Li Rui, Hui Ying, Li Jing, Zhang Xiaoyue, Zhang Shun, Lv Bin, Ni Yuan, Li Xiaoshuai, Liang Xiaoliang, Yang Ling, Lv Han, Li Hongyang, Yang Yingping, Liu Guangfeng, Xie Guotong, Wu Shouling, Wang Zhenchang
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Ping An Healthcare Technology, Beijing, China.
Quant Imaging Med Surg. 2024 Jan 3;14(1):932-943. doi: 10.21037/qims-23-927. Epub 2024 Jan 2.
As the retinal microvasculature shares similarities with the cerebral microvasculature, numerous studies have shown that retinal vascular is associated with cognitive decline. In addition, several population-based studies have confirmed the association between retinal vascular and cerebral small vessel disease (CSVD) burden. However, the association of retinal vascular with CSVD burden as well as cognitive function has not been explored simultaneously. This study investigated the relations of retinal microvascular parameters (RMPs) with CSVD burden and cognitive function.
We conducted a cross-sectional study of participants in the KaiLuan study. Data were collected from subjects aged ≥18 years old who could complete retinal photography and brain magnetic resonance imaging (MRI) between December 2020 to October 2021 in the Kailuan community of Tangshan. RMPs were evaluated using a deep learning system. The cognitive function was measured using the Montreal Cognitive Assessment (MoCA). We conducted logistic regression models, and mediation analysis to evaluate the associations of RMPs with CSVD burden and cognitive decline.
Of the 905 subjects (mean age: 55.42±12.02 years, 54.5% female), 488 (53.9%) were classified with cognitive decline. The fractal dimension (FD) [odds ratio (OR), 0.098, 95% confidence interval (CI): 0.015-0.639, P=0.015] and global vein width (OR: 1.010, 95% CI: 1.005-1.015, P<0.001) were independent risk factors for cognitive decline after adjustment for potential confounding factors. The global artery width was significantly associated with severe CSVD burden (OR: 0.985, 95% CI: 0.974-0.997, P=0.013). The global vein width was sightly associated with severe CSVD burden (OR: 1.005, 95% CI: 1.000-1.010, P=0.050) after adjusting for potential confounders. The multivariable-adjusted odds ratios (95% CI) in highest tertile versus lowest tertile of global vein width were 1.290 (0.901-1.847) for cognitive decline and 1.546 (1.004-2.290) for severe CSVD burden, respectively. Moreover, CSVD burden played a partial mediating role in the association between global vein width and cognitive function (mediating effect 6.59%).
RMPs are associated with cognitive decline and the development of CSVD. A proportion of the association between global vein width and cognitive decline may be attributed to the presence of CSVD burden.
由于视网膜微血管系统与脑微血管系统存在相似性，众多研究表明视网膜血管与认知功能下降有关。此外，多项基于人群的研究证实了视网膜血管与脑小血管疾病（CSVD）负担之间的关联。然而，视网膜血管与CSVD负担以及认知功能之间的关联尚未同时进行探究。本研究调查了视网膜微血管参数（RMPs）与CSVD负担及认知功能的关系。
我们对开滦研究的参与者进行了一项横断面研究。数据收集自2020年12月至2021年10月期间在唐山开滦社区年龄≥18岁且能够完成视网膜摄影和脑磁共振成像（MRI）的受试者。使用深度学习系统评估RMPs。使用蒙特利尔认知评估量表（MoCA）测量认知功能。我们进行了逻辑回归模型和中介分析，以评估RMPs与CSVD负担及认知功能下降之间的关联。
在905名受试者（平均年龄：55.42±12.02岁，54.5%为女性）中，488名（53.9%）被归类为认知功能下降。在对潜在混杂因素进行调整后，分形维数（FD）[比值比（OR），0.098，95%置信区间（CI）：0.015 - 0.639，P = 0.015]和整体静脉宽度（OR：1.010，95% CI：1.005 - 1.015，P < 0.001）是认知功能下降的独立危险因素。整体动脉宽度与严重CSVD负担显著相关（OR：0.985，95% CI：0.974 - 0.997，P = 0.013）。在对潜在混杂因素进行调整后，整体静脉宽度与严重CSVD负担有轻微关联（OR：1.005，95% CI：1.000 - 1.010，P = 0.050）。整体静脉宽度最高三分位数与最低三分位数相比，多变量调整后的认知功能下降比值比（95% CI）为1.290（0.901 - 1.847），严重CSVD负担的比值比为1.546（1.004 - 2.290）。此外，CSVD负担在整体静脉宽度与认知功能的关联中起部分中介作用（中介效应为6.59%）。
RMPs与认知功能下降及CSVD的发展相关。整体静脉宽度与认知功能下降之间的部分关联可能归因于CSVD负担的存在。
