Cardiovascular health and retinal microvascular geometry in Australian 11-12 year-olds

Mengjiao Liu; Kate Lycett; Melissa Wake; Mingguang He; Jessica A Kerr; Richard Saffery; Markus Juonala; Tim Olds; Terry Dwyer; David P Burgner; Tien Yin Wong

doi:10.1016/j.mvr.2019.103966

Cardiovascular health and retinal microvascular geometry in Australian 11-12 year-olds

Microvasc Res. 2020 May:129:103966. doi: 10.1016/j.mvr.2019.103966. Epub 2019 Dec 10.

Authors

Affiliations

¹ The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia.
² The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Centre for Social & Early Emotional Development, Deakin University, Melbourne, VIC, Australia.
³ The University of Melbourne, Melbourne, VIC, Australia; Department of Ophthalmic Epidemiology, Centre for Eye Research Australia, The University of Melbourne, Melbourne, VIC, Australia; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
⁴ Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland.
⁵ Murdoch Children's Research Institute, Melbourne, VIC, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia.
⁶ Murdoch Children's Research Institute, Melbourne, VIC, Australia; The George Institute for Global Health, University of Oxford, Oxford, United Kingdom.
⁷ The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia; Infectious Diseases, Royal Children's Hospital, Melbourne, VIC, Australia.
⁸ The University of Melbourne, Melbourne, VIC, Australia; Department of Ophthalmic Epidemiology, Centre for Eye Research Australia, The University of Melbourne, Melbourne, VIC, Australia; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore. Electronic address: ophwty@nus.edu.sg.

PMID: 31836514
DOI: 10.1016/j.mvr.2019.103966

Abstract

Traditional retinal microvascular parameters (smaller arteriolar and greater venular caliber) are associated with cardiovascular risk factors, pre-clinical vascular phenotypes and clinical cardiovascular events in adults. Although novel retinal microvascular geometric parameters showed analogous associations in adults, less is known whether these parameters are associated with cardiovascular health from childhood. In a population-based cross-sectional study in children (n = 1126, mean age 11.4 years, 50.3% girls), we examined associations of cardiovascular risk factors and pre-clinical arterial phenotypes with retinal geometric parameters. Cardiovascular parameters included body mass index (BMI), an inflammatory marker (GlycA), low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, systolic (SBP) and diastolic blood pressure, large artery functional (pulse wave velocity, PWV and carotid arterial elasticity) and structural (carotid intima-media thickness) phenotypes. Retinal geometric parameters (fractal dimension (D_f) and tortuosity) were quantified from retinal images. Multivariable regression models were performed and adjusted for potential confounders. Higher values for BMI, SBP and PWV showed weak associations with lower (i.e. worse) arteriolar but not venular D_f (standardized mean difference (SMD) ranging from -0.07 to -0.09, 95% CIs -0.15 to -0.01). Higher HDL was associated with greater arteriolar D_f (SMD 0.07, 95% CI 0.01 to 0.13). Only higher SBP was associated with higher (i.e. worse) arteriolar but not venular tortuosity (SMD 0.09, 95% CI 0.02 to 0.16). In generally healthy children, some risk factors and pre-clinical arterial phenotypes show small associations with retinal geometric parameters. In childhood, emerging relationships between microvascular parameters and cardiometabolic risk may be better described by retinal vascular caliber than by geometric parameters.

Keywords: Children; Microcirculation; Population-based study; Pre-clinical vascular phenotypes; Retinal micrvasculature; Retinal vascular parameters; Risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Arterioles / pathology*
Arterioles / physiopathology
Australia / epidemiology
Cardiovascular Diseases / diagnosis
Cardiovascular Diseases / epidemiology*
Cardiovascular Diseases / physiopathology
Child
Cross-Sectional Studies
Female
Health Status
Health Surveys
Humans
Male
Photography*
Predictive Value of Tests
Prognosis
Retinal Vessels / pathology*
Retinal Vessels / physiopathology
Risk Assessment
Risk Factors
Venules / pathology*
Venules / physiopathology