Retinal Vasculometry Associations with Cardiometabolic Risk Factors in the European Prospective Investigation of Cancer—Norfolk Study

Autor: R.A. Welikala, David P. Strachan, Robert Luben, Paul J. Foster, Sarah Barman, Kay-Tee Khaw, Peter H. Whincup, Christopher G. Owen, Alicja R. Rudnicka, Shabina Hayat, Muhammad Moazam Fraz
Přispěvatelé: Luben, Robert [0000-0002-5088-6343], Hayat, Shabina [0000-0001-9068-8723], Khaw, Kay-Tee [0000-0002-8802-2903], Apollo - University of Cambridge Repository
Rok vydání: 2019
Předmět:
Male
BMI
body mass index
Blood Pressure
Type 2 diabetes
CHD
coronary heart disease
Body Mass Index
0302 clinical medicine
Venules
Risk Factors
LDL
low-density lipoprotein
Medicine
Prospective Studies
Myocardial infarction
Prospective cohort study
Stroke
0303 health sciences
Middle Aged
3. Good health
Arterioles
Cardiovascular Diseases
Cardiology
Female
medicine.medical_specialty
Retinal Artery
HDL
high-density lipoprotein
CVD
cardiovascular disease
Article
03 medical and health sciences
Retinal Diseases
Internal medicine
Diabetes mellitus
Humans
Triglycerides
Aged
030304 developmental biology
Glycated Hemoglobin
EPIC
European Prospective Investigation into Cancer
HbA1c
hemoglobin A1c
business.industry
medicine.disease
Retinal Vein
United Kingdom
Confidence interval
CI
confidence interval
Ophthalmology
Blood pressure
Diabetes Mellitus
Type 2
Microvessels
030221 ophthalmology & optometry
SD
standard deviation
business
Body mass index
Zdroj: Ophthalmology
ISSN: 0161-6420
1549-4713
DOI: 10.1016/j.ophtha.2018.07.022
Popis: Purpose To examine associations between retinal vessel morphometry and cardiometabolic risk factors in older British men and women. Design Retinal imaging examination as part of the European Prospective Investigation into Cancer—Norfolk Eye Study. Participants Retinal imaging and clinical assessments were carried out in 7411 participants. Retinal images were analyzed using a fully automated validated computerized system that provides novel measures of vessel morphometry. Methods Associations between cardiometabolic risk factors, chronic disease, and retinal markers were analyzed using multilevel linear regression, adjusted for age, gender, and within-person clustering, to provide percentage differences in tortuosity and absolute differences in width. Main Outcomes Measures Retinal arteriolar and venular tortuosity and width. Results In all, 279 802 arterioles and 285 791 venules from 5947 participants (mean age, 67.6 years; standard deviation [SD], 7.6 years; 57% female) were analyzed. Increased venular tortuosity was associated with higher body mass index (BMI; 2.5%; 95% confidence interval [CI], 1.7%–3.3% per 5 kg/m 2 ), hemoglobin A1c (HbA1c) level (2.2%; 95% CI, 1.0%–3.5% per 1%), and prevalent type 2 diabetes (6.5%; 95% CI, 2.8%–10.4%); wider venules were associated with older age (2.6 μm; 95% CI, 2.2–2.9 μm per decade), higher triglyceride levels (0.6 μm; 95% CI, 0.3–0.9 μm per 1 mmol/l), BMI (0.7 μm; 95% CI, 0.4–1.0 per 5 kg/m 2 ), HbA1c level (0.4 μm; 95% CI, –0.1 to 0.9 per 1%), and being a current smoker (3.0 μm; 95% CI, 1.7–4.3 μm); smoking also was associated with wider arterioles (2.1 μm; 95% CI, 1.3–2.9 μm). Thinner venules were associated with high-density lipoprotein (HDL) (1.4 μm; 95% CI, 0.7–2.2 per 1 mmol/l). Arteriolar tortuosity increased with age (5.4%; 95% CI, 3.8%–7.1% per decade), higher systolic blood pressure (1.2%; 95% CI, 0.5%–1.9% per 10 mmHg), in females (3.8%; 95% CI, 1.4%–6.4%), and in those with prevalent stroke (8.3%; 95% CI, –0.6% to 18%); no association was observed with prevalent myocardial infarction. Narrower arterioles were associated with age (0.8 μm; 95% CI, 0.6–1.0 μm per decade), higher systolic blood pressure (0.5 μm; 95% CI, 0.4–0.6 μm per 10 mmHg), total cholesterol level (0.2 μm; 95% CI, 0.0–0.3 μm per 1 mmol/l), and HDL (1.2 μm; 95% CI, 0.7–1.6 μm per 1 mmol/l). Conclusions Metabolic risk factors showed a graded association with both tortuosity and width of retinal venules, even among people without clinical diabetes, whereas atherosclerotic risk factors correlated more closely with arteriolar width, even excluding those with hypertension and cardiovascular disease. These noninvasive microvasculature measures should be evaluated further as predictors of future cardiometabolic disease.
Databáze: OpenAIRE
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