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Retinal Vasculometry Associations with Cardiometabolic Risk Factors in the European Prospective Investigation of Cancer-Norfolk Study.

Owen, CG; Rudnicka, AR; Welikala, RA; Fraz, MM; Barman, SA; Luben, R; Hayat, SA; Khaw, K-T; Strachan, DP; Whincup, PH; et al. Owen, CG; Rudnicka, AR; Welikala, RA; Fraz, MM; Barman, SA; Luben, R; Hayat, SA; Khaw, K-T; Strachan, DP; Whincup, PH; Foster, PJ (2019) Retinal Vasculometry Associations with Cardiometabolic Risk Factors in the European Prospective Investigation of Cancer-Norfolk Study. Ophthalmology, 126 (1). pp. 96-106. ISSN 1549-4713 https://doi.org/10.1016/j.ophtha.2018.07.022
SGUL Authors: Owen, Christopher Grant Rudnicka, Alicja Regina Strachan, David Peter Whincup, Peter Hynes

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Abstract

PURPOSE: To examine associations between retinal vessel morphometry and cardiometabolic risk factors in older British men and women. DESIGN: Retinal imaging examination as part of the European Prospective Investigation into Cancer-Norfolk Eye Study. PARTICIPANTS: Retinal imaging and clinical assessments were carried out in 7411 participants. Retinal images were analyzed using a fully automated validated computerized system that provides novel measures of vessel morphometry. METHODS: Associations between cardiometabolic risk factors, chronic disease, and retinal markers were analyzed using multilevel linear regression, adjusted for age, gender, and within-person clustering, to provide percentage differences in tortuosity and absolute differences in width. MAIN OUTCOMES MEASURES: Retinal arteriolar and venular tortuosity and width. RESULTS: In all, 279 802 arterioles and 285 791 venules from 5947 participants (mean age, 67.6 years; standard deviation [SD], 7.6 years; 57% female) were analyzed. Increased venular tortuosity was associated with higher body mass index (BMI; 2.5%; 95% confidence interval [CI], 1.7%-3.3% per 5 kg/m2), hemoglobin A1c (HbA1c) level (2.2%; 95% CI, 1.0%-3.5% per 1%), and prevalent type 2 diabetes (6.5%; 95% CI, 2.8%-10.4%); wider venules were associated with older age (2.6 μm; 95% CI, 2.2-2.9 μm per decade), higher triglyceride levels (0.6 μm; 95% CI, 0.3-0.9 μm per 1 mmol/l), BMI (0.7 μm; 95% CI, 0.4-1.0 per 5 kg/m2), HbA1c level (0.4 μm; 95% CI, -0.1 to 0.9 per 1%), and being a current smoker (3.0 μm; 95% CI, 1.7-4.3 μm); smoking also was associated with wider arterioles (2.1 μm; 95% CI, 1.3-2.9 μm). Thinner venules were associated with high-density lipoprotein (HDL) (1.4 μm; 95% CI, 0.7-2.2 per 1 mmol/l). Arteriolar tortuosity increased with age (5.4%; 95% CI, 3.8%-7.1% per decade), higher systolic blood pressure (1.2%; 95% CI, 0.5%-1.9% per 10 mmHg), in females (3.8%; 95% CI, 1.4%-6.4%), and in those with prevalent stroke (8.3%; 95% CI, -0.6% to 18%); no association was observed with prevalent myocardial infarction. Narrower arterioles were associated with age (0.8 μm; 95% CI, 0.6-1.0 μm per decade), higher systolic blood pressure (0.5 μm; 95% CI, 0.4-0.6 μm per 10 mmHg), total cholesterol level (0.2 μm; 95% CI, 0.0-0.3 μm per 1 mmol/l), and HDL (1.2 μm; 95% CI, 0.7-1.6 μm per 1 mmol/l). CONCLUSIONS: Metabolic risk factors showed a graded association with both tortuosity and width of retinal venules, even among people without clinical diabetes, whereas atherosclerotic risk factors correlated more closely with arteriolar width, even excluding those with hypertension and cardiovascular disease. These noninvasive microvasculature measures should be evaluated further as predictors of future cardiometabolic disease.

Item Type: Article
Additional Information: Crown Copyright © 2018 Published by Elsevier Inc. on behalf of the American Academy of Ophthalmology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: 1103 Clinical Sciences, 1113 Ophthalmology And Optometry, 1117 Public Health And Health Services, Ophthalmology & Optometry
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Ophthalmology
ISSN: 1549-4713
Language: eng
Dates:
DateEvent
January 2019Published
1 August 2018Published Online
27 July 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
G0401527Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MR/L02005X/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PG/15/101/31889British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
262Research into Ageing, UKUNSPECIFIED
PubMed ID: 30075201
Web of Science ID: WOS:000453531300025
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/110013
Publisher's version: https://doi.org/10.1016/j.ophtha.2018.07.022

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