Retinal Vasculometry Associations with Cardiometabolic Risk Factors in the European Prospective Investigation of Cancer-Norfolk Study.
Retinal Vasculometry Associations with Cardiometabolic Risk Factors in the European Prospective Investigation of Cancer-Norfolk Study.
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DOI：
10.1016/j.ophtha.2018.07.022
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发表时间：
2019-01
期刊：
影响因子：
13.7
通讯作者：
Foster PJ
中科院分区：
文献类型：
--
作者：
Owen CG;Rudnicka AR;Welikala RA;Fraz MM;Barman SA;Luben R;Hayat SA;Khaw KT;Strachan DP;Whincup PH;Foster PJ
研究英国老年男性和女性视网膜血管形态测量与心脏代谢危险因素之间的关系。视网膜影像学检查作为欧洲癌症前瞻性研究的一部分-诺福克眼科研究。在7411名参与者中进行了视网膜成像和临床评估。视网膜图像进行了分析，使用一个完全自动化的验证计算机化系统，提供新的措施，血管形态。采用多水平线性回归分析心脏代谢危险因素、慢性疾病和视网膜标志物之间的关系，调整年龄、性别和人内聚类，以提供迂曲度的百分比差异和宽度的绝对差异。视网膜小动脉和小静脉的弯曲度和宽度。总共分析了5947名参与者（平均年龄67.6岁;标准差[SD] 7.6岁; 57%为女性）的279802条小动脉和285791条小静脉。小静脉迂曲度的增加与较高的体重指数有关（BMI; 2.5%; 95%置信区间[CI]，1.7%-3.3%/5 kg/m2），血红蛋白A1 c（HbA 1c）水平（2.2%; 95% CI，1.0%-3.5%/1%），和2型糖尿病患病率（6.5%; 95% CI，2.8%-10.4%）;较宽的小静脉与年龄较大相关（2.6 μm; 95% CI，2.2-2.9 μm/十年），甘油三酯水平较高（0.6 μm; 95% CI，0.3-0.9 μm/1 mmol/l），BMI（0.7 μm; 95% CI，0.4-1.0/5 kg/m2），HbA 1c水平（0.4 μm; 95% CI，-0.1至0.9/1%），且目前吸烟（3.0 μm; 95% CI，1.7-4.3 μm）;吸烟也与更宽的小动脉相关（2.1 μm; 95% CI，1.3-2.9 μm）。细静脉变薄与高密度脂蛋白（HDL）相关（1.4 μm; 95% CI，0.7-2.2/1 mmol/l）。小动脉迂曲度随年龄增长而增加（5.4%; 95% CI，3.8%-7.1%/10年），收缩压升高（1.2%; 95% CI，0.5%-1.9%/10 mmHg），女性（3.8%; 95% CI，1.4%-6.4%），并且在患有流行性卒中的患者中（8.3%; 95% CI，-0.6%至18%）;未观察到与流行性心肌梗死相关。狭窄的小动脉与年龄有关（0.8 μm; 95% CI，0.6-1.0 μm/十年），收缩压升高（0.5 μm; 95% CI，0.4-0.6 μm/10 mmHg），总胆固醇水平（0.2 μm; 95% CI，0.0-0.3 μm/1 mmol/l）和HDL（1.2 μm; 95% CI，0.7-1.6 μm/1 mmol/l）。代谢危险因素与视网膜小静脉的迂曲度和宽度呈分级相关，即使在没有临床糖尿病的人群中也是如此，而动脉粥样硬化危险因素与小动脉宽度的相关性更密切，即使排除了高血压和心血管疾病患者。这些无创性微血管测量应作为未来心脏代谢疾病的预测因子进一步评估。
To examine associations between retinal vessel morphometry and cardiometabolic risk factors in older British men and women. Retinal imaging examination as part of the European Prospective Investigation into Cancer—Norfolk Eye Study. 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. 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. Retinal arteriolar and venular tortuosity and width. 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/m2), 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/m2), 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). 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.
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影响因子：
4.9
作者：
Ding J;Wai KL;McGeechan K;Ikram MK;Kawasaki R;Xie J;Klein R;Klein BB;Cotch MF;Wang JJ;Mitchell P;Shaw JE;Takamasa K;Sharrett AR;Wong TY;Meta-Eye Study Group
通讯作者：
Meta-Eye Study Group
影响因子：
16.2
作者：
Nguyen, Thanh Tan;Wang, Jie Jin;Wong, Tien Yin
通讯作者：
Wong, Tien Yin
影响因子：
8.2
作者：
Cheung, Carol Yim-lui;Sabanayagam, Charumathi;Wong, Tien Yin
通讯作者：
Wong, Tien Yin
影响因子：
4.1
作者：
HENKIND, P
通讯作者：
HENKIND, P
DOI：
10.1136/bmj.c6624
发表时间：
2010-12-09
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Hippisley-Cox J;Coupland C;Robson J;Brindle P
通讯作者：
Brindle P