Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520 Turku, Finland.
Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland.
Eur Heart J. 2024 Sep 1;45(33):3072-3085. doi: 10.1093/eurheartj/ehae423.
Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood.
The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years).
The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles.
Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.
视网膜微血管特征可预测心血管发病率和死亡率。本研究旨在探讨终生心血管危险因素与饮食干预对青年成年人视网膜微血管的影响。
该队列来自于纵向特殊图尔库心血管危险因素干预项目研究。特殊图尔库心血管危险因素干预项目是一项为期 20 年的婴儿期开始的随机对照饮食干预研究，研究期间频繁进行访视，并将随访延长至 26 岁。饮食干预旨在实现健康的心脏饮食。在 26 岁的随访时拍摄眼底照片，并得出微血管测量值（动脉和静脉直径、迂曲度（简单和曲率）和分形维数）（n = 486）。根据最长的可用时间段（例如，从 7 个月到 26 岁）确定心血管危险因素和饮食成分的累积暴露作为曲线下面积。
与对照组相比，饮食干预对视网膜微血管有有利影响，使动脉和静脉更加笔直，并且干预组的动脉分形维数增加。即使在控制了累积心血管危险因素的情况下，干预效果仍然存在。干预的主要目标是减少终生累积摄入的饱和脂肪，与静脉迂曲度降低有关。几个终生累积的危险因素与视网膜微血管测量值独立相关，例如，累积收缩压与动脉狭窄有关。
婴儿期开始的 20 年饮食干预对青年成年人的视网膜微血管有有利影响。几个终生累积的心血管危险因素与视网膜微血管结构独立相关。
