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1From the Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia; the 2Singapore Eye Research Institute, National University of Singapore, Singapore; the 3Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; the 4Departments of Medicine and 5Epidemiology, the Johns Hopkins University, Baltimore, Maryland; the 6Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin; and the 7Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina.
PURPOSE. To examine the cross-sectional relationship of the metabolic syndrome (hypertension, hyperglycemia, central obesity, and dyslipidemia) and retinal microvascular abnormalities in middle-aged men and women.
METHODS. A population-based, cross-sectional study involving 11,265 persons aged 49 to 73 years who had retinal photography from 1993 through 1995. Photographs were graded for presence of retinal microvascular signs (microaneurysms, retinal hemorrhages, arteriovenous nicking, and focal arteriolar narrowing) according to a standardized protocol. To quantify retinal vessel diameters, photographs were digitized and individual arteriolar and venular diameters were measured and summarized. The metabolic syndrome was defined according to the Third Report of the National Cholesterol Education Program Adult Treatment Panel.
RESULTS. After adjustment for age, gender, race, education, cigarette smoking and alcohol consumption, persons with the metabolic syndrome were more likely to have retinopathy (odds ratio [OR] 1.68, 95% confidence interval [CI], 1.45–1.96), arteriovenous nicking (OR 1.30, 95% CI, 1.16–1.45), focal arteriolar narrowing (OR 1.24, 95% CI, 1.10–1.38), generalized retinal arteriolar narrowing (OR 1.23, 95% CI, 1.12–1.35), and generalized retinal venular dilatation (OR 1.30, 95% CI, 1.18–1.48) than persons without the metabolic syndrome. Associations for arteriovenous nicking, focal arteriolar narrowing, generalized arteriolar narrowing, and venular dilatation were noted, even in people without diabetes or hypertension.
CONCLUSIONS. These data suggest that the metabolic syndrome is associated with microvascular changes in the retina. This finding reflects, in part, the associations of individual syndrome components with retinal microvascular abnormalities.
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