Özen Bediz, Öztürk Hakan, Çatlı Gönül, Dündar Bumin
University of Health Sciences, Tepecik Training and Research Hospital, Clinic of Ophthalmology, İzmir, Turkey.
Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey.
J Clin Res Pediatr Endocrinol. 2018 Mar 1;10(1):13-18. doi: 10.4274/jcrpe.4810. Epub 2017 Jul 24.
Obesity affects almost all systems in the body. This includes the retinal nerve fibers which may be damaged due to a chronic inflammatory process. To determine changes in retinal nerve fiber layer (RNFL) thickness in non-diabetic children and adolescents using optical coherence tomography (OCT) and to evaluate the relationship between this change, metabolic risk factors and pubertal stage.
Thirty-eight obese and 40 healthy children and adolescents aged 10-18 years were included in the study. RNFL measurements from the optic disk and all surrounding quadrants were obtained using OCT from both eyes of the individuals in the study groups. Correlations between RNFL thickness and age, auxological measurements, pubertal stage, systolic and diastolic blood pressure, homeostasis model assessment-insulin resistance (HOMA-IR) index and lipid values were investigated.
A general decrease was observed in RNFL thickness in obese subjects compared to the controls, the decrease being highest in the inferior quadrant, although these differences were not statistically significant (p>0.05). RNFL thickness was negatively correlated with body mass index (BMI) standard deviation score (SDS) in both groups (control group r=-0.345, p=0.029; obese group r=-0.355, p=0.022). Significant negative correlations were determined between diastolic blood pressure, HOMA-IR, low density lipoprotein cholesterol level and RNFL thickness (r=-0.366, p=0.024; r=-0.394, p=0.016; and r=-0.374, p=0.022, respectively) in the obese group, while there was no association between these parameters and RNFL thickness in the control group.
In this cross-sectional study, no statistically significant difference in RNFL thicknesses between the obese and control groups was determined. However, RNFL thickness was found to decrease in both healthy and obese children as BMI-SDS values increased. Further prospective studies may be of benefit to determine whether the decrease in RNFL values might become more pronounced on long-term follow-up.
肥胖影响身体几乎所有系统。这包括视网膜神经纤维，其可能因慢性炎症过程而受损。使用光学相干断层扫描（OCT）确定非糖尿病儿童和青少年视网膜神经纤维层（RNFL）厚度的变化，并评估这种变化、代谢危险因素与青春期阶段之间的关系。
本研究纳入了38名肥胖儿童和青少年以及40名10 - 18岁的健康儿童和青少年。使用OCT从研究组个体的双眼获取视盘及其所有周边象限的RNFL测量值。研究了RNFL厚度与年龄、体格测量、青春期阶段、收缩压和舒张压、稳态模型评估 - 胰岛素抵抗（HOMA - IR）指数以及血脂值之间的相关性。
与对照组相比，肥胖受试者的RNFL厚度普遍降低，在下象限降低最为明显，尽管这些差异无统计学意义（p>0.05）。两组中RNFL厚度均与体重指数（BMI）标准差评分（SDS）呈负相关（对照组r = - 0.345，p = 0.029；肥胖组r = - 0.355，p = 0.022）。在肥胖组中，舒张压、HOMA - IR、低密度脂蛋白胆固醇水平与RNFL厚度之间存在显著负相关（分别为r = - 0.366，p = 0.024；r = - 0.394，p = 0.016；r = - 0.374，p = 0.022），而在对照组中这些参数与RNFL厚度之间无关联。
在这项横断面研究中，肥胖组和对照组之间RNFL厚度无统计学显著差异。然而，随着BMI - SDS值增加，健康和肥胖儿童的RNFL厚度均降低。进一步的前瞻性研究可能有助于确定RNFL值的降低在长期随访中是否会变得更加明显。
