title: Body fat distribution, metabolic and inflammatory markers and retinal microvasculature in school-age children. The Generation R Study.
abstract: OBJECTIVE
  To examine the associations of body fatness, metabolic and inflammatory markers with retinal vessel calibers among children.
  
  
  METHODS
  We performed a population-based cohort study among 4145 school-age children. At the median age of 6.0 years (95% range 5.8, 8.0 years), we measured body mass index, total and abdominal fat mass, metabolic and inflammatory markers (blood levels of lipids, insulin and C-peptide and C-reactive protein) and retinal vascular calibers from retinal photographs.
  
  
  RESULTS
  We observed that compared with normal weight children, obese children had narrower retinal arteriolar caliber (difference -0.21 s.d. score (SDS; 95% confidence interval (CI) -0.35, -0.06)), but not venular caliber. Continuous analyses showed that higher body mass index and total body fat mass, but not android/gynoid fat mass ratio and pre-peritoneal fat mass, were associated with narrower retinal arteriolar caliber (P<0.05 for body mass index and total body fat mass), but not with retinal venular caliber. Lipid and insulin levels were not associated with retinal vessel calibers. Higher C-reactive protein was associated with only wider retinal venular caliber (difference 0.10 SDS (95% CI 0.06, 0.14) per SDS increase in C-reactive protein). This latter association was not influenced by body mass index.
  
  
  CONCLUSIONS
  Higher body fatness is associated with narrower retinal arteriolar caliber, whereas increased C-reactive protein levels are associated with wider retinal venular caliber. Increased fat mass and inflammation correlate with microvascular development from school-age onwards.
authors.affiliation: The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: O
authors.initials: O
authors.lastname: Gishti
authors.affiliation: The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: V W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Singapore Eye Research Institute, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Memeory Aging & Cognition Centre (MACC), National University Health System, Singapore.
authors.forename: T Y
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.|Memeory Aging & Cognition Centre (MACC), National University Health System, Singapore.|Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M K
authors.initials: MK
authors.lastname: Ikram
authors.affiliation: The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Gaillard
mesh_terms: D015415:Biomarkers; D001794:Blood Pressure; D050218:Body Fat Distribution; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D063766:Pediatric Obesity / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D011159:Population Surveillance; D063177:Pulse Wave Analysis; D012016:Reference Values; D012164:Retinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012171:Retinal Vessels / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D014654:Vascular Patency; D014699:Venules / Q000473:pathology*
chemical_list: D015415:Biomarkers