Hughes Alun D, Wong Tien Y, Witt Nicholas, Evans Richard, Thom Simon A Mcg, Klein Barbara E, Chaturvedi Nish, Klein Ronald
Clinical Pharmacology, NHLI Division, International Centre for Circulatory Health, Faculty of Medicine, Imperial College London, UK.
Microcirculation. 2009 Feb;16(2):159-66. doi: 10.1080/10739680802353868.
Recent studies have shown that changes in the retinal microvasculature predict cardiovascular disease (CVD); however, little is known regarding influences on the retinal microvasculature in healthy people without overt cardiovascular or metabolic disease.
We used a semiautomated computerized technique to analyze digitized retinal photographs from a total of 167 healthy people (age range, 45-75 years; 83 female), without clinical CVD, diabetes, or hypertension, randomly sampled from the population-based Beaver Dam Eye Study. We assessed arteriolar and venular narrowing, arteriolar optimality deviation, and other quantitative aspects of the retinal microvasculature.
Arterioles were significantly narrower and longer, had wider branching angles, and were more tortuous than venules. Increased arteriolar length to diameter ratio (an index of ratio arteriolar narrowing) was positively and independently associated with older age and elevated systolic blood pressure. Arteriolar optimality deviation (an index of microvascular endothelial dysfunction) increased with greater body mass index. Current smoking and increased white blood cell (WBC) count was associated with wider venules. After controlling for smoking, WBC was no longer a significant predictor of venular diameter.
CVD risk factors are associated with retinal microvascular changes in healthy individuals without evidence of CVD, diabetes, or hypertension. CVD risk factors have different influences on the arteriolar and venular bed.
近期研究表明，视网膜微血管变化可预测心血管疾病（CVD）；然而，对于无明显心血管或代谢疾病的健康人群中视网膜微血管的影响因素知之甚少。
我们采用半自动计算机技术分析了来自基于人群的比弗代姆眼研究中随机抽取的167名健康人（年龄范围45 - 75岁；83名女性）的数字化视网膜照片，这些人无临床CVD、糖尿病或高血压。我们评估了小动脉和小静脉变窄情况、小动脉最佳状态偏差以及视网膜微血管的其他定量指标。
小动脉比小静脉明显更窄、更长，分支角度更宽，且更弯曲。小动脉长度与直径比值增加（小动脉变窄指数）与年龄增长和收缩压升高呈正相关且独立相关。小动脉最佳状态偏差（微血管内皮功能障碍指数）随体重指数增加而升高。当前吸烟和白细胞（WBC）计数增加与小静脉变宽有关。在控制吸烟因素后，WBC不再是小静脉直径的显著预测因素。
在无CVD、糖尿病或高血压证据的健康个体中，CVD危险因素与视网膜微血管变化相关。CVD危险因素对小动脉和小静脉床有不同影响。
