Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Germany.
J Hypertens. 2009 Nov;27(11):2201-8. doi: 10.1097/HJH.0b013e32833013fd.
We hypothesized that wall-to-lumen ratio (WLR) of retinal arterioles might serve as an in-vivo parameter of vascular damage. To test this hypothesis we examined whether WLR of retinal arterioles is related with increased urinary albumin excretion and altered vascular reactivity to infusion of the nitric oxide synthase inhibitor N-monomethyl-L-arginine (L-NMMA).
Thirty-nine never-treated male patients aged 18-65 years with a body mass index at least 25 kg/m(2) and without diabetes mellitus or secondary or stage 3 arterial hypertension were examined. WLR of retinal arterioles was assessed using scanning laser Doppler flowmetry. Urinary albumin-to-creatinine ratio (UACR) was measured from first morning spot urine. Vascular reactivity was measured by the change of aortic augmentation index (aAIx) to infusion of L-NMMA.
UACR was related with WLR of retinal arterioles (r = 0.352, P = 0.032). In response to L-NMMA infusion aAIx increased (from 10.7 +/- 11 to 19.7 +/- 11%, P < 0.001). The change of aAIx to L-NMMA infusion was inversely related with WLR of retinal arterioles (r = -0.462, P = 0.003) even after adjustment for changes of hemodynamic parameters to L-NMMA infusion (partial r = -0.475, P = 0.005). The relationships of UACR and the change of aAIx to L-NMMA infusion with WLR of retinal arterioles were found to be independently of other cardiovascular risk factors (ss = 0.386, P = 0.006; ss = -0.369, P = 0.004, respectively) in multiple regression analyses with separate models for both parameters.
Increased WLR of retinal arterioles may thus serve as an in-vivo marker of vascular damage.
我们假设视网膜小动脉的壁腔比（WLR）可能作为血管损伤的体内参数。为了验证这一假设，我们研究了视网膜小动脉的 WLR 是否与尿白蛋白排泄增加和血管对一氧化氮合酶抑制剂 N-单甲基-L-精氨酸（L-NMMA）输注的反应性改变有关。
检查了 39 名未经治疗的年龄在 18-65 岁之间的男性患者，这些患者的体重指数至少为 25kg/m(2)，且无糖尿病或继发性或 3 期动脉高血压。使用扫描激光多普勒血流仪评估视网膜小动脉的 WLR。从第一次晨尿中测量尿白蛋白/肌酐比值（UACR）。通过 L-NMMA 输注测量主动脉增强指数（aAIx）的变化来测量血管反应性。
UACR 与视网膜小动脉的 WLR 相关（r=0.352，P=0.032）。在 L-NMMA 输注后，aAIx 增加（从 10.7 +/- 11 增加到 19.7 +/- 11%，P < 0.001）。L-NMMA 输注后 aAIx 的变化与视网膜小动脉的 WLR 呈负相关（r=-0.462，P=0.003），即使在校正了对 L-NMMA 输注的血流动力学参数的变化后（部分 r=-0.475，P=0.005）。在多元回归分析中，使用两个参数的单独模型，UACR 和 aAIx 对 L-NMMA 输注的变化与视网膜小动脉的 WLR 之间的关系被发现是独立于其他心血管危险因素的（ss=0.386，P=0.006；ss=-0.369，P=0.004）。
因此，视网膜小动脉的 WLR 增加可能作为血管损伤的体内标志物。
