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

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

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.

Go to :

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

References

1. Timar O, Sestier F, Levy E. Metabolic syndrome X: a review. Can J Cardiol. 2000; 16:779–89.

2. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002; 106:3143–421.

3. Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of abdominal syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific abdominal related to definition. Circulation. 2004; 109:433–8.

4. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic abdominal among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002; 287:356–9.

5. Park JS, Park HD, Yun JW, et al. Prevalence of the metabolic abdominal as defined by NCEP – ATPⅢ among the urban Korean population. Korean J Med. 2002; 63:290–8.

6. Klein BE, Klein R, Lee KE. Components of the metabolic abdominal and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care. 2002; 25:1790–4.

7. Golden SH, Folsom AR, Coresh J, et al. Risk factor groupings abdominal to insulin resistance and their synergistic effects on abdominal atherosclerosis: the atherosclerosis risk in communities study. Diabetes. 2002; 51:3069–76.

8. de Jongh RT, Serné EH, IJzerman RG, et al. Impaired abdominal function in obesity: implications for obesity-associated microangiopathy, hypertension, and insulin resistance. Circulation. 2004; 109:2529–35.

9. Wong TY, Kamineni A, Klein R, et al. Quantitative retinal venular caliber and risk of cardiovascular disease in older persons: the abdominal health study. Arch Intern Med. 2006; 166:2388–94.

10. Ikram MK, de Jong FJ, Vingerling JR, et al. Are retinal arteriolar or venular diameters associated with markers for cardiovascular abdominal? The Rotterdam Study. Invest Ophthalmol Vis Sci. 2004; 45:2129–34.

11. Wong TY, Islam FM, Klein R, et al. Retinal vascular caliber, abdominal risk factors, and inflammation: the abdominal study of atherosclerosis (MESA). Invest Ophthalmol Vis Sci. 2006; 47:2341–50.

12. McGeechan K, Liew G, Macaskill P, et al. Meta-analysis: retinal vessel caliber and risk for coronary heart disease. Ann Intern Med. 2009; 151:404–13.

13. Ikram MK, de Jong FJ, Bos MJ, et al. Retinal vessel diameters and risk of stroke: the Rotterdam Study. Neurology. 2006; 66:1339–43.

14. McGeechan K, Liew G, Macaskill P, et al. Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis. Am J Epidemiol. 2009; 170:1323–32.

15. Jeganathan VS, Sabanayagam C, Tai ES, et al. Retinal vascular abdominal and diabetes in a multiethnic Asian population. Microcirculation. 2009; 16:534–43.

16. Islam FM, Nguyen TT, Wang JJ, et al. Quantitative retinal vascular calibre changes in diabetes and retinopathy: the Singapore Malay eye study. Eye (Lond). 2009; 23:1719–24.

17. Ikram MK, Janssen JA, Roos AM, et al. Retinal vessel diameters and risk of impaired fasting glucose or diabetes: the Rotterdam study. Diabetes. 2006; 55:506–10.

18. Wong TY, Duncan BB, Golden SH, et al. Associations between the metabolic syndrome and retinal microvascular signs: the Atherosclerosis Risk In Communities study. Invest Ophthalmol Vis Sci. 2004; 45:2949–54.

19. Liew G, Sharrett AR, Wang JJ, et al. Relative importance of abdominalic determinants of retinal arteriolar and venular caliber: the atherosclerosis risk in communities study. Arch Ophthalmol. 2008; 126:1404–10.

20. Klein R, Klein BE, Knudtson MD, et al. Are inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study. Arch Ophthalmol. 2006; 124:87–94.

21. Nguyen TT, Wang JJ, Sharrett AR, et al. Relationship of retinal vascular caliber with diabetes and retinopathy: the MultiEthnic Study of Atherosclerosis (MESA). Diabetes Care. 2008; 31:544–9.

22. Kawasaki R, Tielsch JM, Wang JJ, et al. The metabolic syndrome and retinal microvascular signs in a Japanese population: the Funagata study. Br J Ophthalmol. 2008; 92:161–6.

23. Yuan Y, Ikram MK, Vingerling JR, et al. Retinal vascular caliber and metabolic syndrome in a Chinese population. Intern Med J. 2012; 42:1014–22.

24. Leung H, Wang JJ, Rochtchina E, et al. Computer-assisted retinal vessel measurement in an older population: correlation between right and left eyes. Clin Experiment Ophthalmol. 2003; 31:326–30.

25. Hubbard LD, Brothers RJ, King WN, et al. Methods for evaluation of retinal microvascular abnormalities associated with abdominal/sclerosis in the Atherosclerosis Risk in Communities Study. Ophthalmology. 1999; 106:2269–80.

26. Knudtson MD, Lee KE, Hubbard LD, et al. Revised formulas for summarizing retinal vessel diameters. Curr Eye Res. 2003; 27:143–9.

27. Frisbee JC. Remodeling of the skeletal muscle microcirculation abdominals resistance to perfusion in obese Zucker rats. Am J Physiol Heart Circ Physiol. 2003; 285:H104–11.

28. Oren S, Grossman E, Frohlich ED. Arterial and venous compliance in obese and nonobese subjects. Am J Cardiol. 1996; 77:665–7.

29. Klein R, Klein BE, Moss SE, et al. Retinal vascular caliber in abdominal with type 2 diabetes: the Wisconsin Epidemiological Study of Diabetic Retinopathy: XX. Ophthalmology. 2006; 113:1488–98.

30. Tikellis G, Wang JJ, Tapp R, et al. The relationship of retinal abdominal calibre to diabetes and retinopathy: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Diabetologia. 2007; 50:2263–71.

31. Curtis TM, Gardiner TA, Stitt AW. Microvascular lesions of abdominal retinopathy: clues towards understanding pathogenesis? Eye (Lond). 2009; 23:1496–508.

32. Kawasaki R, Cheung N, Wang JJ, et al. Retinal vessel diameters and risk of hypertension: the Multiethnic Study of Atherosclerosis. J Hypertens. 2009; 27:2386–93.

33. Cheung N, Sharrett AR, Klein R, et al. Aortic distensibility and abdominal arteriolar narrowing: the abdominal study of atherosclerosis. Hypertension. 2007; 50:617–22.

34. Hemminki V, Kähönen M, Tuomisto MT, et al. Determination of retinal blood vessel diameters and arteriovenous ratios in systemic hypertension: comparison of different calculation formulae. Graefes Arch Clin Exp Ophthalmol. 2007; 245:8–17.

Go to :

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.

undefined

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.

TOOLS

Similar articles