Intern Med J. 2012 Sep;42(9):1014-22. doi: 10.1111/j.1445-5994.2011.02470.x.
Microvascular changes have been associated with the metabolic syndrome.
We included 869 participants aged ≥ 40 years from the High-risk for Diabetes Changfeng Study, who had gradable fundus photographs. On digital photographs sum retinal arteriolar and venular calibers were measured with a semi-automated system. Metabolic syndrome was defined according to the International Diabetes Federation consensus.
A total of 286 (32.9%) participants was diagnosed with metabolic syndrome. Participants with narrower retinal arteriolar caliber were more often diagnosed with metabolic syndrome (odds ratio 1.78, 95% confidence interval 1.02 – 3.10; lowest vs highest quintile). Additionally adjusting for age, gender, education, smoking and weekly activity, and adding arteriolar and venular caliber simultaneously in the same models did not alter these associations. In the component analyses, participants with narrower retinal arteriolar caliber were more likely to have central obesity, dyslipidaemia or raised blood pressure, and less likely to have raised fasting plasma glucose. The association between wider venular caliber and metabolic syndrome was less pronounced and non-significant (odds ratio 1.34; 95% confidence interval 0.79 – 2.38; highest vs lowest quintile).
Retinal arteriolar narrowing and, to a lesser extent, retinal venular dilatation were associated with metabolic syndrome in this Chinese population. These vascular changes, although small in magnitude, may still be important in the pathophysiological mechanisms involved in the metabolic syndrome.
微血管变化与代谢综合征有关。
我们纳入了来自中国糖尿病高危人群 Changfeng 研究的 869 名年龄≥40 岁的参与者,他们有可分级的眼底照片。在数字照片上,使用半自动系统测量视网膜小动脉和小静脉的直径。代谢综合征根据国际糖尿病联合会共识进行定义。
共有 286 名(32.9%)参与者被诊断为代谢综合征。视网膜小动脉直径较窄的参与者更常被诊断为代谢综合征(比值比 1.78,95%置信区间 1.02-3.10;最低五分位与最高五分位相比)。此外,在调整年龄、性别、教育程度、吸烟和每周活动量后,同时在相同模型中加入小动脉和小静脉直径,也不会改变这些关联。在成分分析中,视网膜小动脉直径较窄的参与者更有可能患有中心性肥胖、血脂异常或血压升高,而不太可能出现空腹血糖升高。视网膜小静脉直径变宽与代谢综合征的相关性较弱且不显著(比值比 1.34;95%置信区间 0.79-2.38;最高五分位与最低五分位相比)。
在本中国人群中,视网膜小动脉狭窄,以及在较小程度上,视网膜小静脉扩张,与代谢综合征相关。这些血管变化虽然幅度较小,但在代谢综合征相关的病理生理机制中可能仍然很重要。