.1161/hypertensionaha.119.13752] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Supplemental Digital Content is available in the text. To examine the baseline associations of retinal vessel morphometry with blood pressure (BP) and arterial stiffness in United Kingdom Biobank. The United Kingdom Biobank included 68 550 participants aged 40 to 69 years who underwent nonmydriatic retinal imaging, BP, and arterial stiffness index assessment. A fully automated image analysis program (QUARTZ [Quantitative Analysis of Retinal Vessel Topology and Size]) provided measures of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiovascular disease risk factors/outcomes were examined using multilevel linear regression to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing within person clustering), adjusted for age, sex, ethnicity, clinic, body mass index, smoking, and deprivation index. Greater arteriolar tortuosity was associated with higher systolic BP (relative increase, 1.2%; 95% CI, 0.9; 1.4% per 10 mmHg), higher mean arterial pressure, 1.3%; 0.9, 1.7% per 10 mmHg, and higher pulse pressure (PP, 1.8%; 1.4; 2.2% per 10 mmHg). Narrower arterioles were associated with higher systolic BP (−0.9 µm; −0.94, −0.87 µm per 10 mmHg), mean arterial pressure (−1.5 µm; −1.5, −1.5 µm per 10 mmHg), PP (−0.7 µm; −0.8, −0.7 µm per 10 mmHg), and arterial stiffness index (−0.12 µm; −0.14, −0.09 µm per ms/m2). Associations were in the same direction but marginally weaker for venular tortuosity and diameter. This study assessing the retinal microvasculature at scale has shown clear associations between retinal vessel morphometry, BP, and arterial stiffness index. These observations further our understanding of the preclinical disease processes and interplay between microvascular and macrovascular disease.
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Affiliation(s)
- Robyn J Tapp
- From the Population Health Research Institute, St George's University of London, United Kingdom (R.J.T., C.G.O., P.H.W., D.P.S., A.R.R.).,Melbourne School of Population and Global Health, University of Melbourne, Australia (R.J.T.)
| | - Christopher G Owen
- From the Population Health Research Institute, St George's University of London, United Kingdom (R.J.T., C.G.O., P.H.W., D.P.S., A.R.R.)
| | - Sarah A Barman
- Faculty of Science, Engineering and Computing, Kingston University, Surrey, United Kingdom (S.A.B., R.A.W.)
| | - Roshan A Welikala
- Faculty of Science, Engineering and Computing, Kingston University, Surrey, United Kingdom (S.A.B., R.A.W.)
| | - Paul J Foster
- Integrative Epidemiology Research Group, UCL Institute of Ophthalmology, United Kingdom (P.J.F.).,NIHR Biomedical Research Centre at Moorfields Eye Hospital, United Kingdom (P.J.F.)
| | - Peter H Whincup
- From the Population Health Research Institute, St George's University of London, United Kingdom (R.J.T., C.G.O., P.H.W., D.P.S., A.R.R.)
| | - David P Strachan
- From the Population Health Research Institute, St George's University of London, United Kingdom (R.J.T., C.G.O., P.H.W., D.P.S., A.R.R.)
| | - Alicja R Rudnicka
- From the Population Health Research Institute, St George's University of London, United Kingdom (R.J.T., C.G.O., P.H.W., D.P.S., A.R.R.)
