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OBJECTIVES: We hypothesised that trajectories of adiposity across childhood would be associated with retinal microcirculatory diameters at age 12 years, independent of blood pressure (BP). METHODS: The Avon Longitudinal Study of Parents and Children followed a cohort of children born in 1991-1992. The current study includes all children with retinal images acquired at the 12 year clinic and individual trajectories of ponderal index (PI) from 0-2 years and body mass index (BMI) from 2-10 years. Retinal microvascular measures included retinal arteriolar and venular diameters. RESULTS: Children in this analysis had a birth weight of 3.5 ± 0.4 kg, a PI of 26.2 ± 2.4 kg/m(3) and a gestational age of 39.7 ± 1.4 weeks (mean ± standard deviation (SD)). Analysis of growth trajectories showed that lower PI at birth was associated with narrower retinal arterioles. Higher PI at birth was associated with wider venular diameter, and a stronger positive association was evident between BMI change at 5-5.5 and 8.5-10 years with wider venular diameters. Current fat mass was also associated with wider venular diameters. CONCLUSIONS: Retinal arterioles and venules are differentially associated with growth in early life and childhood adiposity. Early adiposity may adversely affect the microcirculation, with important implications for cardiovascular risk in adulthood. © 2013 John Wiley & Sons Ltd.