Abstract

OBJECTIVE: Microvascular dysfunction is an important underlying mechanism of microvascular diseases. Determinants (age, sex, hypertension, dyslipidemia, hyperglycemia, obesity, and smoking) of macrovascular diseases affect large-artery endothelial function. These risk factors also associate with microvascular diseases. We hypothesized that they are also determinants of microvascular (endothelial) function.

METHODS: In The Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n = 1991, 51% men, aged 59.7±8.2 years), we determined microvascular function as flicker light-induced retinal arteriolar %-dilation and heat-induced skin %-hyperemia. Multiple linear regression analyses were used to assess the associations of cardiovascular risk factors (age, sex, waist circumference, total-to-high-density lipoprotein (HDL) cholesterol ratio, fasting plasma glucose (FPG), 24-h systolic blood pressure, and cigarette smoking) with retinal and skin microvascular function.

RESULTS: In multivariate analyses, age and FPG were inversely associated with retinal and skin microvascular function (regression coefficients per standard deviation (SD) were -0.11SD (95%CI: -0.15;-0.06) and -0.12SD (-0.17;-0.07) for retinal arteriolar %-dilation and -0.10SD (-0.16;-0.05) and -0.11SD (-0.17;-0.06) for skin %-hyperemia, respectively. Men and current smokers had -0.43SD (-0.58;-0.27) and -0.32SD (-0.49;-0.15) lower skin %-hyperemia, respectively. 24-h systolic blood pressure, waist circumference, and total-to-HDL cholesterol ratio were not statistically significantly associated with these microvascular functions.

CONCLUSIONS: Associations between cardiovascular risk factors and retinal and skin microvascular function show a pattern that is partly similar to the associations between cardiovascular risk factors and macrovascular function. Impairment of microvascular function may constitute a pathway through which an adverse cardiovascular risk factor pattern may increase risk of diseases that are partly or wholly of microvascular origin.

Original languageEnglish
Article numbere0187324
Number of pages18
JournalPLOS ONE
Volume12
Issue number10
DOIs
Publication statusPublished - 27 Oct 2017

Keywords

  • Journal Article
  • OPTIC-NERVE
  • OBESITY
  • ENDOTHELIAL DYSFUNCTION
  • INSULIN-RESISTANCE
  • NITRIC-OXIDE
  • VESSEL DIAMETER
  • PATHOLOGY
  • BLOOD-PRESSURE
  • FLOW
  • AGE

Cite this

@article{412c34844d2c4daa8e9cf8e9fdb6e9c3,
title = "Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study",
abstract = "OBJECTIVE: Microvascular dysfunction is an important underlying mechanism of microvascular diseases. Determinants (age, sex, hypertension, dyslipidemia, hyperglycemia, obesity, and smoking) of macrovascular diseases affect large-artery endothelial function. These risk factors also associate with microvascular diseases. We hypothesized that they are also determinants of microvascular (endothelial) function.METHODS: In The Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n = 1991, 51{\%} men, aged 59.7±8.2 years), we determined microvascular function as flicker light-induced retinal arteriolar {\%}-dilation and heat-induced skin {\%}-hyperemia. Multiple linear regression analyses were used to assess the associations of cardiovascular risk factors (age, sex, waist circumference, total-to-high-density lipoprotein (HDL) cholesterol ratio, fasting plasma glucose (FPG), 24-h systolic blood pressure, and cigarette smoking) with retinal and skin microvascular function.RESULTS: In multivariate analyses, age and FPG were inversely associated with retinal and skin microvascular function (regression coefficients per standard deviation (SD) were -0.11SD (95{\%}CI: -0.15;-0.06) and -0.12SD (-0.17;-0.07) for retinal arteriolar {\%}-dilation and -0.10SD (-0.16;-0.05) and -0.11SD (-0.17;-0.06) for skin {\%}-hyperemia, respectively. Men and current smokers had -0.43SD (-0.58;-0.27) and -0.32SD (-0.49;-0.15) lower skin {\%}-hyperemia, respectively. 24-h systolic blood pressure, waist circumference, and total-to-HDL cholesterol ratio were not statistically significantly associated with these microvascular functions.CONCLUSIONS: Associations between cardiovascular risk factors and retinal and skin microvascular function show a pattern that is partly similar to the associations between cardiovascular risk factors and macrovascular function. Impairment of microvascular function may constitute a pathway through which an adverse cardiovascular risk factor pattern may increase risk of diseases that are partly or wholly of microvascular origin.",
keywords = "Journal Article, OPTIC-NERVE, OBESITY, ENDOTHELIAL DYSFUNCTION, INSULIN-RESISTANCE, NITRIC-OXIDE, VESSEL DIAMETER, PATHOLOGY, BLOOD-PRESSURE, FLOW, AGE",
author = "S{\"o}rensen, {Ben M} and Houben, {Alfons J H M} and Berendschot, {Tos T J M} and Schouten, {Jan S A G} and Kroon, {Abraham A} and {van der Kallen}, {Carla J H} and Henry, {Ronald M A} and Annemarie Koster and Dagnelie, {Pieter C} and Schaper, {Nicolaas C} and Schram, {Miranda T} and Stehouwer, {Coen D A}",
year = "2017",
month = "10",
day = "27",
doi = "10.1371/journal.pone.0187324",
language = "English",
volume = "12",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "10",

