Abstract：
OBJECTIVE: Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood.
METHODS: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years).
RESULTS: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles.
CONCLUSIONS: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.
METHODS: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years).
RESULTS: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles.
CONCLUSIONS: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.
摘要：
目的：视网膜微血管特征可预测心血管发病率和死亡率。这项研究调查了成年后终生心血管危险因素与饮食干预对视网膜微血管的影响之间的关系。
方法：该队列来自纵向特殊图尔库冠状动脉危险因素干预项目研究。特殊图尔库冠状动脉危险因素干预项目是一项为期20年的婴儿期发病的随机对照饮食干预研究，经常进行研究访问并随访至26岁。饮食干预旨在改善心脏健康的饮食。在26年的随访中拍摄了眼底照片，和微血管测量[小动脉和静脉直径，得到弯曲度(简单和曲率)和分形维数](n=486)。在最长的可用时间段(例如从7个月至26岁)内确定作为心血管危险因素和饮食成分的曲线下面积的累积暴露量。
结果：与对照组相比，饮食干预对视网膜微脉管系统具有良好的影响，从而减少了小动脉和小静脉的曲折，并增加了小动脉分形维数。即使控制了累积的心血管危险因素，也可以发现干预效果。减少饱和脂肪的终身累积摄入量，干预的主要目标，也与较少曲折的小静脉有关。几个终身累积危险因素与视网膜微血管测量独立相关，例如，小动脉狭窄的累积收缩压。
结论：婴儿发病20年的饮食干预对年轻成年期的视网膜微血管系统有良好的影响。几个终身累积心血管危险因素与视网膜微血管结构独立相关。
方法：该队列来自纵向特殊图尔库冠状动脉危险因素干预项目研究。特殊图尔库冠状动脉危险因素干预项目是一项为期20年的婴儿期发病的随机对照饮食干预研究，经常进行研究访问并随访至26岁。饮食干预旨在改善心脏健康的饮食。在26年的随访中拍摄了眼底照片，和微血管测量[小动脉和静脉直径，得到弯曲度(简单和曲率)和分形维数](n=486)。在最长的可用时间段(例如从7个月至26岁)内确定作为心血管危险因素和饮食成分的曲线下面积的累积暴露量。
结果：与对照组相比，饮食干预对视网膜微脉管系统具有良好的影响，从而减少了小动脉和小静脉的曲折，并增加了小动脉分形维数。即使控制了累积的心血管危险因素，也可以发现干预效果。减少饱和脂肪的终身累积摄入量，干预的主要目标，也与较少曲折的小静脉有关。几个终身累积危险因素与视网膜微血管测量独立相关，例如，小动脉狭窄的累积收缩压。
结论：婴儿发病20年的饮食干预对年轻成年期的视网膜微血管系统有良好的影响。几个终身累积心血管危险因素与视网膜微血管结构独立相关。
