Association between Metabolic Syndrome and Retinal Vascular Changes in Koreans based on Health Check-ups

Kyeong Do Jeong; Jae Suk Kim

doi:10.3341/jkos.2016.57.7.1102

Journal List > J Korean Ophthalmol Soc > v.57(7) > 1010339

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Jeong and Kim: Association between Metabolic Syndrome and Retinal Vascular Changes in Koreans based on Health Check-ups

Original Article

J Korean Ophthalmol Soc 2016;57(7):1102-1108.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.7.1102

Association between Metabolic Syndrome and Retinal Vascular Changes in Koreans based on Health Check-ups

Kyeong Do Jeong, MD, Jae Suk Kim, MD, PhD

Department of Ophthalmology, Inje University Sanggye Paik Hospital, Seoul, Korea

Address reprint requests to Jae Suk Kim, MD, PhD Department of Ophthalmology, Inje University Sanggye Paik Hospital, #1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea Tel: 82-2-950-1096, Fax: 82-2-935-6904 E-mail: 991027js@hanmail.net

Received 10 March 2016 Accepted 23 June 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the associations between components of metabolic syndrome and retinal vascular changes in a Korean population based on data collected at health check-ups.

Methods

Fundus photographs of 381 patients participating in a health check-up were examined to identify central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriovenous ratio (AVR) by IVAN software. Retinal hemorrhage, arteriovenous nicking, and retinal exudate were also noted. The association between metabolic syndrome and each component was then analyzed.

Results

Significant associations were shown between metabolic syndrome and CRAE (p = 0.032), central obesity and CRAE (p = 0.037), triglyceride and CRAE (p = 0.011), and triglyceride and AVR (p = 0.005), in addition to central obesity and arteriovenous nicking (odds ratio [OR] = 2.68, p = 0.013), central obesity and retinal exudate (OR = 2.30, p = 0.038), serum glucose and retinal hemorrhage (OR = 8.06, p = 0.030), and blood pressure and arteriovenous nicking (OR = 2.78, p = 0.007).

Conclusions

Metabolic syndrome showed a significant relationship with retinal artery diameter. Central obesity showed the greatest relationship with retinal vascular changes among each of the components of metabolic syndrome.

Keywords: Metabolic syndrome, Retinal artery, Retinal hemorrhage, Retinal vein

References

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Figure 1.

Fundus photograph centered at the optic disc of left eye, grader analysis measures arteries and veins, the largest six arteries (red) and veins (blue) are used to calculate the central retinal artery equivalent and central retinal vein equivalent by the “Big 6” method. Yellow line is the vessel indicator of the IVAN. DD = disc diameter.

Table 1.

Demographics of participants with or without metabolic syndrome, defined with National Cholesterol Education Program Adult Treatment Panel III (NCEP III) criteria

	Metabolic syndrome
	Present (N = 52)	Absent (N = 269)	p-value^*
Age (years)	58.5 ± 10.8	54.6 ± 10.0	0.012
Gender (% male)	37 (71.2)	165 (59.5)	0.122
Height (kg)	165.8 ± 9.7	163.8 ± 8.7	0.135
Weight (cm)	73.9 ± 11.8	64.6 ± 10.2	<0.001
Body mass index (kg/m2)	26.8 ± 2.7	24.0 ± 2.6	<0.001
Waist circumference (cm)	89.9 ± 7.15	79.7 ± 8.5	<0.001
Systolic blood pressure (mm Hg)	129.4 ± 6.1	119.5 ± 9.7	<0.001
Diastolic blood pressure (mm Hg)	78.1 ± 5.6	74.3 ± 5.9	<0.001
Triglyceride (mg/dL)	189.2 ± 84.0	114.2 ± 66.8	<0.001
HDL cholesterol (mg/dL)	40.9 ± 7.6	51.5 ± 10.7	<0.001
Fasting glucose (mg/dL)	118.3 ± 36.0	94.5 ± 14.6	<0.001

Values are presented as mean ± SD unless otherwise indicated.

