Obesity, blood pressure and retinal microvascular phenotype in a bi-ethnic cohort of young children. (June 2022)

• Record Type: Journal Article
• Authors: Köchli, Sabrina; Smith, Wayne; Lona, Giulia; Goikoetxea-Sotelo, Gaizka; Breet, Yolandi; Botha-Le Roux, Shani; Mokwatsi, Gontse G.; Kruger, Ruan; Hanssen, Henner
• Is Part Of: Atherosclerosis. Volume 350(2022)
• Page Start: 51
• Page End: 57
• Publication Date: 2022-06
• Subjects: Childhood obesity -- Blood pressure -- Retinal vessels -- Ethnicity -- Primary prevention; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2022.04.018
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Childhood obesity and high blood pressure (BP) are main determinants for cardiovascular disease development with regional and ethnic differences. Narrower arteriolar (CRAE) and wider venular (CRVE) retinal vessel diameters are sensitive markers of early vascular compromise in children. We aimed to compare retinal vessel diameters and investigate associations and odds ratios with body mass index (BMI) and BP in a multi-national/ethnic childhood study. Methods: BMI, systolic (SBP) and diastolic BP (DBP) were screened in 929 black and white South African (SA) and 1171 Swiss children (aged 5–9 years). Retinal assessments were performed using a retinal vessel analyzer to determine CRAE and CRVE. Results: Black SA children had wider CRVE compared to white SA and Swiss children (all p < 0.001). However, BMI or BP was not associated with CRVE in black SA children. Higher BMI and BP associated with narrower CRAE in all children, except for BMI in black SA children, in whom narrower CRAE was found for every unit increase in SBP (β = −0.199 μm, p = 0.001) and DBP (β = −0.312 μm, p < 0.001). Obesity (OR:1.38[1.01; 1.89]), hypertension (OR:1.90[1.53; 2.36]) and black ethnicity (OR:1.50[1.18; 1.92]) increased the likelihood for arteriolar narrowing. Conclusions: Black SA children presented with wider retinal venules compared to their white SA and Swiss peers, which was unexplained by conventional risk factors. The overall risk of arteriolar narrowing was driven by obesity, hypertension and ethnicity. Our findings indicate the importance to differentiate cardiovascular risk by microvascular phenotype in different populations and ethnicity early in life. Graphical abstract: Image 1 Highlights: Retinal vessel diameters as biomarkers of cardiovascular risk differ between large bi-ethnic cohorts of young children. Black South African children are characterized by venular widening, not explained by classical risk factors. The overall risk for arteriolar narrowing is driven by body composition, blood pressure and ethnicity.