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Association of the apolipoproteins with retinal arteriosclerosis in a health examination population
Xinghe Sun1, Lijuan Guo1, Hui Lv2
1Department of Cardiology, Peking University International Hospital, Beijing, China.
Insights
The Apolipoprotein B/Apolipoprotein A1 ratio is linked to retinal arteriosclerosis, particularly in older adults. This suggests apolipoprotein profiling can aid in early microvascular damage detection via the eye-heart axis.
Area of Science:
- Ophthalmology
- Cardiovascular Medicine
- Biochemistry
Background:
- Retinal arteriosclerosis serves as a non-invasive marker for systemic microvascular damage and early atherosclerosis.
- Traditional lipid measures are used for cardiovascular risk, but apolipoproteins (ApoB, ApoA1) may offer deeper insight into atherogenic burden.
- The association between apolipoproteins and retinal arteriosclerosis in general populations remains under-explored.
Purpose of the Study:
- To investigate the association between apolipoproteins (ApoB, ApoA1, and ApoB/ApoA1 ratio) and retinal arteriosclerosis in a general health examination cohort.
- To determine if apolipoprotein levels are independent predictors of retinal arteriosclerosis, considering various confounders.
Main Methods:
- A cross-sectional study of 4,938 adults from a health examination cohort.
- Retinal arteriosclerosis assessed via fundus photography and SCHEIE classification.
- Multivariable logistic regression and restricted cubic spline analyses were employed, adjusting for demographic, lifestyle, clinical, and laboratory factors.
Main Results:
- Retinal arteriosclerosis was more prevalent in males (13.98%) than females (8.57%).
- Individuals with retinal arteriosclerosis exhibited higher ApoB levels and ApoB/ApoA1 ratios.
- Both ApoB (OR 1.12) and ApoB/ApoA1 ratio (OR 1.14) were independently associated with retinal arteriosclerosis, particularly in adults aged 45+, non-smokers, and non-hypertensives.
Conclusions:
- The ApoB/ApoA1 ratio shows an independent association with retinal arteriosclerosis, especially in older adults.
- Integrating apolipoprotein profiling into cardiovascular risk assessment may enhance early detection of microvascular damage.
- The findings highlight the utility of the "eye-heart" axis in understanding systemic vascular health.
Background:
Retinal arteriosclerosis is a non-invasive indicator for systemic microvascular damage and early atherosclerosis. While traditional lipid measures are used to establish cardiovascular risk predictors, Apolipoprotein B (ApoB), Apolipoprotein A1 (ApoA1), and their ratio might provide more insights into the atherogenic burden. However, their association with retinal arteriosclerosis in general health populations has not yet been explored.
Methods:
This cross-sectional study included 4,938 adults from a health examination cohort. Retinal arteriosclerosis was evaluated by employing fundus photography and the SCHEIE classification. Multivariable logistic regression and restricted cubic spline analyses were used to evaluate the associations between apolipoproteins (ApoA1, ApoB/ApoA1 ratio) and retinal arteriosclerosis, accounting for demographic, lifestyle, clinical, and laboratory confounders.
Results:
In males, retinal arteriosclerosis prevalence was 13.98%, which is higher than females, who have 8.57%. People with retinal arteriosclerosis showed significantly higher ApoB levels and ApoB/ApoA1 ratios. In fully adjusted models, both ApoB (per 1-SD increase: OR 1.12, 95% CI 1.01-1.24) and ApoB/ApoA1 ratio (per 1-SD increase: OR 1.14, 95% CI 1.03-1.27) remained independently associated with retinal arteriosclerosis. Subgroup analyses revealed significant associations in adults ≥45 years, non-smokers, and non-hypertensive individuals.
Conclusion:
The ApoB/ApoA1 ratio is independently linked to retinal arteriosclerosis, especially in older adults. These findings indicate that integrating apolipoprotein profiling into cardiovascular risk assessment could improve the early detection of microvascular damage by leveraging the "eye-heart" axis.
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