Characteristics of the retinal microvasculature in association with cardiovascular risk markers in children with overweight, obesity and morbid obesity

Jesse Rijks,Anita Vreugdenhil,Kylie Karnebeek,Jogchum Plat,Elke Dorenbos,Peter Joris,Tos Berendschot,Ronald Mensink

doi:10.1038/s41598-018-35279-6

Abstract

To aim of this study was to evaluate characteristics of the retinal microvasculature, but particularly potential associations with classic and novel (endothelial function and low-grade inflammation)markers for cardiovascular risk, in a cohort of children with overweight and (morbid) obesity. Central retinal arteriolar equivalent(CRAE) and central retinal venular equivalent(CRVE) were assessed. CRAE was significantly lower and AVR significantly higher in children with morbid obesity than in children with overweight and normal weight(p < 0.01). CRVE did not differ significantly between the four weight categories. A multiple linear regression model with CRAE as dependent variable showed that only DBP z-score(β = −2.848,p = 0.029) and plasma glucose concentrations(β = 6.029,p = 0.019) contributed significantly to the variation in CRAE. Remarkably, despite a correlation between CRAE and circulating concentrations of the adhesion molecules VCAM-1 or ICAM-1, markers for inflammation and endothelial function did not contribute to the variation in CRAE. This is the first study showing in population of children with overweight and obesity that the retinal arteriolar microvasculature, but not venular diameter is aberrant, with increasing BMI z-score. CRAE was significantly associated with several cardiovascular risk markers, and multiple linear regression showed that a higher diastolic blood pressure z-score and lower fasting plasma glucose concentrations significantly contributed to the variance in CRAE.

Highlights

Children with overweight and obesity, and in particular with morbid obesity, have a high risk to develop cardiovascular disease, both during their youth and in adulthood[1,2]
There are numerous studies evaluating the association between retinal vasculature and classical CVD risk factors like blood pressure, serum lipids and insulin resistance, there is a lack of detailed knowledge regarding associations between the retinal microvasculature and markers reflecting inflammation and endothelial dysfunction
Several cardiovascular risk markers including serum total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), C-reactive protein (CRP), interleukin 6 (IL-6), and insulin concentrations were significantly different between the three weight status categories, and increased across weight status categories, except for HDL-C that decreased across weight status categories (Table 3)

Summary

Introduction

Children with overweight and obesity, and in particular with morbid obesity, have a high risk to develop cardiovascular disease, both during their youth and in adulthood[1,2]. There are numerous studies evaluating the association between retinal vasculature and classical CVD risk factors like blood pressure, serum lipids and insulin resistance, there is a lack of detailed knowledge regarding associations between the retinal microvasculature and markers reflecting inflammation and endothelial dysfunction. Regarding inflammation, scattered and inconsistent information regarding associations between retinal calibers and CRP can be found[12], associations with circulating pro-inflammatory cytokines and chemokines have to the best of our knowledge not been evaluated In this cross-sectional study, we aimed to evaluate characteristics of the microvasculature in the fundus in a selected high-risk group of children with overweight and (morbid) obesity and to evaluate associations with anthropometric parameters, cardiovascular risk markers, and markers for inflammation and endothelial function

Methods

Results

Discussion

Conclusion