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Köchli S, Endes K, Infanger D, Zahner L, Hanssen H. Obesity, Blood Pressure, and Retinal Vessels: A Meta-analysis. Pediatrics 2018; 141:peds.2017-4090. [PMID: 29743194 DOI: 10.1542/peds.2017-4090] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 01/30/2023] Open
Abstract
CONTEXT Retinal vessel imaging is a noninvasive diagnostic tool used to evaluate cardiovascular risk. Childhood obesity and elevated blood pressure (BP) are associated with retinal microvascular alterations. OBJECTIVE To systematically review and meta-analyze associations between obesity, BP, and physical activity with retinal vessel diameters in children. DATA SOURCES We conducted a literature search through the databases of PubMed, Embase, Ovid, Web of Science, and the Cochrane Register of Controlled Trials. STUDY SELECTION School- and population-based cross-sectional data. DATA EXTRACTION General information, study design, participants, exposure, and outcomes. RESULTS A total of 1751 studies were found, and 30 full-text articles were analyzed for eligibility. Twenty-two articles (18 865 children and adolescents) were used for further assessment and reflection. Eleven articles were finally included in the meta-analysis. We found that a higher BMI is associated with narrower retinal arteriolar (pooled estimate effect size -0.37 [95% confidence interval (CI): -0.50 to -0.24]) and wider venular diameters (0.35 [95% CI: 0.07 to 0.63]). Systolic and diastolic BP are associated with retinal arteriolar narrowing (systolic BP: -0.63 [95% CI: -0.92 to -0.34]; diastolic BP: -0.60 [95% CI -0.95 to -0.25]). Increased physical activity and fitness are associated with favorable retinal vessel diameters. LIMITATIONS Long-term studies are needed to substantiate the prognostic relevance of retinal vessel diameters for cardiovascular risk in children. CONCLUSIONS Our results indicate that childhood obesity, BP, and physical inactivity are associated with retinal microvascular abnormalities. Retinal vessel diameters seem to be sensitive microvascular biomarkers for cardiovascular risk stratification in children.
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Affiliation(s)
- Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel-Stadt, Switzerland
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Sayers A, Heron J, Smith A, Macdonald-Wallis C, Gilthorpe MS, Steele F, Tilling K. Joint modelling compared with two stage methods for analysing longitudinal data and prospective outcomes: A simulation study of childhood growth and BP. Stat Methods Med Res 2016; 26:437-452. [PMID: 25213115 PMCID: PMC5476230 DOI: 10.1177/0962280214548822] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a growing debate with regards to the appropriate methods of analysis of growth trajectories and their association with prospective dependent outcomes. Using the example of childhood growth and adult BP, we conducted an extensive simulation study to explore four two-stage and two joint modelling methods, and compared their bias and coverage in estimation of the (unconditional) association between birth length and later BP, and the association between growth rate and later BP (conditional on birth length). We show that the two-stage method of using multilevel models to estimate growth parameters and relating these to outcome gives unbiased estimates of the conditional associations between growth and outcome. Using simulations, we demonstrate that the simple methods resulted in bias in the presence of measurement error, as did the two-stage multilevel method when looking at the total (unconditional) association of birth length with outcome. The two joint modelling methods gave unbiased results, but using the re-inflated residuals led to undercoverage of the confidence intervals. We conclude that either joint modelling or the simpler two-stage multilevel approach can be used to estimate conditional associations between growth and later outcomes, but that only joint modelling is unbiased with nominal coverage for unconditional associations.
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Affiliation(s)
- A Sayers
- 1 School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Heron
- 1 School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Adac Smith
- 1 School of Social and Community Medicine, University of Bristol, Bristol, UK.,2 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - C Macdonald-Wallis
- 1 School of Social and Community Medicine, University of Bristol, Bristol, UK.,2 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - M S Gilthorpe
- 3 Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - F Steele
- 4 Department of Statistics, London School of Economics, London, UK
| | - K Tilling
