title: Vitamin D and retinal microvascular damage: The Rotterdam Study.
abstract: Vitamin D has been linked to various cardiovascular risk factors including indices of large-vessel disease. However, it remains unclear whether vitamin D is also associated with microvascular damage. In a community-dwelling population, we studied associations between vitamin D serum levels and retinal microvascular damage defined as retinopathy signs, narrower arterioles, and wider venules.From the population-based Rotterdam Study, we included 5675 participants (age ≥45 years) with vitamin D data and gradable retinal photographs. Serum levels of vitamin D were measured using an antibody-based assay. Retinal exudates, microaneurysms, cotton wool spots, and dot/blot hemorrhages were graded on fundus photographs by experienced graders in the whole sample; retinal vascular calibers, that is, arteriolar and venular diameters, were semiautomatically measured in a subsample (n = 2973). We examined the cross-sectional association between vitamin D and retinal microvascular damage using logistic and linear regression models, adjusting for age, sex, and cardiovascular risk factors.We found that persons with lower vitamin D levels were more likely to have retinopathy (adjusted odds ratio per standard deviation (SD) decrease of vitamin D = 1.30; 95% confidence interval (CI): = 1.12-1.49). Furthermore, lower vitamin D levels were associated with wider venular calibers (adjusted mean difference per SD decrease in vitamin D = 1.35; 95% CI = 0.64-2.06). This association was strongest among men (P for interaction = 0.023).Lower levels of vitamin D are associated with retinal microvascular damage, suggesting that the link with cardiovascular risk may partly run through changes in the microvasculature.
authors.affiliation: Department of Epidemiology Department of Ophthalmology Department of Radiology Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts Department of Retinal Signal Processing, Netherlands Institute for Neuroscience Department of Ophthalmology, Academic Medical Center, Amsterdam Department of Ophthalmology, Leiden University Medical Center, Leiden Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Unal
authors.initials: U
authors.lastname: Mutlu
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Paulus T V M
authors.initials: PTVM
authors.lastname: de Jong
authors.forename: Andre G
authors.initials: AG
authors.lastname: Uitterlinden
authors.forename: Caroline C W
authors.initials: CCW
authors.lastname: Klaver
authors.forename: M Kamran
authors.initials: MK
authors.lastname: Ikram
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012164:Retinal Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012171:Retinal Vessels / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D