Body fat evolution as predictor of retinal microvasculature in children
C J C Van Aart1, N Michels1, I Sioen1,2
1Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Insights
Changes in children's body fat over time are linked to retinal microvasculature changes, particularly in boys. This suggests early cardiovascular aging markers may be influenced by childhood adiposity.
Area of Science:
- Pediatric cardiovascular health
- Ophthalmology
- Developmental biology
Background:
- Overweight in children is a growing concern linked to cardiovascular disease.
- Microvascular changes are potential early indicators of cardiovascular aging.
- Understanding the link between body fat and vascular health in children is crucial.
Purpose of the Study:
- To investigate the association between changes in children's body fat over time and retinal microvasculature.
- To explore if body fat accumulation in childhood predicts cardiovascular aging markers.
- To examine sex-specific differences in these associations.
Main Methods:
- Longitudinal study of 171 healthy Flemish children over 7 years.
- Measurements included body mass index (zBMI), waist circumference (zWC), and fat mass index (zFMI).
- Retinal microvasculature (CRAE, CRVE) assessed using digital retinal photographs and IVAN software.
Main Results:
- Higher fat mass index (zFMI) in boys was cross-sectionally associated with higher central retinal venular equivalent (CRVE).
- Boys with high zFMI also showed a lower central retinal arteriolar to venular equivalent ratio.
- Longitudinal analysis revealed changes in zFMI over time were positively associated with CRVE in boys.
Conclusions:
- Changes in body fat during childhood are associated with retinal microvascular alterations, specifically the CRVE.
- These findings highlight potential early cardiovascular aging effects in children related to adiposity.
- The association was particularly evident in boys, suggesting sex-specific effects.
Objectives:
Microvascular changes may represent an underlying mechanism through which overweight contributes to cardiovascular disease development. Therefore, the aim of this study was to investigate whether changes in children's body fat over time are associated with the retinal microvasculature, a marker of cardiovascular aging.
Methods:
In a longitudinal design, 171 healthy Flemish children (53.8% boys) were followed-up for 7 years (2008-2015), aged 2.7-8.1 years at baseline.Z-scores of body mass index (zBMI; 4.1% overweight), waist circumference (zWC) and fat mass index (zFMI by BODPOD) were obtained using standardized protocols during each visit. Retinal arteriolar (central retinal arteriolar equivalent (CRAE)) and venular equivalents (central retinal venular equivalent (CRVE)) were measured from digital retinal photographs (2015) using IVAN software. Cross-sectional and longitudinal associations between changes in body fat and retinal microvasculature were explored using multivariable regression analysis, while controlling for age, sex, mean arterial pressure, alternate retinal caliber, physical activity, diet and birth weight.
Results:
In cross-sectional analysis, children with high zFMI had a higher CRVE, but only in boys (β=0.25, P=0.02). In addition, boys with high zFMI had also a lower CRAE to CRVE ratio (β=-0.26, P=0.03). No associations were seen with the CRAE, or between zBMI or zWC and the retinal microvasculature. Only changes in zFMI over time were found to be positively associated with the CRVE in boys (β=0.38, P=0.01).
Conclusions:
Our analysis over a 7-year period shows that changes in body fat during childhood are already associated with the CRVE (especially in boys).
