Mengjiao Liu1,2, Kate Lycett1,2,3, Tien Yin Wong1,4,5, Jessica A Kerr1,2, Mingguang He1,4,6, Markus Juonala7,8, Tim Olds2,9, Terry Dwyer10, David Burgner1,2,11, Melissa Wake12,13. 1. Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia. 2. Murdoch Children's Research Institute, Melbourne, VIC, Australia. 3. Centre for Social & Early Emotional Development, Deakin University, Melbourne, VIC, Australia. 4. Department of Ophthalmic Epidemiology, Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia. 5. Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore. 6. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China. 7. Department of Medicine, University of Turku, Turku, Finland. 8. Division of Medicine, Turku University Hospital, Turku, Finland. 9. Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia. 10. The George Institute for Global Health, University of Oxford, Oxford, UK. 11. Department of Paediatrics, Monash University, Melbourne, VIC, Australia. 12. Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia. melissa.wake@mcri.edu.au. 13. Murdoch Children's Research Institute, Melbourne, VIC, Australia. melissa.wake@mcri.edu.au.
Abstract
BACKGROUND/ OBJECTIVES: Microvascular changes may contribute to obesity-associated cardiovascular disease. We examined whether body mass index (BMI) and waist-to-height ratio (WHtR) (1) at multiple earlier time points and (2) decade-long trajectories predicted retinal microvascular parameters in mid-childhood/adulthood. METHODS: Participants/design: 1288 11-12 year olds (51% girls) and 1264 parents (87% mothers) in the population-based Child Health CheckPoint (CheckPoint) module within the Longitudinal Study of Australian Children (LSAC). LSAC exposure measures: biennial BMI z-score and WHtR for children at five time points from age 2-3 to 10-11 years and self-reported parent BMI at six time points from child age 0-1 years to 10-11 years. CheckPoint outcome measures: retinal arteriolar and venular caliber. ANALYSES: BMI/WHtR trajectories were identified by group-based trajectory modeling; linear regression models estimated associations between BMI/WHtR at each time point/trajectories and later retinal vascular caliber, adjusted for age, sex, and family socioeconomic status. RESULTS: In time point analyses, higher child BMI/WHtR from age 4 to 5 years was associated with narrower arteriolar caliber at the age of 11-12 years, but not venular caliber. For example, each standard deviation higher in BMI z-score at 4-5 years was associated with narrower arteriolar caliber at 11-12 years (standardized mean difference (SMD): -0.05, 95% confidence interval (CI): -0.10 to 0.01); by 10-11 years, associations had doubled to -0.10 (95% CI: -0.16 to -0.05). In adults, these finding were similar, except the magnitude of BMI and arteriolar associations were similar across all time points (SMD: -0.11 to -0.13). In child and adult BMI trajectory analyses, less favorable trajectories predicted narrower arteriolar (p-trend < 0.05), but not venular (p-trend > 0.1), caliber. Compared with those in the average BMI trajectory, SMDs in arterial caliber for children and adults in the highest trajectory were -0.25 (95% CI: -0.44 to -0.07) and -0.42 (95% CI: -0.73 to -0.10), respectively. Venular caliber showed late associations with child WHtR, but not with BMI in children or adults. CONCLUSIONS: Associations of decade-long high BMI trajectories with narrowed retinal arteriolar caliber emerge in children, and are clearly evident by midlife. Adiposity appears to exert its early adverse life course impacts on the microcirculation more via arteriolar than venular mechanisms.
BACKGROUND/ OBJECTIVES: Microvascular changes may contribute to obesity-associated cardiovascular disease. We examined whether body mass index (BMI) and waist-to-height ratio (WHtR) (1) at multiple earlier time points and (2) decade-long trajectories predicted retinal microvascular parameters in mid-childhood/adulthood. METHODS:Participants/design: 1288 11-12 year olds (51% girls) and 1264 parents (87% mothers) in the population-based Child Health CheckPoint (CheckPoint) module within the Longitudinal Study of Australian Children (LSAC). LSAC exposure measures: biennial BMI z-score and WHtR for children at five time points from age 2-3 to 10-11 years and self-reported parent BMI at six time points from child age 0-1 years to 10-11 years. CheckPoint outcome measures: retinal arteriolar and venular caliber. ANALYSES: BMI/WHtR trajectories were identified by group-based trajectory modeling; linear regression models estimated associations between BMI/WHtR at each time point/trajectories and later retinal vascular caliber, adjusted for age, sex, and family socioeconomic status. RESULTS: In time point analyses, higher child BMI/WHtR from age 4 to 5 years was associated with narrower arteriolar caliber at the age of 11-12 years, but not venular caliber. For example, each standard deviation higher in BMI z-score at 4-5 years was associated with narrower arteriolar caliber at 11-12 years (standardized mean difference (SMD): -0.05, 95% confidence interval (CI): -0.10 to 0.01); by 10-11 years, associations had doubled to -0.10 (95% CI: -0.16 to -0.05). In adults, these finding were similar, except the magnitude of BMI and arteriolar associations were similar across all time points (SMD: -0.11 to -0.13). In child and adult BMI trajectory analyses, less favorable trajectories predicted narrower arteriolar (p-trend < 0.05), but not venular (p-trend > 0.1), caliber. Compared with those in the average BMI trajectory, SMDs in arterial caliber for children and adults in the highest trajectory were -0.25 (95% CI: -0.44 to -0.07) and -0.42 (95% CI: -0.73 to -0.10), respectively. Venular caliber showed late associations with child WHtR, but not with BMI in children or adults. CONCLUSIONS: Associations of decade-long high BMI trajectories with narrowed retinal arteriolar caliber emerge in children, and are clearly evident by midlife. Adiposity appears to exert its early adverse life course impacts on the microcirculation more via arteriolar than venular mechanisms.
Authors: Jie J Wang; Bronwen Taylor; Tien Y Wong; Brian Chua; Elena Rochtchina; Ronald Klein; Paul Mitchell Journal: Obesity (Silver Spring) Date: 2006-02 Impact factor: 5.002
Authors: Emil D Kurniawan; Carol Y Cheung; Wan Ting Tay; Paul Mitchell; Seang-Mei Saw; Tien Yin Wong; Ning Cheung Journal: J Pediatr Date: 2014-09-26 Impact factor: 4.406
Authors: Oana Sorop; T Dylan Olver; Jens van de Wouw; Ilkka Heinonen; Richard W van Duin; Dirk J Duncker; Daphne Merkus Journal: Cardiovasc Res Date: 2017-07-01 Impact factor: 10.787
Authors: Tien Yin Wong; Ronald Klein; A Richey Sharrett; Bruce B Duncan; David J Couper; James M Tielsch; Barbara E K Klein; Larry D Hubbard Journal: JAMA Date: 2002-03-06 Impact factor: 56.272
Authors: Agnes Ho; Carol Y Cheung; Jason S Wong; Yuzhou Zhang; Fang Yao Tang; Ka Wai Kam; Alvin L Young; Li Jia Chen; Patrick Ip; Tien Y Wong; Chi Pui Pang; Clement C Tham; Jason C Yam Journal: J Am Heart Assoc Date: 2021-01-26 Impact factor: 5.501