Abstract
People of South Asian descent have an increased risk of cardiovascular disease (CVD) and diabetes, but little is known about the microcirculation in South Asian people despite evidence that this plays an important role in the aetiology of CVD. We compared the retinal microcirculation in a population-based sample of 287 middle-aged adults (144 European 143 South Asian) matched for age and sex. Retinal photographs were taken and analysed using a validated semi-automated program and microvascular measures were compared. Blood pressure, anthropometry and fasting bloods were also measured. South Asians had significantly fewer arteriolar and venular vessels and bifurcations. Arterioles and venules were longer and venules were also more tortuous in South Asians. These differences were not explained by adjustment for traditional risk factors including blood pressure, body mass index, diabetes or measures of insulin resistance. People of South Asian descent have rarefaction of the retinal microcirculation compared to age-sex matched individuals of European descent. Reduced microvascular density could contribute to the elevated risk of CVD and impaired glucose tolerance in South Asian people.
Highlights
People of South Asian descent, whether resident in the Indian subcontinent [1] or other countries, [2] have an increased risk of cardiovascular disease (CVD), myocardial infarction and stoke
It has been suggested that capillary rarefaction could contribute to their risk of CVD; [6] there are conflicting reports regarding the prevalence of microalbuminuria in people of South Asian descent with or without diabetes[7,8,9,10] and comparisons of diabetic retinopathy have been inconsistent.[7,11,12,13]
In view of the high rates of diabetes and CVD in South Asians we investigated whether abnormalities of the retinal microcirculation were more prevalent in this ethnic group, and explored whether any differences observed could be explained by conventional CVD risk factors, including abnormalities of glycaemic control
Summary
People of South Asian descent, whether resident in the Indian subcontinent [1] or other countries, [2] have an increased risk of cardiovascular disease (CVD), myocardial infarction and stoke. It has been suggested that capillary rarefaction could contribute to their risk of CVD; [6] there are conflicting reports regarding the prevalence of microalbuminuria in people of South Asian descent with or without diabetes[7,8,9,10] and comparisons of diabetic retinopathy have been inconsistent.[7,11,12,13]. In view of the high rates of diabetes and CVD in South Asians we investigated whether abnormalities of the retinal microcirculation were more prevalent in this ethnic group, and explored whether any differences observed could be explained by conventional CVD risk factors, including abnormalities of glycaemic control
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