| BackgroundMicrocirculatory dysfunction is a precursor of cardiovascular and metabolic diseases,and the control of microcirculatory dysfunction may become a new target for the prevention and treatment of cardiovascular diseases.Retinal vessels belong to the microcirculation which are the only blood vessels that can be viewed directly,in vivo,repetitively and noninvasively,and can be used as an intermediate variable to predict the risk of cardiovascular disease and evaluate the therapeutic effect.To establish the normal reference values of retinal arteriolar and venular diameters and study the influencing factors of retinopathy is of great significance to explore the mechanism of microcirculation disorders,effectively control microcirculation disorders and predict the risk of cardiovascular diseases.ObjectiveTo describe retinal vascular parameters of 20-79 years old residents in xinxiang city.Based on epidemiological studies,the factors affecting retinal vessel diameter were explored,and the possible mechanisms suggested by these factors were discussed,so as to find potential research problems and clinical significance,and provide clues for the control of microcirculation disorders and the treatment of cardiovascular diseases in the future.To explore the diagnostic value of logistic regression model combined retinal vascular parameters in coronary heart disease.MethodsThis study conducted a cross-sectional survey of 20-79 year old residents from 17villages in longgong miao and qiliying towns,xinxiang county,xinxiang city,henan province from April to June 2017.A total of 10280 permanent residents who had lived in the area for?6 months were selected by cluster sampling method.During the survey,15%of participants were randomly selected according to their age group for fundus photography,and 1423 participants completed fundus photography.Excluding unqualified pictures,a total of 1223 participants obtained all the required information and were included in this study.The retinal vascular diameter measurement software IVAN was used to analyze the fundus photos,so as to obtain the central retinal arteriolar equivalent(CRAE),central retinal venular equivalent(CRVE)and the arteriovenous ratio(AVR).For each participant,eyes which with clear fundus image quality and small diameter standard deviation of retinal vascular diameter measurement were selected for analysis.The retinal vascular diameter parameters of 20-79 years old population in xinxiang county,xinxiang city were described and the relationship between retinal vascular diameter and age,sex,lifestyle,disease history,physical examination and laboratory examination was discussed by single factor and multi-factor linear regression analysis.The binary logistic regression model of influencing factors of coronary heart disease was established with and without retinal vascular diameter,and the ROC curve of both was drawn.The differences in specificity,sensitivity and the area under the curve(AUC)between logistic regression models included and excluded retinal vascular parameters were compared to evaluate the diagnostic value of retinal vascular parameters for coronary heart disease.Results1.This study finally included 1223 participants with an average age of 51.79±12.08years,including 552 males(45.13%)and 671 females(54.87%).There was no statistically significant gender difference among the age groups(?~2=1.750,P=0.883).The CRAE,CRVE and AVR of the study population were 142.36±11.54?m?206.61±16.72?m,0.69±0.06,respectively.2.The influence of age and gender on CRAE and CRVE was not statistically significant.Systolic blood pressure,diastolic blood pressure and serum creatinine were negatively correlated with CRAE.Smoking,BMI and fasting blood glucose were independently positively correlated with CRVE,while systolic blood pressure and HDL cholesterol were independently negatively correlated with CRVE.3.After adjusting for age,sex,alanine aminotransferase and HDL cholesterol,CRAE level had an independent negative correlation with the incidence of coronary heart disease,and CRVE had an independent positive correlation with the incidence of coronary heart disease.The AUC of the coronary heart disease diagnostic model with CRAE and CRVE was 0.781,the sensitivity was 73.05%,the specificity was 71.77%,and the youden index was 0.448,which was better than the diagnostic model without retinal vascular parameters and the diagnostic model with AVR included.Therefore,retinal vascular parameters can improve the diagnostic efficiency of coronary heart disease.ConclusionSystolic blood pressure,diastolic blood pressure and serum creatinine were negatively correlated with CRAE.Smoking,BMI and fasting blood glucose were independently positively correlated with CRVE,while systolic blood pressure and HDL were independently negatively correlated with CRVE.Retinal vascular parameters can improve the diagnostic efficiency of coronary heart disease. |
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