The Generation R Study Group, Department of Pediatrics, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
The Generation R Study Group, Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands;
Pediatrics. 2015 Apr;135(4):678-85. doi: 10.1542/peds.2014-3341. Epub 2015 Mar 9.
Alterations in retinal microvasculature are associated with increased risk of cardiovascular disease. We examined the associations of retinal vessel caliber with cardiovascular markers in school-age children.
Among 4007 school-age children (median age of 6.0 years), we measured cardiovascular markers and retinal vessel calibers from digitized retinal photographs.
Narrower retinal arteriolar caliber was associated with higher systolic and diastolic blood pressure (-0.20 SD score [SDS] [95% confidence interval (CI) -0.24 to -0.18] and -0.14 SDS [-0.17 to -0.11], respectively, per SDS increase in retinal arteriolar caliber), mean arterial pressure, and pulse pressure, but not with carotid-femoral pulse wave velocity, heart rate, cardiac output, or left ventricular mass. A wider retinal venular caliber was associated with lower systolic blood pressure, mean arterial pressure, and pulse pressure and higher carotid-femoral pulse wave velocity (carotid-femoral pulse wave velocity difference = 0.04 SDS [95% CI 0.01 to 0.07] per SDS increase in retinal venular caliber). Both narrower retinal arteriolar and venular calibers were associated with higher risk of hypertension at the age of 6 years, with the strongest association for retinal arteriolar caliber (odds ratio 1.35 [95% CI 1.21 to 1.45] per SDS decrease in arteriolar caliber). Adjustment for parental and infant sociodemographic factors did not influence the observed associations.
Both retinal arteriolar and venular calibers are associated with blood pressure in school-age children, whereas retinal venular caliber is associated with carotid-femoral pulse wave velocity. Microvascular adaptations in childhood might influence cardiovascular health and disease from childhood onward.
视网膜微血管的改变与心血管疾病风险的增加有关。我们研究了在校儿童视网膜血管口径与心血管标志物之间的关系。
在 4007 名在校儿童（平均年龄为 6.0 岁）中，我们从数字化视网膜照片中测量了心血管标志物和视网膜血管口径。
视网膜小动脉口径较窄与收缩压和舒张压较高相关（每增加 0.20 个标准差分数（SDS）[95%置信区间（CI）为 0.24 至 -0.18]和 -0.14 SDS [-0.17 至 -0.11]）、平均动脉压和脉压，但与颈动脉-股动脉脉搏波速度、心率、心输出量或左心室质量无关。视网膜小静脉口径较宽与收缩压、平均动脉压和脉压较低以及颈动脉-股动脉脉搏波速度较高相关（颈动脉-股动脉脉搏波速度差异=0.04 SDS [95% CI 0.01 至 0.07]，每增加 0.01 SDS 的视网膜小静脉口径）。视网膜小动脉和小静脉口径较窄均与 6 岁时高血压的风险增加相关，而视网膜小动脉口径的相关性最强（每 SDS 减少，比值比为 1.35 [95% CI 1.21 至 1.45]）。调整父母和婴儿的社会人口统计学因素并不影响观察到的关联。
在校儿童的视网膜小动脉和小静脉口径均与血压相关，而视网膜小静脉口径与颈动脉-股动脉脉搏波速度相关。儿童期的微血管适应性可能会影响儿童期以后的心血管健康和疾病。
