Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Australia.
Microcirculation. 2010 Jan;17(1):21-31. doi: 10.1111/j.1549-8719.2009.00007.x.
Low birth weight is an indicator of exposure to unfavorable fetal environment and has been associated with the development of hypertension and cardiovascular disease in adulthood. There is now growing evidence suggesting that alterations in the microcirculation associated with exposure to a suboptimal in utero environment play a key role in the development of cardiovascular disease. Proposed hypothetical mechanisms include: fetal circulatory redistribution, impaired synthesis of elastin, and endothelial dysfunction in response to antenatal and postnatal environment. More recent studies have shown associations of low birth weight with capillary rarefaction and narrowing retinal arteriolar caliber in both children and adults. This suggests that vascular adaptations in utero persist into maladaptive circulatory changes in adulthood, which may reflect an increased susceptibility to hypertension and cardiovascular disease later in life. Therefore, the association between low birth weight and narrower retinal arteriolar caliber, together with associations between narrower retinal arteriolar caliber and risk of hypertension and cardiovascular disease, suggest that retinal arteriolar narrowing may be a marker on the microvascular pathway and mechanisms linking early life exposures and subsequent cardiovascular disease.
低出生体重是暴露于不良胎儿环境的指标，与成年后患高血压和心血管疾病有关。现在越来越多的证据表明，与暴露于不理想的宫内环境相关的微循环改变在心血管疾病的发展中起着关键作用。提出的假设机制包括：胎儿循环再分配、弹性蛋白合成受损以及对产前和产后环境的内皮功能障碍。最近的研究表明，低出生体重与儿童和成人的毛细血管稀疏以及视网膜小动脉直径变窄有关。这表明宫内血管适应会持续到成年后的适应性循环变化，这可能反映出以后生活中患高血压和心血管疾病的易感性增加。因此，低出生体重与视网膜小动脉直径变窄之间的关联，以及视网膜小动脉直径变窄与高血压和心血管疾病风险之间的关联，表明视网膜小动脉狭窄可能是微血管途径和将早期生活暴露与随后的心血管疾病联系起来的机制的标志物。
