Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.
Microcirculation. 2010 Nov;17(8):660-8. doi: 10.1111/j.1549-8719.2010.00062.x.
In the current study, we aimed to examine the associations of low birth weight with retinal vascular caliber and vascular fractal dimension during early adolescence.
A population-based study of 12-year-old schoolchildren (2353/3144 [75.3%]) recruited from a random cluster sample of 21 schools. Birth weight, birth length and head circumference were obtained via parent report of the child's birth record. Retinal images were taken and vessel diameter and fractal dimension were quantified using validated computer-based methods.
After adjusting for age, sex, ethnicity, body mass index, iris color, axial length, mean arterial blood pressure, prematurity and fellow retinal vascular caliber, children in the lowest quartiles of birth weight had ∼2.5 μm narrower mean retinal arteriolar caliber than those in the highest quartiles (p for trend = 0.001). Associations were observed between shorter birth length and smaller head circumference with narrower retinal arterioles. Smaller head circumference was associated with decreased fractal dimension (p for trend = 0.03).
Children with lower birth weight were more likely to have narrower retinal arterioles, while those with smaller head circumference were more likely to have reduced complexity of their retinal microvasculature. These variations in microvascular structure in adolescence could reflect a susceptibility to cardiovascular disease during adulthood, resulting from a disadvantaged growth environment in utero.
本研究旨在探讨青少年早期低出生体重与视网膜血管口径和血管分形维数的相关性。
本研究采用基于人群的研究方法，选取了来自 21 所学校的随机聚类样本中的 12 岁学龄儿童（2353/3144[75.3%]）。通过询问儿童的出生记录，获取出生体重、出生身长和头围。使用经过验证的基于计算机的方法获取视网膜图像，并对血管直径和分形维数进行量化。
在校正年龄、性别、种族、体重指数、虹膜颜色、眼轴长度、平均动脉血压、早产和对侧视网膜血管口径等因素后，出生体重最低四分位数的儿童视网膜小动脉平均口径比最高四分位数的儿童窄约 2.5 μm（趋势 p 值=0.001）。出生长度较短和头围较小与视网膜小动脉变窄有关。头围较小与分形维数降低有关（趋势 p 值=0.03）。
出生体重较低的儿童更有可能出现视网膜小动脉狭窄，而头围较小的儿童更有可能出现视网膜微血管复杂性降低。这些青春期微血管结构的变化可能反映了成年期心血管疾病的易感性，这是由于宫内生长环境不利所致。
