视网膜血管异常及其与心脑血管疾病的关联：中国哈尔滨西南部农村的一项研究。
Retinal vascular abnormalities and their associations with cardiovascular and cerebrovascular diseases: a Study in rural southwestern Harbin, China.
机构信息
Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China.
Department of Pharmacology, College of Pharmacy, Harbin Medical University, Harbin, China.
出版信息
BMC Ophthalmol. 2020 Apr 6;20(1):136. doi: 10.1186/s12886-020-01407-y.
BACKGROUND
Limited data is available on retinal vessel morphology in the north China. The study aimed to evaluate the prevalence of retinal vascular abnormalities (RVAs) and investigate their associations with the self-reported diagnosis of cardiovascular and cerebrovascsular diseases (CCVds) in a rural adult population of northeast China.
METHODS
A population-based, cross-sectional study was conducted, using the cluster random sampling method. One eye of each participant was photographed with a non-mydriatic fundus camera. RVAs including focal and general arteriolar narrowing (FAN and GAN), arteriovenous nicking (AVN), arteriolar sheathing (AS), and retinopathy were evaluated. Data on self-reported diagnosis of cardiovascular and cerebrovascular diseases and status of smoking and alcohol drinking were obtained from questionnaires.
RESULTS
Among the 6267 participants with an age ≥ 50 years, photographs were obtained of 99.2%, with quality sufficient to perform retinal evaluations in 82.5%. The prevalence of FAN, AVN, AS, retinopathy and GAN were 9.1, 8.9, 5.0, 6.6 and 6.2%, respectively. All the retinal lesions were associated with hypertension (all P < 0.01). After adjusting for age, gender, and left/right eyes, hypertension, hyperlipidaemia, diabetes mellitus, habits of past or current smoking and alcohol consumption, AVN was strongly associated with the self-reported diagnosis histories of coronary heart diseases(CHD) (OR, 1.44; 95% CI, 1.09, 1.89) and retinopathy was significantly associated with a self-reported diagnosis of stroke (OR, 2.05; 95% CI, 1.18, 3.57).
CONCLUSIONS
The overall prevalence of retinal microvascular abnormalities in this population was relatively higher than that reported in other regions of the world. Retinopathy is associated with the self-reported diagnosis of stroke while AVN was associated with the self-reported diagnosis of CHD, but the remaining retinal lesions were not consistently associated with CCVds. Thus, an examination of retinal microvascular characteristics may offer clues to CCVds and could be a potentially novel biomarkers for CCVds risk.
背景
有关中国北方视网膜血管形态的资料有限。本研究旨在评估东北农村成年人群视网膜血管异常（RVA）的发生率，并探讨其与心血管和脑血管疾病（CCVd）自我报告诊断之间的关系。
方法
采用整群随机抽样方法进行了一项基于人群的横断面研究。使用非散瞳眼底照相机拍摄每位参与者的一只眼睛。评估了包括局灶性和普遍性小动脉狭窄（FAN 和 GAN）、动静脉缩窄（AVN）、小动脉鞘（AS）和视网膜病变在内的 RVA。从调查问卷中获得了心血管和脑血管疾病的自我报告诊断以及吸烟和饮酒状况的数据。
结果
在 6267 名年龄≥50 岁的参与者中，有 99.2%的人拍摄了照片，其中 82.5%的照片质量足以进行视网膜评估。FAN、AVN、AS、视网膜病变和 GAN 的患病率分别为 9.1%、8.9%、5.0%、6.6%和 6.2%。所有视网膜病变均与高血压有关（均 P<0.01）。在校正年龄、性别和左右眼后，高血压、高脂血症、糖尿病、过去或现在的吸烟和饮酒习惯，AVN 与冠心病（CHD）的自我报告诊断史强烈相关（OR，1.44；95%CI，1.09，1.89），而视网膜病变与中风的自我报告诊断显著相关（OR，2.05；95%CI，1.18，3.57）。
结论
在该人群中，视网膜微血管异常的总体患病率相对高于世界其他地区的报告。视网膜病变与中风的自我报告诊断有关，而 AVN 与 CHD 的自我报告诊断有关，但其余视网膜病变与 CCVd 不一致相关。因此，对视网膜微血管特征的检查可能为 CCVd 提供线索，并可能成为 CCVd 风险的潜在新型生物标志物。
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