Retinal Vascular Caliber, Cardiovascular Risk Factors, and Inflammation: The Multi-Ethnic Study of Atherosclerosis (MESA)

Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Investigative Ophthalmology &amp Visual Science (Impact Factor: 3.4). 07/2006; 47(6):2341-50. DOI: 10.1167/iovs.05-1539
Source: PubMed


To describe the relationship of retinal arteriolar and venular caliber with cardiovascular risk factors, including inflammatory biomarkers, in a multiethnic population of whites, blacks, Hispanics, and Chinese.
A cross-sectional study comprising 5979 persons aged 45 to 84 years residing in six U.S. communities. Retinal vascular caliber was measured and summarized from digital retinal photographs. Standard cardiovascular risk factors, including biomarkers of inflammation (e.g., high-sensitivity C-reactive protein [hsCRP], interleukin [IL]-6, and plasma fibrinogen) and endothelial dysfunction (e.g., soluble intercellular adhesion molecule [sICAM]-1 [, plasminogen activator inhibitor [PAI]-1) were assessed.
Mean retinal arteriolar caliber was 144.1+/-14.4 (SD) microm, and venular caliber 214.0+/-22.2 microm. In models controlling for age, gender, race-ethnicity, and center, smaller retinal arteriolar caliber was related to higher systolic and diastolic blood pressure, hypertension status, current alcohol consumption, greater body mass index, and higher levels of total homocysteine; larger retinal arteriolar caliber was related to diabetes, current cigarette smoking, and higher levels of plasma fibrinogen; and larger retinal venular caliber was related to diabetes, current cigarette smoking, greater body mass index and waist-hip ratio, higher levels of serum glucose, plasma triglyceride, plasma LDL-cholesterol, hsCRP, plasma fibrinogen, IL6, sICAM-1, and PAI-1 and lower levels of HDL-cholesterol. In multivariate analyses, blacks and Hispanics had larger retinal arteriolar and venular calibers than did whites and Chinese.
Retinal arteriolar and venular caliber is associated with a range of cardiovascular risk factors, including hypertension, diabetes, measures of obesity, and dyslipidemia. Venular caliber is also associated with systemic inflammation.

