The Metabolic Syndrome and Retinal Microvascular Signs in a Rural Chinese Population: The Handan Eye Study.

1. Yang Zhao¹
2. Feng Hua Wang¹
3. Yuan Bo Liang¹
4. Tien Yin Wong²
5. Ningli Wang¹
6. Jie Jin Wang³

¹Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China.
²Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
³Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, University of Sydney, Australia.

Purpose: To examine the relationship of metabolic syndrome and its components with retinal microvascular abnormalities in a rural Chinese population.

Methods: The Handan Eye Study recruited 6830 (90.4% of eligible) rural Chinese aged 30 or older. The metabolic syndrome was diagnosed following definitions of the International Diabetes Federation. Retinal microvascular signs were assessed from fundus photographs by graders who were trained at the Retinal Vascular Imaging Centre, University of Melbourne. Retinal arteriolar and venular diameters were measured using a specific computer-assisted program.

Results: Of 7557 eligible individuals, 6830 (90.4%) participated in the study, and 5519 (81% of 6830) had all the relevant data and thus included in this report. After adjusting for age, gender and smoking, participants with the MetS, or with components of higher blood pressure or higher FPG, were more likely to have retinopathy, arteriovenous nicking, focal arteriolar narrowing, enhanced arteriolar wall reflex and generalized retinal arteriolar narrowing than those without the MetS or the corresponding component. Persons with a larger waist circumference were significantly more likely to have arteriovenous nicking and enhanced retinal arteriolar reflex and retinopathy lesions; persons with higher triglyceride levels were significantly more likely to have arteriovenous nicking and retinopathy.

Conclusions: We reported cross-sectional associations of the MetS with retinal microvascular signs and retinal vessel diameter in rural Chinese adults. These data suggest that individual components of the MetS were associated with different retinal microvascular signs and with the diameters of CRAE and CRVE.