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  • Pediatric Original Article
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Body fat distribution, metabolic and inflammatory markers and retinal microvasculature in school-age children. The Generation R Study

International Journal of Obesity volume 39, pages 1482–1487 (2015)Cite this article

Subjects

Abstract

Objective:

To examine the associations of body fatness, metabolic and inflammatory markers with retinal vessel calibers among children.

Design:

We performed a population-based cohort study among 4145 school-age children. At the median age of 6.0 years (95% range 5.8, 8.0 years), we measured body mass index, total and abdominal fat mass, metabolic and inflammatory markers (blood levels of lipids, insulin and C-peptide and C-reactive protein) and retinal vascular calibers from retinal photographs.

Results:

We observed that compared with normal weight children, obese children had narrower retinal arteriolar caliber (difference −0.21 s.d. score (SDS; 95% confidence interval (CI) −0.35, −0.06)), but not venular caliber. Continuous analyses showed that higher body mass index and total body fat mass, but not android/gynoid fat mass ratio and pre-peritoneal fat mass, were associated with narrower retinal arteriolar caliber (P<0.05 for body mass index and total body fat mass), but not with retinal venular caliber. Lipid and insulin levels were not associated with retinal vessel calibers. Higher C-reactive protein was associated with only wider retinal venular caliber (difference 0.10 SDS (95% CI 0.06, 0.14) per SDS increase in C-reactive protein). This latter association was not influenced by body mass index.

Conclusions:

Higher body fatness is associated with narrower retinal arteriolar caliber, whereas increased C-reactive protein levels are associated with wider retinal venular caliber. Increased fat mass and inflammation correlate with microvascular development from school-age onwards.

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Acknowledgements

The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (STAR), Rotterdam. We gratefully acknowledge the contribution of participating mothers, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam, the Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development. This research also received funding from the European Union's Seventh Framework Programme (FP7/2007-2013), project Early Nutrition under grant agreement no. 289346. Dr Jaddoe received an additional grant from the Netherlands Organization for Health Research and Development (ZonMw –VIDI 016.136.361). Dr Ikram received additional funding from the Singapore Ministry of Health's National Medical Research Council (NMRC/CSA/038/2013) and the Netherlands Organisation for Health Research and Development (ZonMW; VENI project number: 91612163). OG and RG completed the background literature search, contributed to the analysis protocol, completed the analyses, wrote the first draft of the paper and collated comments from other authors. VWVJ obtained funds, designed the study, had overall responsibility for managing the study. OG, RG and VWVJ are guarantors of the study and accept full responsibility for the work and the conduct of the study. AH, TYW, MKI contributed to the manuscript. All authors have access to all of the data and approved the final version of the manuscript.

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Authors and Affiliations

  1. The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands

    O Gishti, V W V Jaddoe & R Gaillard

  2. Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands

    O Gishti, V W V Jaddoe & R Gaillard

  3. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

    O Gishti, V W V Jaddoe, A Hofman & R Gaillard

  4. Singapore Eye Research Institute, Singapore

    T Y Wong & M K Ikram

  5. Duke-NUS Graduate Medical School, National University of Singapore, Singapore

    T Y Wong & M K Ikram

  6. Memeory Aging & Cognition Centre (MACC), National University Health System, Singapore

    T Y Wong & M K Ikram

  7. Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    M K Ikram

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  1. O Gishti
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Corresponding author

Correspondence to V W V Jaddoe.

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Gishti, O., Jaddoe, V., Hofman, A. et al. Body fat distribution, metabolic and inflammatory markers and retinal microvasculature in school-age children. The Generation R Study. Int J Obes 39, 1482–1487 (2015). https://doi.org/10.1038/ijo.2015.99

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