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Obesity (Silver Spring). 2013 Dec;21(12):E577-85. doi: 10.1002/oby.20450. Epub 2013 Jul 2.

Retinal vessel abnormalities as a possible biomarker of brain volume loss in obese adolescents.

Author information

1
Department of Psychiatry, New York University School of Medicine, New York, USA.

Abstract

OBJECTIVE:

Endothelial dysfunction in childhood obesity may precede cerebrovascular damage and cognitive impairment in adulthood. A noninvasive proxy of microvascular health is required to identify the risk for microvascular damage in obese children.

DESIGN AND METHODS:

The associations of hippocampal volumes and global cerebral atrophy were assessed with retinal vessel caliber in 40 normal BMI controls and 62 obese age-matched nondiabetic adolescents and the contribution of inflammation, obesity, and insulin resistance to retinal vessel caliber was evaluated.

RESULTS:

Compared to controls, obese adolescents had smaller retinal arterioles (8.3% decrease, P < 0.05) and wider venules (5.4% increase, P < 0.01). Larger retinal arteriole diameters were associated with less global cerebral atrophy (B = -0.24 [95% confidence interval, CI: -0.48, -0.002]) and larger hippocampal volumes (B = 0.01 [95% CI: 0, 0.02]). Venule diameters (B = 84.2 [95% CI: 30.3, 138.1]) were predicted by inflammation (fibrinogen). Arteriolar diameters were predicted by insulin resistance, indicated by logHOMA (homeostatic model assessment, HOMA) values (B = -17.03 [95% CI: -28.25, -5.81)] and body mass index (BMI) (B = -.67 [95% CI: -1.09, -0.24)]. All analyses were adjusted for mean arterial pressure, sleep apnea, and vessel diameter.

CONCLUSIONS:

Measures of brain health, BMI, and insulin resistance are associated with retinal vessel caliber. If confirmed in larger studies, retinal arteriolar caliber may serve as a possible noninvasive proxy for brain atrophy in obese adolescents, and the identification of elevated risk for cerebral microvascular disease in adulthood.

PMID:
23512847
PMCID:
PMC3695074
DOI:
10.1002/oby.20450
[Indexed for MEDLINE]
Free PMC Article

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