视网膜血管直径和冠心病关系的流行病学研究进展

Progress in epidemiological study between retinal vascular caliber and coronary artery disease

以人群为基础的研究资料表明,视网膜动脉和静脉管径的改变可能反映了不同的病理生理过程,与一系列全身因素、环境因素及基因危险因素相关。视网膜动脉狭窄及动静脉管径比值较小与年龄偏大、血压水平偏高(既往、现在、将来)以及肥胖明显相关,预示糖尿病和冠心病高发。而视网膜静脉管径较宽与年龄偏低、糖尿病、肥胖、血脂异常、吸烟史、炎症及血管内皮功能障碍相关,预示脑卒中和冠心病高发。因此,提高对视网膜血管直径改变的流行病学认识,有助于及早控制系统性危险因素,降低冠心病的危害。

Population-based studies have shown that changes in retinal arteriolar and venular caliber size may reflect the differential pathophysiological mechanisms, which may be correlated with a range of systemic, environmental, and genetic risk factors. Narrower retinal arteriolar caliber and smaller arteriovenous ratio are related to older age; higher levels of past, current, and future blood pressure and obesity predict the incidence of diabetes and coronary heart disease. In contrast, wider retinal venular caliber is associated with younger age, diabetes, obesity, dyslipidemia, cigarette smoking, inflammation and endothelial dysfunction; and that predicts the risk of stroke and coronary heart disease. As a result, it is beneficial to realize the epidemiology of retinal vascular caliber in order to control the systemic risk factors and decrease the damage from coronary heart disease.