Emil D Kurniawan1, Carol Y Cheung2, Wan Ting Tay3, Paul Mitchell4, Seang-Mei Saw2, Tien Yin Wong2, Ning Cheung5. 1. Center for Eye Research Australia, University of Melbourne, Melbourne, Australia. 2. Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 3. Singapore Eye Research Institute, Singapore National Eye Center, Singapore. 4. Center for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia. 5. Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, University of Hong Kong, Hong Kong SAR, China. Electronic address: dannycheung@hotmail.com.
Abstract
OBJECTIVE: To examine the longitudinal relationship between changes in childhood body mass index (BMI) and retinal vascular caliber. STUDY DESIGN: A prospective study of 421 healthy children aged 7-9 years in 2001 who returned for follow-up in 2006. At both visits, retinal photographs and anthropometric measurements were taken following standardized protocols. Retinal arteriolar and venular calibers were measured using a computer-based program and summarized as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE). RESULTS: At follow-up, mean weight, height, and BMI increased significantly (P < .001). Mean CRVE increased by 3.4 μm (P < .001) but mean CRAE did not alter significantly (P = .340). On multivariate analysis, greater BMI was cross-sectionally associated with narrower CRAE (P < .01) and wider CRVE (P < .01). On longitudinal analysis, increasing BMI was associated with increasing CRVE (P = .04) over the 5-year period. Baseline BMI was associated with increased venular caliber and decreased arteriolar caliber at follow-up, and vice versa (P < .05). CONCLUSIONS: Increasing BMI is associated with increasing retinal venular caliber over time in children, and baseline retinal vascular caliber changes increase the risk of higher BMI at follow-up. As both widened retinal venular caliber and greater BMI are associated with risk of cardiovascular events in adults, progressive retinal venular widening could be a manifestation of an adverse microvascular effect of obesity early in life.
OBJECTIVE: To examine the longitudinal relationship between changes in childhood body mass index (BMI) and retinal vascular caliber. STUDY DESIGN: A prospective study of 421 healthy children aged 7-9 years in 2001 who returned for follow-up in 2006. At both visits, retinal photographs and anthropometric measurements were taken following standardized protocols. Retinal arteriolar and venular calibers were measured using a computer-based program and summarized as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE). RESULTS: At follow-up, mean weight, height, and BMI increased significantly (P < .001). Mean CRVE increased by 3.4 μm (P < .001) but mean CRAE did not alter significantly (P = .340). On multivariate analysis, greater BMI was cross-sectionally associated with narrower CRAE (P < .01) and wider CRVE (P < .01). On longitudinal analysis, increasing BMI was associated with increasing CRVE (P = .04) over the 5-year period. Baseline BMI was associated with increased venular caliber and decreased arteriolar caliber at follow-up, and vice versa (P < .05). CONCLUSIONS: Increasing BMI is associated with increasing retinal venular caliber over time in children, and baseline retinal vascular caliber changes increase the risk of higher BMI at follow-up. As both widened retinal venular caliber and greater BMI are associated with risk of cardiovascular events in adults, progressive retinal venular widening could be a manifestation of an adverse microvascular effect of obesity early in life.
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