- 1 School of Social and Community Medicine, University of Bristol, Bristol, UK.,2 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Li LJ, Ikram MK, Wong TY. Retinal vascular imaging in early life: insights into processes and risk of cardiovascular disease. J Physiol 2015; 594:2175-203. [PMID: 26435039 DOI: 10.1113/jp270947] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/28/2015] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent years, studies have shown that the origins of CVD may be traced to vascular and metabolic processes in early life. Retinal vascular imaging is a new technology that allows detailed non-invasive in vivo assessment and monitoring of the microvasculature. In this systematic review, we described the application of retinal vascular imaging in children and adolescents, and we examined the use of retinal vascular imaging in understanding CVD risk in early life. We reviewed all publications with quantitative retinal vascular assessment in two databases: PubMed and Scopus. Early life CVD risk factors were classified into four groups: birth risk factors, environmental risk factors, systemic risk factors and conditions linked to future CVD development. Retinal vascular changes were associated with lower birth weight, shorter gestational age, low-fibre and high-sugar diet, lesser physical activity, parental hypertension history, childhood hypertension, childhood overweight/obesity, childhood depression/anxiety and childhood type 1 diabetes mellitus. In summary, there is increasing evidence supporting the view that structural changes in the retinal microvasculature are associated with CVD risk factors in early life. Thus, the retina is a useful site for pre-clinical assessment of microvascular processes that may underlie the future development of CVD in adulthood.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Mohammad Kamran Ikram
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Graduate Medical School, National University of Singapore, Singapore
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Tapp RJ, Hussain SM, Battista J, Hutri-Kähönen N, Lehtimäki T, Hughes AD, Thom SAM, Metha A, Raitakari OT, Kähönen M. Impact of blood pressure on retinal microvasculature architecture across the lifespan: the Young Finns Study. Microcirculation 2015; 22:146-55. [PMID: 25559612 DOI: 10.1111/micc.12187] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/02/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The present study examined the impact of BP from childhood to mid-adulthood on retinal microvascular architecture. METHODS The Cardiovascular Risk in Young Finns Study included children aged 3-18 years, from five Finnish University cities, with participants chosen randomly from the national population registrar from those areas. The age of participants included in the current analyses in childhood (1980) ranged from three to nine years and in mid-adulthood (2011) ranged from 34 to 40 years (complete data n = 657). Measures of retinal microvasculature architecture measured in adulthood included diameters, tortuosity, lengths, and LDR. RESULTS Regression analysis showed a strong negative association between childhood systolic BP and adult arteriolar diameter (standardized regression coefficient [β] -0.300; p < 0.001) and with change in systolic BP from childhood to adulthood (β = -0.249; p < 0.001). For arteriolar tortuosity, there was a strong positive association between childhood systolic BP and adult arteriolar tortuosity (β = 0.154; p < 0.001) and no association with change in systolic BP from childhood to adulthood (β = 0.072; p = 0.110). CONCLUSIONS High BP in childhood and increased BP from childhood to adulthood impacts on retinal microvascular architecture in mid-adulthood.
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Affiliation(s)
- Robyn J Tapp
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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9
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Impact of birth parameters and early life growth patterns on retinal microvascular structure in children. J Hypertens 2015; 33:1429-37. [DOI: 10.1097/hjh.0000000000000561] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Hussain SM, Kähönen M, Raitakari OT, Skilton MR, Witt N, Chaturvedi N, Hutri-Kähönen N, Lehtimäki T, Vaahtoranta-Lehtonen H, Juonala M, Wijetunge S, Hughes AD, McG Thom SA, Metha A, Tapp RJ. Impact of Fetal Growth and Preterm Birth on the Retinal Microvasculature in Mid-Adulthood. Microcirculation 2015; 22:285-93. [DOI: 10.1111/micc.12197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/26/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sultana Monira Hussain
- Department of Optometry and Vision Sciences; The University of Melbourne; Parkville Victoria Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Mika Kähönen
- Department of Clinical Physiology; Tampere University Hospital and the University of Tampere; Tampere Finland
| | - Olli T. Raitakari
- The Research Centre of Applied and Preventive Cardiovascular Medicine; University of Turku; Turku Finland
- Department of Clinical Physiology and Nuclear Medicine; Turku University Hospital; Turku Finland
| | - Michael R. Skilton
- Boden Institute of Obesity Nutrition Exercise and Eating Disorders; University of Sydney; Sydney New South Wales Australia
| | - Nicholas Witt
- International Centre for Circulatory Health; NHLI; Imperial College; London and Imperial College Healthcare NHS Trust; London UK
| | - Nish Chaturvedi
- International Centre for Circulatory Health; NHLI; Imperial College; London and Imperial College Healthcare NHS Trust; London UK
| | - Nina Hutri-Kähönen
- Department of Pediatrics; University of Tampere and Tampere University Hospital; Tampere Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry; Fimlab Laboratories; University of Tampere School of Medicine; Tampere Finland
