title: The relationship between changes in body mass index and retinal vascular caliber in children.
abstract: OBJECTIVE
  To examine the longitudinal relationship between changes in childhood body mass index (BMI) and retinal vascular caliber.
  
  
  METHODS
  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.
authors.affiliation: Center for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Emil D
authors.initials: ED
authors.lastname: Kurniawan
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
authors.forename: Wan Ting
authors.initials: WT
authors.lastname: Tay
authors.affiliation: Center for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Department of Ophthalmology, University of Hong Kong, Hong Kong SAR, China. Electronic address: dannycheung@hotmail.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Cheung
mesh_terms: D015992:Body Mass Index; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000473:pathology*; D011446:Prospective Studies; D012161:Retinal Artery / Q000033:anatomy & histology; D012169:Retinal Vein / Q000033:anatomy & histology; D012171:Retinal Vessels / Q000033:anatomy & histology*; D014699:Venules / Q000033:anatomy & histology