Department of Ophthalmology and Visual Sciences.
Center for Genomic Medicine, Kyoto University Graduate School of Medicine.
J Hypertens. 2018 Mar;36(3):587-593. doi: 10.1097/HJH.0000000000001602.
Morphological change in retinal vessel calibers has been reported as a marker of cardiovascular risk, but its association with arterial stiffening, a possible factor relating retinal vessel sings and cardiovascular outcomes, is not clear. The study aim was to clarify the relationship between retinal small vessel calibers and longitudinal change in large arterial stiffness in a sample of the general population.
The study included 6720 Japanese participants (52.1 ± 12.8 years). Central retinal arteriolar equivalent (CRAE) and venular equivalent were measured by fundus photography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV) at baseline and at 5 years.
The overall change in baPWV (ΔbaPWV) during a mean follow-up 1814 ± 136 days was 41 ± 131 cm/s (3.4 ± 9.9%), and was significantly increased in individuals with narrower CRAE (quartiles: Q1, 4.3 ± 10.6%; Q2, 3.3 ± 10.0%; Q3, 3.1 ± 9.3%; Q4, 3.1 ± 9.7%, P = 0.001). No significant association was observed with central retinal venular equivalent. Multivariate analysis identified CRAE as a significant inverse determinant of ΔbaPWV (β = -0.033, P = 0.006) independent of possible covariates including age, sex, blood pressure, and baseline baPWV. The association between CRAE and ΔbaPWV was prominent in a middle-aged (age Q2, β = -0.078, P = 0.002), but not younger (Q1, P = 0.232) or older (Q3, P = 0.427; Q4, P = 0.542) participants.
Narrower CRAE in middle-age was associated with the long-term risk of arteriosclerosis in a general population sample.
视网膜血管口径的形态变化已被报道为心血管风险的标志物，但它与动脉僵硬度的关系（可能与视网膜血管变化和心血管结局相关的因素）尚不清楚。本研究旨在阐明一般人群样本中视网膜小血管口径与大动脉僵硬度纵向变化之间的关系。
该研究纳入了 6720 名日本参与者（52.1±12.8 岁）。通过眼底照相测量中央视网膜小动脉等效值（CRAE）和小静脉等效值。在基线和 5 年时通过臂踝脉搏波速度（baPWV）评估动脉僵硬度。
在平均随访 1814±136 天期间，baPWV 的总体变化（ΔbaPWV）为 41±131cm/s（3.4±9.9%），CRAE 较窄的个体（四分位间距：Q1，4.3±10.6%；Q2，3.3±10.0%；Q3，3.1±9.3%；Q4，3.1±9.7%，P=0.001）的ΔbaPWV 显著增加。中央视网膜小静脉等效值与ΔbaPWV 无显著相关性。多变量分析表明，CRAE 是 ΔbaPWV 的显著负相关决定因素（β= -0.033，P=0.006），独立于可能的协变量，包括年龄、性别、血压和基线 baPWV。CRAE 与 ΔbaPWV 的相关性在中年参与者（年龄 Q2，β= -0.078，P=0.002）中较为显著，但在年轻（Q1，P=0.232）或年老（Q3，P=0.427；Q4，P=0.542）参与者中不显著。
中年时 CRAE 较窄与一般人群样本中动脉硬化的长期风险相关。