| | | | - Markus Juonala
- Division of Medicine; Turku University Hospital; Turku Finland
| | - Sumangali Wijetunge
- International Centre for Circulatory Health; NHLI; Imperial College; London and Imperial College Healthcare NHS Trust; London UK
| | - Alun D. Hughes
- International Centre for Circulatory Health; NHLI; Imperial College; London and Imperial College Healthcare NHS Trust; London UK
- Institute of Cardiovascular Science; University College London; London UK
| | - Simon A. McG Thom
- International Centre for Circulatory Health; NHLI; Imperial College; London and Imperial College Healthcare NHS Trust; London UK
| | - Andrew Metha
- Department of Optometry and Vision Sciences; The University of Melbourne; Parkville Victoria Australia
| | - Robyn J. Tapp
- Department of Optometry and Vision Sciences; The University of Melbourne; Parkville Victoria Australia
- The Melbourne School of Population and Global Health; The University of Melbourne; Parkville Victoria Australia
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Musa MG, Torrens C, Clough GF. The microvasculature: a target for nutritional programming and later risk of cardio-metabolic disease. Acta Physiol (Oxf) 2014; 210:31-45. [PMID: 23758932 DOI: 10.1111/apha.12131] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 06/03/2013] [Indexed: 12/25/2022]
Abstract
There is compelling evidence that microvascular deficits affecting multiple tissues and organs play an important role in the aetiopathogenesis of cardio-metabolic disease. Furthermore, both in humans and animal models, deficits in small vessel structure and function can be detected early, often before the onset of macrovascular disease and the development of end-organ damage that is common to hypertension and obesity-associated clinical disorders. This article considers the growing evidence for the negative impact of an adverse maternal diet on the long-term health of her child, and how this can result in a disadvantageous vascular phenotype that extends to the microvascular bed. We describe how structural and functional modifications in the offspring microcirculation during development may represent an important and additional risk determinant to increase susceptibility to the development of cardio-metabolic disease in adult life and consider the cell-signalling pathways associated with endothelial dysfunction that may be 'primed' by the maternal environment. Published studies were identified that reported outcomes related to the microcirculation, endothelium, maternal diet and vascular programming using NCBI PubMed.gov, MEDLINE and ISI Web of Science databases from 1980 until April 2013 using pre-specified search terms. Information extracted from over 230 original reports and review articles was critically evaluated by the authors for inclusion in this review.
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Affiliation(s)
- M. G. Musa
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Torrens
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - G. F. Clough
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
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Hughes AD, Bathula R, Park C, Tillin T, Wit N, McG Thom S, Chaturvedi N. Microcirculatory rarefaction in South Asians - a potential mechanism for increased cardiovascular risk and diabetes. PLoS One 2013; 8:e76680. [PMID: 24116136 PMCID: PMC3792020 DOI: 10.1371/journal.pone.0076680] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 08/30/2013] [Indexed: 12/15/2022] Open
Abstract
People of South Asian descent have an increased risk of cardiovascular disease (CVD) and diabetes, but little is known about the microcirculation in South Asian people despite evidence that this plays an important role in the aetiology of CVD. We compared the retinal microcirculation in a population-based sample of 287 middle-aged adults (144 European 143 South Asian) matched for age and sex. Retinal photographs were taken and analysed using a validated semi-automated program and microvascular measures were compared. Blood pressure, anthropometry and fasting bloods were also measured. South Asians had significantly fewer arteriolar and venular vessels and bifurcations. Arterioles and venules were longer and venules were also more tortuous in South Asians. These differences were not explained by adjustment for traditional risk factors including blood pressure, body mass index, diabetes or measures of insulin resistance. People of South Asian descent have rarefaction of the retinal microcirculation compared to age-sex matched individuals of European descent. Reduced microvascular density could contribute to the elevated risk of CVD and impaired glucose tolerance in South Asian people.
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Affiliation(s)
- Alun D. Hughes
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
- * E-mail:
| | - Raj Bathula
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Chloe Park
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Therese Tillin
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Nicholas Wit
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Simon McG Thom
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Nish Chaturvedi
- International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
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