Retinal vascular diameters in relation to physical activity in Danish children — The CHAMPS Eye Study

Abstract

Our objective was to determine associations between retinal vascular caliber and physical activity (PA) in a school-based child cohort. In a prospective study, we created a childhood cumulative average PA-index using objectively measured PA (accelerometry) assessed at four periods between 2009 and 2015. Cumulative exposure to PA intensities was estimated. Cross-sectional examinations on biomarkers, anthropometry, and ophthalmological data including retinal fundus photographs were performed in 2015. Semi-automated measurements of retinal vascular diameters were performed and summarized into central retinal arteriolar and venular equivalents (CRAE, CRVE). We included 307 participants. Mean age in 2015 was 15.4 years (0.7). The mean CRAE and CRVE were 156.5 μm (2.8) and 217.6 μm (7.7), respectively. After adjusting for age, gender, and axial length, more time in PA was independently related to thinner retinal venules (β-coefficient = -1.25 μm/%, 95% confidence interval = -2.20, -0.30, P < .01). Sedentary time was associated with wider venules (P < .01). Furthermore, birthweight (β-coefficient = 0.56 μm/%, 95% confidence interval = 0.18, 0.95, P < .01) was associated with CRVE. Blood pressure was associated with thinner retinal arterioles (β-coefficient = -0.19 μm/mmHg, 95% confidence interval = -0.36, -0.01, P = .04). We concluded that children with higher PA in childhood had thinner retinal venular caliber. Our results suggest that PA during childhood positively impacts the retinal microcirculation and that retinal vascular analysis may be a possible assessment to detect microvascular impairments in children with an increased risk of future cardiovascular disease.

The Effect of Physical Exercise on the Retina and Choroid

“…In the Childhood Health, Activity, and Motor Performance School (CHAMPS) study in Denmark higher physical activity in childhood over the 6-year study period was associated with a thinner retinal venular caliber at the end of the study, which suggested an impaired vascular status in the most inactive participants. In-terestingly, total body fat mass, BMI, and waist circumference were not independently associated with retinal vascular calibers [11].…”

Systematic review on retinal microvasculature, physical activity, sedentary behaviour and adiposity in children and adolescents

“…Ages ranged from 30 weeks of gestation to 18 years. We found 23 studies reporting on measures of weight status (88%) as exposure, while measures of PA were present in six studies (23%) and SB was assessed in three studies (12%); four studies (15%) reported measures of weight status and PA/SB …”

“…We found 20 cross‐sectional studies. The exposures varied between birthweight, BMI, WC, other measures of adiposity, SB and PA …”

“…We found 23 studies reporting on measures of weight status (88%) as exposure, 23,28,38,39,[55][56][57][58][59][60][61][62][63][64][65][68][69][70][71][72][73][74][75] while measures of PA were present in six studies (23%) 41,64-67, 73 and SB was assessed in three studies (12%) 28,41,73 ; four studies (15%) reported measures of weight status and PA/SB. 28,64,65,73 Adiposity assessments included birthweight (n = 5), BMI (n = 11), OCT device, non-mydriatic vessel analyzer and a spectralis OCT device (4% each). PA and SB were mainly assessed using subjective measures (questionnaires or self-report-71%), while objectively measured PA/SB were only present in two studies (accelerometer and heart rate monitor-29%).…”

“…We found 20 cross-sectional studies. The exposures varied between birthweight, 56,59,70,73 BMI, 23,28,38,39,55,[57][58][59]61,62,65,69,72 WC, 28,38,55,57 other measures of adiposity, 28,39,58,61,68,71 SB 28,41,73 and PA. 41,65,67,73 One study stated that children born with low-birth-weight were 4% more likely to have abnormal vascularisation than normal birthweight children. 70 Also, Kandasamy et al, 56 found that low birthweight was related to larger arterioles and venules.…”