肥胖与微血管：系统评价和荟萃分析。

BACKGROUND

Overweight and obesity are thought to significantly influence a person's risk of cardiovascular disease, possibly via its effect on the microvasculature. Retinal vascular caliber is a surrogate marker of microvascular disease and a predictor of cardiovascular events. The aim of this systematic review and meta-analysis was to determine the association between body mass index (BMI) and retinal vascular caliber.

METHODS AND FINDINGS

Relevant studies were identified by searches of the MEDLINE and EMBASE databases from 1966 to August 2011. Standardized forms were used for data extraction. Among over 44,000 individuals, obese subjects had narrower arteriolar and wider venular calibers when compared with normal weight subjects, independent of conventional cardiovascular risk factors. In adults, a 1 kg/m(2) increase in BMI was associated with a difference of 0.07 μm [95% CI: -0.08; -0.06] in arteriolar caliber and 0.22 μm [95% CI: 0.21; 0.23] in venular caliber. Similar results were found for children.

CONCLUSIONS

Higher BMI is associated with narrower retinal arteriolar and wider venular calibers. Further prospective studies are needed to examine whether a causative relationship between BMI and retinal microcirculation exists.

背景

超重和肥胖被认为会显著影响一个人患心血管疾病的风险，其可能通过对微血管的影响而产生作用。视网膜血管直径是微血管疾病的替代标志物，也是心血管事件的预测因子。本系统评价和荟萃分析的目的是确定体重指数（BMI）与视网膜血管直径之间的关系。

方法和发现

通过对 1966 年至 2011 年 8 月 MEDLINE 和 EMBASE 数据库的检索，确定了相关研究。使用标准化表格进行数据提取。在超过 44000 名个体中，与正常体重者相比，肥胖者的小动脉和小静脉直径更窄，且独立于传统心血管危险因素。在成年人中，BMI 每增加 1 kg/m(2)，小动脉直径的差异为 0.07 μm [95% CI: -0.08; -0.06]，小静脉直径的差异为 0.22 μm [95% CI: 0.21; 0.23]。在儿童中也发现了类似的结果。