2.4 SERUM BIOMARKERS AND RETINAL VESSEL DIAMETERS IN SCHOOL CHILDREN

Abstract

Objectives. Retinal vessel analysis is a valid diagnostic tool to detect subclinical signs of atherosclerosis in the cerebrovascular microcirculation as early as childhood. The aim of the study was to investigate the association between specific obesity-related biomarkers and retinal vessel diameters in school children. Methods. We studied 381 children aged 10 to 13 years in a school-based setting. Anthropometric measurements and blood sampling were conducted using standard protocols for children. The serum biomarkers leptin, insulin, adiponectin and IL-6 were assessed and correlated with retinal arteriolar (CRAE) and venular (CRVE) diameters and the arteriolar-to- venular ratio (AVR). Retinal vessel analysis was performed by use of a non-mydriatic vessel analyser (SVA-T) using a computer-based program. Results. Overweight and obese children had higher leptin and insulin levels and reduced adiponectin levels compared to normal weight children (p < 0.05). IL-6-levels were significantly higher in obese children compared to normal weight peers (p < 0.001). Wider CRVE (p = 0.031) and lower AVR (P = 0.01) were associated with higher leptin levels. Insulin levels were associated with arteriolar as well as venular dilatation depending on confounder adjustment. Conclusions. All of the above serum risk factors are altered in childhood obesity. However, only leptin and insulin levels are associated with retinal vessel diameter changes, a cumulative microvascular biomarker. Intervention studies are warranted to examine whether lifestyle improvements can prevent alterations of the vasculature early in life.