title: Retinal arteriolar tortuosity and cardiovascular risk factors in a multi-ethnic population study of 10-year-old children; the Child Heart and Health Study in England (CHASE).
abstract: OBJECTIVE
  To examine the association between cardiovascular risk factors and retinal arteriolar tortuosity in a multi-ethnic child population.
  
  
  RESULTS
  Cross sectional study of 986 UK primary school children of South Asian, black African Caribbean, and white European origin aged 10 to 11 years. Anthropometric measurements and retinal imaging were carried out and a fasting blood sample collected. Digital images of retinal arterioles were analyzed using a validated semiautomated measure of tortuosity. Associations between tortuosity and cardiometabolic risk factors were analyzed using multi-level linear regression, adjusted for gender, age, ethnicity, arteriole branch status, month, and school. Levels of arteriolar tortuosity were similar in boys and girls and in different ethnic groups. Retinal arteriolar tortuosity was positively associated with levels of triglyceride, total and LDL cholesterol, and systolic and diastolic blood pressure. One standard deviation increases in these risk factors were associated with 3.7% (95% CI: 1.2%, 6.4%), 3.3% (0.9%, 5.8%), 3.1% (0.6%, 5.6%), 2.0% (-0.3%, 4.2%), and 2.3% (0.1%, 4.6%) increases in tortuosity, respectively. Adiposity, insulin resistance, and blood glucose showed no associations with tortuosity.
  
  
  CONCLUSIONS
  Established cardiovascular risk factors, strongly linked to coronary heart disease in adulthood, may influence retinal arteriolar tortuosity at the end of the first decade of life.
authors.affiliation: Division of Population Health Sciences and Education, St George's, University of London, UK. cowen@sgul.ac.uk
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.forename: Claire M
authors.initials: CM
authors.lastname: Nightingale
authors.forename: Robert
authors.initials: R
authors.lastname: Mullen
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Barman
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D001160:Arterioles / Q000473:pathology; D001208:Asia / Q000208:ethnology; D044466:Asian People; D044383:Black People; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D004739:England; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D012161:Retinal Artery / Q000473:pathology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014900:West Indies / Q000208:ethnology; D044465:White People
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol