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Koko Saito, Yumiko Kawasaki, Yukio Nagao, Ryo Kawasaki; Retinal arteriolar narrowing and 4-year risk of incident metabolic syndrome. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5338.
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Although retinal vessel caliber changes have been linked to metabolic syndrome in cross-sectional studies, no studies have shown temporal relationship in a longitudinal study. We aimed to determine whether retinal vessel changes at baseline is associated with risk of developing metabolic syndrome over 4-years in healthy adults who participated in health screening program.
In April, 2009, we recruited 90 healthy adults without metabolic syndrome in the health screening program at Shinoda general hospital (Yamagata, Japan) (mean ± standard deviation [SD] age 48.9±8.2 years old, 27.8% female). We performed a 4-year follow-up examination in April, 2013. Retinal vessel caliber was calculated as the central retinal artery equivalent and vein equivalent (CRAE and CRVE) from non-mydriatic digital fundus images using semi-automated standardized software (IVAN, University of Wisconsin, WI). Incidence of metabolic syndrome was determined as having no metabolic syndrome at baseline (following the guideline of the Japanese Obesity Society) and having metabolic syndrome at follow-up. Multiple logistic regression models were used to estimate odds ratios (ORs) for incident metabolic syndrome by change in retinal vessel caliber, adjusting for age, gender, and five components of metabolic syndrome (waist circumference, systolic blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol).
There were 18 (20%) incident metabolic syndrome cases over 4-years. Narrower arteriolar caliber at baseline was associated with increased risk of incident metabolic syndrome over 4-years (adjusted OR per -1SD change in CRAE: 2.92, 95% confidence interval 1.03, 8.24; p=0.043). The area under the receiver operating curve for the model with retinal vessel caliber was larger than that without retinal vessel caliber (0.863 and 0.833, respectively), while it was not statistically significant (p= 0.142).
Persons with narrower retinal arteriolar caliber size had increased risk of developing metabolic syndrome over 4-years. Given retinal vessel calibers have been linked to adiponectin and insulin resistance, it might reflect early pathophysiological changes of metabolic syndrome. Genetic predisposition determining retinal arteriolar caliber size might be one of the potentials link as well.
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