Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.
Health Support Center WELPO, Toyota Motor Corporation.
J Atheroscler Thromb. 2022 Jan 1;29(1):11-23. doi: 10.5551/jat.59857. Epub 2020 Nov 25.
Small arteries can be visualized in the ocular fundus, and findings of retinopathy based on Scheie classification are often applied to evaluate the impact of hypertension and atherosclerosis. However, the relationship between damage in the large and small arteries has not been investigated sufficiently, especially in the early stages. The present study investigated possible associations between large artery atherosclerosis and small artery retinopathy in untreated middle-aged individuals.
Untreated middle-aged workers undergoing periodic health check-ups (n=7,730, 45±8 years) were enrolled in this study. The absence or presence and extent of retinopathy were characterized by ophthalmologists as hypertensive (H0-4) and atherosclerotic grades (S0-4) based on Scheie classification. Large artery atherosclerosis was examined based on functional assessment of the cardio-ankle vascular index (CAVI) and morphological assessment of the carotid intima-media thickness (IMT) by ultrasound.
We found significant differences in CAVI and carotid IMT between individuals with and without hypertensive or atherosclerotic retinopathy. Multivariable regression analysis showed that the presence of hypertensive and atherosclerotic retinopathy was significantly associated with CAVI and carotid IMT. Logistic regression analysis with the endpoint of a hypertensive or atherosclerotic lesion revealed that CAVI and carotid IMT are independent determinants of retinopathy.
CAVI and carotid IMT were significantly associated with the presence of retinopathy based on Scheie classification in untreated middle-aged subjects, implying that atherosclerotic examination in large arteries could reveal early-stage small artery retinopathy.
眼底可观察到小动脉，根据 Scheie 分类的视网膜病变发现常用于评估高血压和动脉粥样硬化的影响。然而，大、小动脉之间的关系尚未得到充分研究，尤其是在早期阶段。本研究旨在探讨未经治疗的中年人群中大动脉粥样硬化与小动脉视网膜病变之间的可能关联。
本研究纳入了未经治疗的中年工作者（n=7730，45±8 岁）进行定期健康检查。眼科医生根据 Scheie 分类将视网膜病变的有无和程度描述为高血压（H0-4）和动脉粥样硬化程度（S0-4）。大动脉粥样硬化通过心血管踝血管指数（CAVI）的功能评估和颈动脉内膜中层厚度（IMT）的形态评估来检查。
我们发现存在高血压或动脉粥样硬化性视网膜病变的个体与无高血压或动脉粥样硬化性视网膜病变的个体之间，CAVI 和颈动脉 IMT 存在显著差异。多变量回归分析显示，高血压和动脉粥样硬化性视网膜病变的存在与 CAVI 和颈动脉 IMT 显著相关。以高血压或动脉粥样硬化病变为终点的逻辑回归分析表明，CAVI 和颈动脉 IMT 是视网膜病变的独立决定因素。
在未经治疗的中年受试者中，CAVI 和颈动脉 IMT 与 Scheie 分类的视网膜病变存在显著相关，这表明大动脉粥样硬化检查可揭示早期小动脉视网膜病变。