}

TY - JOUR

T1 - Cardiovascular risk factors as determinants of retinal and skin microvascular function

T2 - The Maastricht Study

AU - Sörensen, Ben M

AU - Houben, Alfons J H M

AU - Berendschot, Tos T J M

AU - Schouten, Jan S A G

AU - Kroon, Abraham A

AU - van der Kallen, Carla J H

AU - Henry, Ronald M A

AU - Koster, Annemarie

AU - Dagnelie, Pieter C

AU - Schaper, Nicolaas C

AU - Schram, Miranda T

AU - Stehouwer, Coen D A

PY - 2017/10/27

Y1 - 2017/10/27

N2 - OBJECTIVE: Microvascular dysfunction is an important underlying mechanism of microvascular diseases. Determinants (age, sex, hypertension, dyslipidemia, hyperglycemia, obesity, and smoking) of macrovascular diseases affect large-artery endothelial function. These risk factors also associate with microvascular diseases. We hypothesized that they are also determinants of microvascular (endothelial) function.METHODS: In The Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n = 1991, 51% men, aged 59.7±8.2 years), we determined microvascular function as flicker light-induced retinal arteriolar %-dilation and heat-induced skin %-hyperemia. Multiple linear regression analyses were used to assess the associations of cardiovascular risk factors (age, sex, waist circumference, total-to-high-density lipoprotein (HDL) cholesterol ratio, fasting plasma glucose (FPG), 24-h systolic blood pressure, and cigarette smoking) with retinal and skin microvascular function.RESULTS: In multivariate analyses, age and FPG were inversely associated with retinal and skin microvascular function (regression coefficients per standard deviation (SD) were -0.11SD (95%CI: -0.15;-0.06) and -0.12SD (-0.17;-0.07) for retinal arteriolar %-dilation and -0.10SD (-0.16;-0.05) and -0.11SD (-0.17;-0.06) for skin %-hyperemia, respectively. Men and current smokers had -0.43SD (-0.58;-0.27) and -0.32SD (-0.49;-0.15) lower skin %-hyperemia, respectively. 24-h systolic blood pressure, waist circumference, and total-to-HDL cholesterol ratio were not statistically significantly associated with these microvascular functions.CONCLUSIONS: Associations between cardiovascular risk factors and retinal and skin microvascular function show a pattern that is partly similar to the associations between cardiovascular risk factors and macrovascular function. Impairment of microvascular function may constitute a pathway through which an adverse cardiovascular risk factor pattern may increase risk of diseases that are partly or wholly of microvascular origin.

AB - OBJECTIVE: Microvascular dysfunction is an important underlying mechanism of microvascular diseases. Determinants (age, sex, hypertension, dyslipidemia, hyperglycemia, obesity, and smoking) of macrovascular diseases affect large-artery endothelial function. These risk factors also associate with microvascular diseases. We hypothesized that they are also determinants of microvascular (endothelial) function.METHODS: In The Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n = 1991, 51% men, aged 59.7±8.2 years), we determined microvascular function as flicker light-induced retinal arteriolar %-dilation and heat-induced skin %-hyperemia. Multiple linear regression analyses were used to assess the associations of cardiovascular risk factors (age, sex, waist circumference, total-to-high-density lipoprotein (HDL) cholesterol ratio, fasting plasma glucose (FPG), 24-h systolic blood pressure, and cigarette smoking) with retinal and skin microvascular function.RESULTS: In multivariate analyses, age and FPG were inversely associated with retinal and skin microvascular function (regression coefficients per standard deviation (SD) were -0.11SD (95%CI: -0.15;-0.06) and -0.12SD (-0.17;-0.07) for retinal arteriolar %-dilation and -0.10SD (-0.16;-0.05) and -0.11SD (-0.17;-0.06) for skin %-hyperemia, respectively. Men and current smokers had -0.43SD (-0.58;-0.27) and -0.32SD (-0.49;-0.15) lower skin %-hyperemia, respectively. 24-h systolic blood pressure, waist circumference, and total-to-HDL cholesterol ratio were not statistically significantly associated with these microvascular functions.CONCLUSIONS: Associations between cardiovascular risk factors and retinal and skin microvascular function show a pattern that is partly similar to the associations between cardiovascular risk factors and macrovascular function. Impairment of microvascular function may constitute a pathway through which an adverse cardiovascular risk factor pattern may increase risk of diseases that are partly or wholly of microvascular origin.

KW - Journal Article

KW - OPTIC-NERVE

KW - OBESITY

KW - ENDOTHELIAL DYSFUNCTION

KW - INSULIN-RESISTANCE

KW - NITRIC-OXIDE

KW - VESSEL DIAMETER

KW - PATHOLOGY

KW - BLOOD-PRESSURE

KW - FLOW

KW - AGE

U2 - 10.1371/journal.pone.0187324

DO - 10.1371/journal.pone.0187324

M3 - Article

C2 - 29077770

VL - 12

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 10

M1 - e0187324

ER -