Are retinal arteriolar abnormalities related to atherosclerosis? The atherosclerosis risk in communities study
Are retinal arteriolar abnormalities related to atherosclerosis? The atherosclerosis risk in communities study
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DOI：
10.1161/01.atv.20.6.1644
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发表时间：
2000-06-01
影响因子：
8.7
通讯作者：
Evans, G
中科院分区：
文献类型：
--
作者：
Klein, R;Sharrett, AR;Evans, G
本研究的目的是描述视网膜小动脉异常与动脉粥样硬化的临床和亚临床表现以及一组广泛的血管疾病危险因素之间的关系。1993年至1995年对4个社区的8772名成年人（48 - 72岁）进行了调查。视网膜动静脉切口和局灶性小动脉狭窄通过使用标准化方案的45度眼底照片的灯箱分级来确定。在数字化照片中测量小动脉和小静脉的直径，并得出概括的小动脉与小静脉比率作为全身性小动脉狭窄的指标，局灶性小动脉狭窄仅与高血压相关，全身性小动脉狭窄与颈动脉斑块相关，但与任何其他动脉粥样硬化证据无关，临床（心血管疾病或中风）或亚临床（颈动脉或腘动脉厚度或下肢阻塞性疾病）或血浆胆固醇。它还与吸烟、炎症标志物（白色血细胞计数、纤维蛋白原和白蛋白减少）以及与炎症相关的甘油三酯和高密度脂蛋白胆固醇变化相关。动静脉切口与亚临床动脉粥样硬化的相关性不一致，与心血管疾病、中风或血浆胆固醇无关。动静脉切迹与炎症和血管内皮功能障碍的标志物（von Willebrand因子和因子VIII）相关，小动脉狭窄和切迹似乎与高血压和炎症因子相关。切口也可能与内皮功能障碍有关。结果表明，这些小动脉变化在病理上不同于动脉粥样硬化。在人群研究中包括它们的测量可能允许评估小动脉疾病对心脏、大脑和其他器官的各种缺血性疾病的独立贡献。
The objective of this study was to describe associations of retinal arteriolar abnormalities with clinical and subclinical manifestations of atherosclerosis and a broad group of risk factors for vascular disease. A biracial population of 8772 adults (aged 48 to 72 years) living in 4 communities was examined from 1993 to 1995 were studied for that purpose. Retinal arteriovenous nicking and focal arteriolar narrowing were determined by light-box grading of a 45 degrees fundus photograph by use of a standardized protocol. Diameters of arterioles and venules were measured in digitized photographs, and a summary arteriolar-to-venular ratio was derived as an index of generalized arteriolar narrowing, Focal arteriolar narrowing was associated only with hypertension, Generalized arteriolar narrowing was associated with carotid plaque but not with any other evidence of atherosclerosis, either clinical (cardiovascular disease or stroke) or subclinical (carotid or popliteal artery thickness or lower limb obstructive disease), or with plasma cholesterol. It was also associated with smoking, with inflammatory markers (white blood cell count, fibrinogen, and reduced albumin), and with the triglyceride and high density lipoprotein cholesterol changes associated with inflammation. Arteriovenous nicking was inconsistently associated with subclinical atherosclerosis, It was not associated with cardiovascular disease, stroke, or plasma cholesterol. Arteriovenous nicking was associated with markers of inflammation and vascular endothelial dysfunction (von Willebrand factor and factor VIII), Arteriolar narrowing and nicking appear to be related to hypertension and inflammatory factors. Nicking may also be related to endothelial dysfunction, Results suggest that these arteriolar changes are pathologically distinct from atherosclerosis. Including their measurement in population studies may permit evaluation of the independent contribution of arteriolar disease to various ischemic diseases of the heart, brain, and other organs.