HDL = high density lipoprotein.

^* Independent t-test.

Table 2.

Relationship of retinal vascular calibers with metabolic syndrome factors

	CRAE (μ m)	CRVE (μ m)	AVR
Waist circumference
≥90 cm (M), ≥85 cm (F)	144.63 ± 18.56	209.00 ± 25.30	0.70 ± 0.11
＜90 cm (M), ＜85 cm (F)	150.85 ± 17.26	211.85 ± 20.42	0.72 ± 0.09
p-value	0.037	0.602	0.250
Triglyceride
≥150 mg/dL	144.80 ± 16.10	212.06 ± 20.27	0.69 ± 0.08
＜150 mg/dL	151.07 ± 17.98	210.95 ± 22.02	0.72 ± 0.10
p-value	0.011	0.566	0.005
HDL cholesterol
≤40 mg/dL (M), ≤50 mg/dL (F)	149.45 ± 18.08	210.75 ± 21.52	0.71 ± 0.09
＞40 mg/dL (M), ＞50 mg/dL (F)	149.50 ± 17.60	211.41 ± 21.63	0.71 ± 0.09
p-value	0.994	0.864	0.958
Glucose
≥110 mg/dL	146.49 ± 16.51	213.07 ± 24.06	0.69 ± 0.08
＜110 mg/dL	149.93 ± 17.86	210.96 ± 21.21	0.72 ± 0.10
p-value	0.543	0.279	0.169
Blood pressure
≥130/85 mm Hg	147.77 ± 16.90	209.21 ± 25.03	0.71 ± 0.10
＜130/85 mm Hg	150.65 ± 18.18	212.58 ± 18.83	0.71 ± 0.09
p-value	0.360	0.316	0.755
Metabolic syndrome
Yes	144.08 ± 15.83	209.99 ± 22.30	0.69 ± 0.08
No	150.54 ± 17.89	211.47 ± 21.46	0.72 ± 0.10
p-value	0.032	0.750	0.084

Values are presented as mean ± SD unless otherwise indicated. All components are adjusted for age and gender.

CRAE = central retinal artery equivalent; CRVE = central retinal vein equivalent; AVR = arteriovenous ratio; M = male; F = female; HDL = high density lipoprotein.

Table 3.

Odds ratio (95% confidence interval) for components of metabolic syndrome

	Retinal hemorrhage	Arteriovenous nicking	Retinal exudate
Waist circumference	0.59 (0.06–5.58)	2.68 (1.23–5.83)	2.30 (1.06–4.03)
≥90 cm (M), ≥85 cm (F)	p = 0.642	p = 0.013	p = 0.038
Triglyceride	1.89 (0.31–11.65)	0.98 (0.44–2.20)	0.68 (0.26–1.78)
≥150 mg/dL	p = 0.493	p = 0.957	p = 0.431
HDL-cholesterol	0.60 (0.07–5.54)	0.95 (0.44–2.08)	0.57 (0.22–1.49)
≤40 mg/dL (M), ≤50 mg/dL (F)	p = 0.654	p = 0.898	p = 0.250
Glucose	8.06 (1.22–53.05)	0.78 (0.25–2.41)	1.03 (0.35–2.98)
≥110 mg/dL	p = 0.030	p = 0.665	p = 0.962
Blood pressure	0.72 (0.12–4.56)	2.78 (1.33–5.84)	1.34 (0.60–2.98)
≥130/85 mm Hg	p = 0.729	p = 0.007	p = 0.479
Metabolic syndrome	1.02 (0.11–9.52)	1.53 (0.64–3.66)	0.82 (0.29–2.34)
	p = 0.988	p = 0.337	p = 0.713

All components are adjusted for age and gender.

M = male; F = female; HDL = high density lipoprotein.

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