Yang Jing Yan, Yang Xuan, Li Yang, Xu Jie, Zhou Yong, Wang An Xin, Gao Xiang, Xu Liang, Wu Shou Ling, Wei Wen Bin, Zhao Xing Quan, Jonas Jost B
Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
PLoS One. 2016 Dec 1;11(12):e0166993. doi: 10.1371/journal.pone.0166993. eCollection 2016.
To assess relationships between carotid artery atherosclerosis and retinal arteriolar and venular diameters.
The community-based longitudinal Asymptomatic Polyvascular Abnormalities Community Study (APAC) included a sub-population of the Kailuan study which consisted of 101,510 employees and retirees of a coal mining industry. Based on the Chinese National Census 2010 and excluding individuals with history of cerebrovascular ischemic events, 4004 individuals were included into the APAC. All participants underwent a detailed clinical examination including blood laboratory tests and carotid artery duplex ultrasound examination. The cerebrospinal fluid pressure (CSFP) was estimated using the formula: CSFP[mmHg] = 0.44xBody Mass Index[kg/m2]+0.16xDiastolic Blood Pressure[mmHg]-0.18 x Age[Years]-1.91.
In multivariable analysis (goodness of fit r2:0.12), thicker retinal arteries were associated with a thinner common carotid artery intima-media thickness (IMT) (P = 0.002; standardized regression coefficient beta:-0.06; non-standardized regression coefficient B:-6.92;95% confidence interval (CI):-11.2,-2.61) after adjusting for thicker retinal nerve fiber layer (P<0.001;beta:0.18;B:0.35;95%CI:0.28,0.42), lower diastolic blood pressure (P<0.001;beta:-0.16;B:-0.17;95%CI:-0.21,-0.3), younger age (P<0.001;beta:-0.08; B:-0.16;95%;CI:-0.25,-0.08), and less abdominal circumference (P = 0.003;beta:-0.06;B:-0.11;95%CI:-0.18,-0.03). Thicker retinal vein diameter was associated (r = 0.40) with higher estimated CSFP (P<0.001;beta:0.09;B:0.78;95%CI:0.47,1.08) after adjusting for wider retinal arteries (P<0.001;beta:0.27;B:0.36;95%CI:0.31,0.41), thicker retinal nerve fiber layer thickness (P = 0.03;beta:0.22;B:0.56;95%CI:0.46,0.65) and male gender (P<0.001;beta:-0.08;B:-3.98;95%CI:-5.88,2.09).
Thinner retinal artery diameter was significantly, however weakly, associated with increased common carotid artery IMT. It suggests that retinal microvascular changes were only week indicators for an atherosclerotic carotid artery pathology. Thicker retinal vein diameter was associated with higher estimated CSFP, confirming associations between higher estimated CSFP and higher incidence of retinal vein occlusion.
评估颈动脉粥样硬化与视网膜动静脉直径之间的关系。
基于社区的纵向无症状多血管异常社区研究（APAC）纳入了开滦研究的一个亚组人群，该亚组由某煤炭行业的101,510名员工和退休人员组成。根据2010年中国全国人口普查数据，并排除有脑血管缺血事件病史的个体，4004人被纳入APAC。所有参与者均接受了详细的临床检查，包括血液实验室检测和颈动脉双功超声检查。脑脊液压力（CSFP）采用以下公式估算：CSFP[mmHg]=0.44×体重指数[kg/m²]+0.16×舒张压[mmHg]-0.18×年龄[岁]-1.91。
在多变量分析中（拟合优度r²：0.12），在调整了较厚的视网膜神经纤维层（P<0.001；β：0.18；B：0.35；95%置信区间（CI）：0.28,0.42）、较低的舒张压（P<0.001；β：-0.16；B：-0.17；95%CI：-0.21,-0.3）、较年轻的年龄（P<0.001；β：-0.08；B：-0.16；95%CI：-0.25,-0.08）和较小的腹围（P = 0.003；β：-0.06；B：-0.11；95%CI：-0.18,-0.03）后，较厚的视网膜动脉与较薄的颈总动脉内膜中层厚度（IMT）相关（P = 0.002；标准化回归系数β：-0.06；非标准化回归系数B：-6.92；95%CI：-11.2,-2.61）。在调整了较宽的视网膜动脉（P<0.001；β：0.27；B：0.36；95%CI：0.31,0.41）、较厚的视网膜神经纤维层厚度（P = 0.03；β：0.22；B：0.56；95%CI：0.46,0.65）和男性性别（P<0.001；β：-0.08；B：-3.98；95%CI：-5.88,2.09）后，较厚的视网膜静脉直径与较高的估算CSFP相关（r = 0.40）（P<0.001；β：0.09；B：0.78；95%CI：0.47,1.08）。
较细的视网膜动脉直径与颈总动脉IMT增加显著相关，但相关性较弱。这表明视网膜微血管变化只是颈动脉粥样硬化病变的弱指标。较厚的视网膜静脉直径与较高的估算CSFP相关，证实了较高的估算CSFP与视网膜静脉阻塞较高发生率之间的关联。
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