Cardiovascular Prevention Unit, Department of Endocrinology and Metabolism, APHP.6 Sorbonne University, Paris, France.
INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Sorbonne Université, 75006, Paris, France.
Clin Res Cardiol. 2021 Jul;110(7):959-970. doi: 10.1007/s00392-020-01680-3. Epub 2020 Jun 3.
Ageing, hypertension and diabetes have an intricate effect on microvascular structure. In the retina, the respective contribution of remodeling and hypertrophy in such process is still unclear. We aimed at disentangling age, blood pressure and glycaemia effects on retinal microcirculation using the non-invasive adaptive optics ophthalmoscopy (AOO).
We included 429 subjects, distributed into 4 groups according to normal (nBP) or high blood pressure (hBP) and/or normal (nGly) or high fasting glycaemia (hGly). The nBP/nGly group was stratified in age tertiles to isolate the effect of ageing. AOO was used to measure arteriolar wall thickness (WT, µm), arteriolar (aID, µm) and venular internal diameter (vID, µm) and calculate arteriolar wall-to-lumen ratio (WLR), wall cross-sectional area (WCSA, µm). One-way ANOVA for parametric variables and Kruskal-Wallis test for non-parametric variables were used for comparison among groups. A multivariate regression analysis including age, gender, BP, hGly and antihypertensive treatment was performed to calculate independent predictors of retinal remodeling.
WT was increased with ageing (tertile1: 22.5 ± 3.2, tertile2: 24.2 ± 3.5, tertile 3: 25.2 ± 3.8, p = 0.001) and BP (hBP: 25.2 ± 4.1 vs nBP: 23.9 ± 3.7, p = 0.003). aID decreased with BP (hBP: 90.2 ± 13.4 vs nBP: 93.6 ± 11.6, p = 0.013) and increased with glycaemia (hGly: 97.7 ± 12.5 vs nGly: 93.6 ± 11.6, p = 0.002). A multivariate analysis showed independent association of hBP with WLR; hGly with WCSA; ageing with WLR and WCSA.
AOO non-invasively identifies retinal structural changes in human confirming that microvascular remodeling is exclusively related to hypertension, whereas vascular growth is related to ageing and hyperglycaemia.
衰老、高血压和糖尿病对微血管结构有复杂的影响。在视网膜中，重塑和肥大在这个过程中的各自贡献仍不清楚。我们旨在使用非侵入性自适应光学眼底镜 (AOO) 来解析年龄、血压和血糖对视网膜微循环的影响。
我们纳入了 429 名受试者，根据正常血压 (nBP) 或高血压 (hBP) 以及正常血糖 (nGly) 或高空腹血糖 (hGly) 将其分为 4 组。将 nBP/nGly 组按年龄三分位分层，以分离衰老的影响。使用 AOO 测量小动脉壁厚度 (WT，µm)、小动脉内直径 (aID，µm) 和小静脉内直径 (vID，µm)，并计算小动脉壁腔比 (WLR)、血管壁横截面积 (WCSA，µm)。对于参数变量使用单向方差分析，对于非参数变量使用 Kruskal-Wallis 检验进行组间比较。进行多元回归分析，包括年龄、性别、BP、hGly 和降压治疗，以计算视网膜重塑的独立预测因子。
WT 随年龄增长而增加（三分位 1：22.5±3.2，三分位 2：24.2±3.5，三分位 3：25.2±3.8，p=0.001）和血压（hBP：25.2±4.1 vs nBP：23.9±3.7，p=0.003）。aID 随血压降低（hBP：90.2±13.4 vs nBP：93.6±11.6，p=0.013）和血糖升高（hGly：97.7±12.5 vs nGly：93.6±11.6，p=0.002）而降低。多元分析显示，hBP 与 WLR 独立相关；hGly 与 WCSA 独立相关；年龄与 WLR 和 WCSA 独立相关。
AOO 无创性地识别了人类视网膜的结构变化，证实了微血管重塑仅与高血压有关，而血管生长与衰老和高血糖有关。
