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Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents

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Abstract
Background: We investigated whether cardiometabolic risk factors measured in serum (total cholesterol [TC], high-density lipoprotein [HDL], triglyceride, leptin, insulin, glucose and insulin resistance) are associated with the retinal microvasculature, a marker of cardiovascular aging, in healthy children and adolescents. Moreover, we tested whether these associations are due to direct biological effects or more indirectly due to adiposity-related side effects. Methods: We recruited 168 healthy Flemish children (7-16 years old, 54.8% boys). Blood samples and retinal photographs were taken during clinical examinations. Arteriolar and venular vessel calibers were calculated using a semi-automated computer program. Multivariable regression models were used and adjusted for age, sex, mean arterial pressure (MAP) and alternate retinal caliber. In a second step, we adjusted for body mass index z-score (zBMI). Results: Only continuous serum leptin was associated with retinal parameters, i.e. wider arterioles; however, this disappeared after adjustment for zBMI. Children with high cardiometabolic risk factors (>90th percentile for serum leptin, insulin and insulin resistance) had wider arterioles compared to children with lower concentrations, even after additional adjustment for zBMI. No significant associations were found with lipids. Conclusions: In this healthy population of children and adolescents, the hormones insulin and leptin and insulin resistance were associated with retinal microvasculature alterations, mainly in children with high cardiometabolic factors (>90th percentile), while lipids were not. These associations were independent of zBMI.
Keywords
cardiometabolic factors, children, insulin, leptin, microvasculature, retinal vessel, CARDIOVASCULAR RISK-FACTORS, BEAVER DAM EYE, VESSEL DIAMETERS, ATHEROSCLEROSIS RISK, DISEASE, OBESITY, CALIBER, ABNORMALITIES, INFLAMMATION, COMMUNITIES

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MLA
van Aart, Carola et al. “Associations of Leptin, Insulin and Lipids with Retinal Microvasculature in Children and Adolescents.” JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM 31.2 (2018): 143–150. Print.
APA
van Aart, C., Michels, N., Sioen, I., De Decker, A., Nawrot, T. S., & De Henauw, S. (2018). Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents. JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM, 31(2), 143–150.
Chicago author-date
van Aart, Carola, Nathalie Michels, Isabelle Sioen, Annelies De Decker, Tim S Nawrot, and Stefaan De Henauw. 2018. “Associations of Leptin, Insulin and Lipids with Retinal Microvasculature in Children and Adolescents.” Journal of Pediatric Endocrinology & Metabolism 31 (2): 143–150.
Chicago author-date (all authors)
van Aart, Carola, Nathalie Michels, Isabelle Sioen, Annelies De Decker, Tim S Nawrot, and Stefaan De Henauw. 2018. “Associations of Leptin, Insulin and Lipids with Retinal Microvasculature in Children and Adolescents.” Journal of Pediatric Endocrinology & Metabolism 31 (2): 143–150.
Vancouver
1.
van Aart C, Michels N, Sioen I, De Decker A, Nawrot TS, De Henauw S. Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents. JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM. 2018;31(2):143–50.
IEEE
[1]
C. van Aart, N. Michels, I. Sioen, A. De Decker, T. S. Nawrot, and S. De Henauw, “Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents,” JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM, vol. 31, no. 2, pp. 143–150, 2018.
@article{8601593,
  abstract     = {Background: We investigated whether cardiometabolic risk factors measured in serum (total cholesterol [TC], high-density lipoprotein [HDL], triglyceride, leptin, insulin, glucose and insulin resistance) are associated with the retinal microvasculature, a marker of cardiovascular aging, in healthy children and adolescents. Moreover, we tested whether these associations are due to direct biological effects or more indirectly due to adiposity-related side effects. 
Methods: We recruited 168 healthy Flemish children (7-16 years old, 54.8% boys). Blood samples and retinal photographs were taken during clinical examinations. Arteriolar and venular vessel calibers were calculated using a semi-automated computer program. Multivariable regression models were used and adjusted for age, sex, mean arterial pressure (MAP) and alternate retinal caliber. In a second step, we adjusted for body mass index z-score (zBMI). 
Results: Only continuous serum leptin was associated with retinal parameters, i.e. wider arterioles; however, this disappeared after adjustment for zBMI. Children with high cardiometabolic risk factors (>90th percentile for serum leptin, insulin and insulin resistance) had wider arterioles compared to children with lower concentrations, even after additional adjustment for zBMI. No significant associations were found with lipids. 
Conclusions: In this healthy population of children and adolescents, the hormones insulin and leptin and insulin resistance were associated with retinal microvasculature alterations, mainly in children with high cardiometabolic factors (>90th percentile), while lipids were not. These associations were independent of zBMI.},
  author       = {van Aart, Carola and Michels, Nathalie and Sioen, Isabelle and De Decker, Annelies and Nawrot, Tim S and De Henauw, Stefaan},
  issn         = {0334-018X},
  journal      = {JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM},
  keywords     = {cardiometabolic factors,children,insulin,leptin,microvasculature,retinal vessel,CARDIOVASCULAR RISK-FACTORS,BEAVER DAM EYE,VESSEL DIAMETERS,ATHEROSCLEROSIS RISK,DISEASE,OBESITY,CALIBER,ABNORMALITIES,INFLAMMATION,COMMUNITIES},
  language     = {eng},
  number       = {2},
  pages        = {143--150},
  title        = {Associations of leptin, insulin and lipids with retinal microvasculature in children and adolescents},
  url          = {http://dx.doi.org/10.1515/jpem-2017-0374},
  volume       = {31},
  year         = {2018},
}

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