西班牙普通人群中的视网膜血管管径与血管老化：一项EVA研究。

Retinal blood vessel calibre and vascular ageing in a general Spanish population: A EVA study.

作者信息

Gómez-Sánchez Leticia, Gómez-Sánchez Marta, Patino-Alonso Carmen, Recio-Rodríguez Jose I, González-Sánchez Jesús, Agudo-Conde Cristina, Maderuelo-Fernández José A, Rodríguez-Sánchez Emiliano, García-Ortiz Luis, Gómez-Marcos Manuel A

机构信息

Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, España.

Departamento de Estadística, Universidad de Salamanca, Calle Alfonso X el Sabio s/n, Salamanca, España.

出版信息

Eur J Clin Invest. 2022 Feb;52(2):e13684. doi: 10.1111/eci.13684. Epub 2021 Oct 4.

DOI:10.1111/eci.13684

PMID:34582566

Abstract

INTRODUCTION

The aim of this work was to analyse the association of the retinal arteriolar calibre and the arteriole/venule index (AV index) with vascular ageing in a general population without previous cardiovascular disease.

MATERIALS AND METHODS

Descriptive cross-sectional study. A total of 482 individuals without cardiovascular disease (mean age: 55.6 ± 14.2 years) were selected by random sampling, stratified by age and sex. The retinal arteriolar calibre was measured using digital fundus images of the back of the eye captured with a validated, semiautomatized and computer-assisted software (Index calculator). Vascular ageing was defined using three criteria based on the values of: (1) Carotid-femoral Pulse Wave Velocity (cfPWV), (2) Brachial-ankle Pulse Wave Velocity (baPWV) and (3) Carotid Intima-Media Thickness.

RESULTS

The AV index and arteriolar calibre show a negative correlation with age, arterial pressure, cardiovascular risk and parameters of vascular structure and function (p < 0.001 in all cases). We found lower mean values of the AV index and arteriolar calibre in the individuals with early vascular ageing compared to those with healthy vascular ageing. AV index was negatively correlated with cfPWV ((β=-2.9; 95% CI (-4.7; -1.1)), baPWV ((β=-3.2; 95% CI (-5.4; -0.9)) and vascular ageing index ((β=-1.7; 95% CI (-2.7; -0.7)). Arteriolar calibre showed a negative correlation with baPWV (β=-0.1; 95% CI (-0.2; -0.1)). In the logistic regression analysis, lower values of AV index ((OR=0.01; 95% CI (0.01-0.10), OR=0.03; 95% CI (0.01-0.11) and OR=0.09; 95% CI (0.01-0.67)) were associated with EVA defined with cfPWV, baPWV and vascular ageing index respectively, and lower values of arteriolar calibre ((OR=0.71; 95% CI (0.55-0.91)) were associated with EVA defined with vascular ageing index.

CONCLUSIONS

Lower values of AV index and retinal arteriolar calibre were associated with vascular ageing in a general Spanish population without previous cardiovascular disease.

摘要

引言

本研究旨在分析在无心血管疾病史的普通人群中，视网膜小动脉管径和动静脉指数（AV指数）与血管老化之间的关联。

材料与方法

描述性横断面研究。通过随机抽样选取482例无心血管疾病的个体（平均年龄：55.6±14.2岁），并按年龄和性别分层。使用经过验证的半自动计算机辅助软件（Index计算器），通过眼底图像测量视网膜小动脉管径。基于以下三个指标定义血管老化：（1）颈股脉搏波速度（cfPWV）；（2）臂踝脉搏波速度（baPWV）；（3）颈动脉内膜中层厚度。

结果

AV指数和小动脉管径与年龄、动脉压、心血管风险以及血管结构和功能参数呈负相关（所有情况下p<0.001）。我们发现，与血管老化健康者相比，血管老化早期个体的AV指数和小动脉管径平均值更低。AV指数与cfPWV（β=-2.9；95%CI（-4.7；-1.1））、baPWV（β=-3.2；95%CI（-5.4；-0.9））以及血管老化指数（β=-1.7；95%CI（-2.7；-0.7））呈负相关。小动脉管径与baPWV呈负相关（β=-0.1；95%CI（-0.2；-0.1））。在逻辑回归分析中，AV指数较低值（OR=0.01；95%CI（0.01 - 0.10）、OR=0.03；95%CI（0.01 - 0.11）和OR=0.09；95%CI（0.01 - 0.67））分别与基于cfPWV、baPWV和血管老化指数定义的早期血管老化（EVA）相关，小动脉管径较低值（OR=0.71；95%CI（0.55 - 0.91））与基于血管老化指数定义的EVA相关。