Van Aart C J C, Michels N, Sioen I, De Decker A, Nawrot T S, De Henauw S
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
Int J Obes (Lond). 2017 Apr;41(4):527-532. doi: 10.1038/ijo.2016.226. Epub 2016 Dec 23.
Microvascular changes may represent an underlying mechanism through which overweight contributes to cardiovascular disease development. Therefore, the aim of this study was to investigate whether changes in children's body fat over time are associated with the retinal microvasculature, a marker of cardiovascular aging.
In a longitudinal design, 171 healthy Flemish children (53.8% boys) were followed-up for 7 years (2008-2015), aged 2.7-8.1 years at baseline.Z-scores of body mass index (zBMI; 4.1% overweight), waist circumference (zWC) and fat mass index (zFMI by BODPOD) were obtained using standardized protocols during each visit. Retinal arteriolar (central retinal arteriolar equivalent (CRAE)) and venular equivalents (central retinal venular equivalent (CRVE)) were measured from digital retinal photographs (2015) using IVAN software. Cross-sectional and longitudinal associations between changes in body fat and retinal microvasculature were explored using multivariable regression analysis, while controlling for age, sex, mean arterial pressure, alternate retinal caliber, physical activity, diet and birth weight.
In cross-sectional analysis, children with high zFMI had a higher CRVE, but only in boys (β=0.25, P=0.02). In addition, boys with high zFMI had also a lower CRAE to CRVE ratio (β=-0.26, P=0.03). No associations were seen with the CRAE, or between zBMI or zWC and the retinal microvasculature. Only changes in zFMI over time were found to be positively associated with the CRVE in boys (β=0.38, P=0.01).
Our analysis over a 7-year period shows that changes in body fat during childhood are already associated with the CRVE (especially in boys).
微血管变化可能是超重导致心血管疾病发生的潜在机制。因此，本研究旨在调查儿童体脂随时间的变化是否与视网膜微血管系统相关，视网膜微血管系统是心血管衰老的一个标志物。
采用纵向设计，对171名健康的佛兰芒儿童（53.8%为男孩）进行了7年（2008 - 2015年）的随访，基线时年龄为2.7 - 8.1岁。每次随访时使用标准化方案获取体重指数Z评分（zBMI；4.1%超重）、腰围Z评分（zWC）和脂肪量指数（通过BODPOD测量的zFMI）。使用IVAN软件从数字视网膜照片（2015年）中测量视网膜小动脉（视网膜中央动脉等效直径（CRAE））和小静脉等效直径（视网膜中央静脉等效直径（CRVE））。在控制年龄、性别、平均动脉压、交替视网膜管径、身体活动、饮食和出生体重的同时，使用多变量回归分析探讨体脂变化与视网膜微血管系统之间的横断面和纵向关联。
在横断面分析中，zFMI高的儿童CRVE较高，但仅在男孩中如此（β = 0.25，P = 0.02）。此外，zFMI高的男孩CRAE与CRVE的比值也较低（β = -0.26，P = 0.03）。未发现CRAE、zBMI或zWC与视网膜微血管系统之间存在关联。仅发现男孩中zFMI随时间的变化与CRVE呈正相关（β = 0.38，P = 0.01）。
我们为期7年的分析表明，儿童期体脂变化已与CRVE相关（尤其是在男孩中）。
