Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study
Research output: Contribution to journal › Article › Academic › peer-review
- Interne Geneeskunde
- Promovendi CARIM
- BC - Alg. Interne Geneeskunde
- CARIM - Vascular complications of diabetes and the metabolic syndrome
- NUTRIM - Obesity, diabetes and cardiovascular health
- MHeNs - Neuroscience
- OG - Oogheelkunde
- Oogheelkunde Atrium
- CARIM - Hypertension and target organ damage
- HV - Pieken Maastricht Studie
- Sociale Geneeskunde
- CAPHRI - Inequity, Participation and Globalisation
- CAPHRI - Optimising Patient Care
- BC - Endocrinologie
- CAPHRI - Creating Value-Based Health Care
- MHeNs - Cognitive Neuropsychiatry and Clinical Neuroscience
- BC - Interne Geneeskunde
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.
- Journal Article, OPTIC-NERVE, OBESITY, ENDOTHELIAL DYSFUNCTION, INSULIN-RESISTANCE, NITRIC-OXIDE, VESSEL DIAMETER, PATHOLOGY, BLOOD-PRESSURE, FLOW, AGE