The relationship between changes in body mass index and retinal vascular caliber in children
Emil D Kurniawan1, Carol Y Cheung2, Wan Ting Tay3
1Center for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Insights
Childhood obesity is linked to changes in retinal blood vessels. Increasing body mass index (BMI) in children is associated with wider retinal venules, a potential early sign of cardiovascular risk.
Area of Science:
- Ophthalmology
- Pediatrics
- Cardiovascular Health
Background:
- Childhood obesity is a growing public health concern.
- Retinal vascular caliber changes may reflect systemic vascular health.
- Longitudinal data on the relationship between childhood BMI and retinal vasculature are limited.
Purpose of the Study:
- To investigate the longitudinal association between changes in childhood body mass index (BMI) and retinal vascular caliber.
- To determine if baseline retinal vascular caliber predicts future BMI changes.
Main Methods:
- Prospective cohort study of 421 healthy children aged 7-9 years.
- Retinal photographs and anthropometric measurements collected at baseline (2001) and follow-up (2006).
- Retinal arteriolar and venular calibers measured as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
Main Results:
- Mean BMI significantly increased over the 5-year follow-up period.
- Mean central retinal vein equivalent (CRVE) increased significantly, while central retinal artery equivalent (CRAE) did not.
- Increasing BMI was longitudinally associated with increasing CRVE, and baseline BMI predicted changes in both CRAE and CRVE.
Conclusions:
- Progressive increases in BMI during childhood are associated with widening of retinal venules.
- Retinal venular widening may represent an early microvascular consequence of obesity.
- These findings suggest a potential link between childhood obesity, retinal vascular changes, and future cardiovascular risk.
Objective:
To examine the longitudinal relationship between changes in childhood body mass index (BMI) and retinal vascular caliber.
Study Design:
A prospective study of 421 healthy children aged 7-9 years in 2001 who returned for follow-up in 2006. At both visits, retinal photographs and anthropometric measurements were taken following standardized protocols. Retinal arteriolar and venular calibers were measured using a computer-based program and summarized as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
Results:
At follow-up, mean weight, height, and BMI increased significantly (P < .001). Mean CRVE increased by 3.4 μm (P < .001) but mean CRAE did not alter significantly (P = .340). On multivariate analysis, greater BMI was cross-sectionally associated with narrower CRAE (P < .01) and wider CRVE (P < .01). On longitudinal analysis, increasing BMI was associated with increasing CRVE (P = .04) over the 5-year period. Baseline BMI was associated with increased venular caliber and decreased arteriolar caliber at follow-up, and vice versa (P < .05).
Conclusions:
Increasing BMI is associated with increasing retinal venular caliber over time in children, and baseline retinal vascular caliber changes increase the risk of higher BMI at follow-up. As both widened retinal venular caliber and greater BMI are associated with risk of cardiovascular events in adults, progressive retinal venular widening could be a manifestation of an adverse microvascular effect of obesity early in life.