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Available from: T-Y Wong, Feb 21, 2015
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    • "CI confidence interval, CRAE central retinal arteriolar equivalent, CRVE central retinal venular equivalent, MTT maximal treadmill test, SMTT submaximal treadmill test, CC control condition. a Available in 16 (94 %) and 15 (100 %) seniors and young adults, respectively response to exhaustive exercise may also affect venular diameters (Wong et al. 2006a; Klein et al. 2006 "
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    ABSTRACT: Alterations of retinal vessel diameters are associated with increased cardiovascular risk. We aimed to investigate changes in retinal vessel diameters in response to acute dynamic exercise of different intensities and whether these changes are age dependent. Seventeen healthy seniors (median (IQR) age 68 (65, 69) years) and 15 healthy young adults (median (IQR) age 26 (25, 28) years) first performed a maximal treadmill test (MTT) followed by a submaximal treadmill test (SMTT) and a resting control condition in randomised order. Central retinal arteriolar (CRAE) and central retinal venular (CRVE) diameter equivalents were measured before as well as 5 (t5) and 40 (t40) minutes after exercise cessation using a static retinal vessel analyser. Both exercise intensities induced a significant dilatation in CRAE and CRVE at t5 compared to the control condition (P < 0.001). At t40, the mean increase in CRAE and CRVE was greater for MTT compared to that for SMTT (CRAE 1.7 μm (95 % confidence interval (CI) −0.1, 3.6; P = 0.061); CRVE 2.2 μm (95 % CI 0.4, 4.1; P = 0.019)). However, the estimated difference at t5 between seniors and young adults in their response to MTT compared to SMTT was 5.3 μm (95 % CI 2.0, 8.5; P = 0.002) for CRAE and 4.1 μm (95 % CI −0.4, 8.6; P = 0.076) for CRVE. Wider arteries and veins after maximal versus submaximal exercise for seniors compared to young adults suggest that myogenic vasoconstriction in response to exhaustive exercise may be reduced in seniors. Age-related loss of vascular reactivity has clinical implications since the arteriolar vasoconstriction protects the retinal capillary bed from intraluminal pressure peaks. Electronic supplementary material The online version of this article (doi:10.1007/s11357-014-9650-3) contains supplementary material, which is available to authorized users.
    Age 04/2014; 36(3). DOI:10.1007/s11357-014-9650-3 · 3.45 Impact Factor
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    • "Inflammation is recognised as a key pathogenic process in HIV infection, and also in HIV-related accelerated ageing (Deeks, 2009). Larger retinal venular calibre is associated with systemic inflammatory markers such as CRP, fibrinogen, IL-6 and smoking, independently of age (Ikram et al., 2004; Klein et al., 2006; Wong et al., 2006). This suggests that the heightened inflammatory processes observed in HIV infection are consistent with a biologically aged phenotype as manifest by shorter TL. "
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    ABSTRACT: HIV-infected individuals have an increased risk of age-related morbidity despite antiretroviral treatment (ART). Several anatomic and functional ophthalmological parameters are associated with increasing chronological age. These may, therefore, potentially serve as biomarkers of ageing. We investigated associations between ocular parameters (lens density, retinal vessel calibre, corneal endothelium and retinal nerve fibre layer thickness) and two 'cellular' biomarkers of ageing (leukocyte telomere length and CDKN2A expression) and with frailty in a cross-sectional study of 216 HIV-infected individuals. All ocular parameters, telomere length and frailty were associated with chronological age, whereas CDKN2A expression was not. Retinal venular calibre and lens density were associated with shorter telomere length (p-trend=0.04, and 0.08, respectively), whereas CDKN2A expression and frailty status were not associated with ocular parameters. Longitudinal studies are warranted to assess the integration of retinal vascular calibre and lens density with systemic markers to develop an overall index of biological ageing in HIV infection.
    Mechanisms of ageing and development 08/2013; 134(9). DOI:10.1016/j.mad.2013.08.002 · 3.40 Impact Factor
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    • "Hyperlipidemia is known to be a risk factor for diabetic retinopathy [29] [30]. Studies conducted previously also showed that widened venular caliber was related to hyperlipidemia [31] [32] and this may be due to inflammation and endothelial dysfunction [33] [34] [35]. We also found that hypertension status may attenuate the relationship between retinal venular caliber and diabetic retinopathy. "
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    ABSTRACT: To describe the relationship of retinal arteriolar and venular caliber with diabetes, retinopathy and hyperglycemia, in an Asian Indian population. This was a population-based cross-sectional study of 3400 (75.6% response rate) Singapore ethnic Indians aged 40-80 years. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were obtained using a validated computer-assisted program. Diabetes mellitus was identified using standardized criteria. Diabetic retinopathy was graded based on the modified Airlie House Classification System. There were 980 (32.2%) participants with diabetes. Of these, 327 (33.4%) had diabetic retinopathy. After multivariate adjustment, diabetic persons had a wider CRAE (145.23μm vs 142.38μm, P<0.001). This relationship was stronger in persons without hyperlipidemia (P-interaction<0.1). Among diabetic participants, wider CRVE was related to increasing severity of retinopathy (P for trend<0.05) and this association may be altered by hypertensive status. Retinal arteriolar caliber widened with increasing glucose (P<0.001) and HbA1C (P<0.001) levels. In Indian adults, wider retinal arteriolar caliber is associated with diabetes and hyperglycemia, while wider retinal venular caliber is associated with diabetic retinopathy. This is consistent with white populations and confirms the differential systemic association of retinal vascular caliber in Asian Indians.
    Diabetes research and clinical practice 08/2011; 94(2):291-8. DOI:10.1016/j.diabres.2011.07.032 · 2.54 Impact Factor
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