Breet Yolandi, Craig Ashleigh, Smith Wayne, Botha-Le Roux Shani, Gafane-Matemane Lebo F, Brits Sanette, van Rooyen Johannes M, Hanssen Henner, Kruger Ruan
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
Front Pediatr. 2021 Dec 16;9:795301. doi: 10.3389/fped.2021.795301. eCollection 2021.
Cross-talk between the macro-and microvasculature is considered an important contributor to target organ damage. Previous findings were predominantly in adult populations and investigation into this mechanism in children may provide insight into the development of early adverse vascular changes. Whether any ethnic differences in cross-talk is evident, also remains to be determined. To determine whether retinal microvascular diameters are associated with large artery stiffness in young children and whether ethnic differences are evident. In this cross-sectional study, 730 black ( = 437) and white ( = 293) school children aged 5-9 years were included. Pulse wave velocity (PWV) was measured and the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) diameters were calculated from fundus images. The arterio-venous ratio (AVR) was subsequently calculated. Pulse wave velocity was lower ( ≤ 0.001) in the black group when compared to the white group. The black group had a narrower CRAE, wider CRVE and lower AVR (all < 0.001). Pulse wave velocity associated negatively with CRAE ( = -0.141, = 0.003) and AVR ( = -0.185, ≤ 0.001) in the black group only. A positive association between PWV and CRVE was seen in the black ( = 0.174, ≤ 0.001) and white ( = 0.119, = 0.043) group. Large artery stiffness is associated with retinal arterial narrowing and venular widening in children, suggesting cross-talk between the macro-and microvasculature. Ethnic differences in these associations are also evident. Our findings warrant further investigation into environmental and sociocultural risk factors contributing to premature cardiovascular disease development.
大血管和微血管之间的相互作用被认为是导致靶器官损伤的一个重要因素。以往的研究主要针对成年人群，而对儿童这一机制的研究可能有助于深入了解早期不良血管变化的发展过程。大血管和微血管之间的相互作用是否存在种族差异也有待确定。本研究旨在确定幼儿视网膜微血管直径是否与大动脉僵硬度相关，以及是否存在明显的种族差异。在这项横断面研究中，纳入了730名5至9岁的黑人（n = 437）和白人（n = 293）学童。测量了脉搏波速度（PWV），并从眼底图像中计算出视网膜中央动脉等效直径（CRAE）和视网膜中央静脉等效直径（CRVE）。随后计算动静脉比（AVR）。与白人组相比，黑人组的脉搏波速度更低（P≤0.001）。黑人组的CRAE更窄，CRVE更宽，AVR更低（均P<0.001）。仅在黑人组中，脉搏波速度与CRAE呈负相关（r = -0.141，P = 0.003），与AVR呈负相关（r = -0.185，P≤0.001）。在黑人组（r = 0.174，P≤0.001）和白人组（r = 0.119，P = 0.043）中，PWV与CRVE呈正相关。大动脉僵硬度与儿童视网膜动脉狭窄和静脉增宽有关，提示大血管和微血管之间存在相互作用。这些关联中的种族差异也很明显。我们的研究结果值得进一步调查导致心血管疾病过早发展的环境和社会文化风险因素。
