Association Between Cardiovascular Health and Retinopathy in US Adults: From NHANES 2005-2008

Xiangliang Liu; Yu Chang; Yuguang Li; Yingrui Liu; Naifei Chen; Jiuwei Cui

doi:10.1016/j.ajo.2024.05.019

Association Between Cardiovascular Health and Retinopathy in US Adults: From NHANES 2005-2008

Am J Ophthalmol. 2024 May 16:S0002-9394(24)00223-X. doi: 10.1016/j.ajo.2024.05.019. Online ahead of print.

Authors

Xiangliang Liu¹, Yu Chang¹, Yuguang Li¹, Yingrui Liu², Naifei Chen³, Jiuwei Cui⁴

Affiliations

¹ The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China.
² Ophthalmology, Shenzhen People's Hospital.
³ The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China. Electronic address: chennaifei@jlu.edu.cn.
⁴ The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China. Electronic address: cuijw@jlu.edu.cn.

PMID: 38762091
DOI: 10.1016/j.ajo.2024.05.019

Abstract

Purpose: Investigating the relationship between cardiovascular health (CVH) and retinopathy in the adult population of the United States.

Design: The cross-sectional study Methods: The study utilized samples, including the diabetes population, from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008 (N= 4,249), to assess cardiovascular health (CVH) using the Life's Essential 8 (LE8) assessment. Retinopathy are determined through imaging assessment by professionals independently grading fundus photographs. Univariable and multivariable weighted logistic regression models, restricted cubic splines (RCS), Subgroup analysis and weighted quantile sum (WQS) regression approaches were employed to assess the association between LE8 score-based CVH status and retinopathy. The mediation analysis was conducted to investigate whether serum albumin levels mediated the relationship between LE8 score and retinopathy.

Results: In a fully adjusted logistic regression model, participants in the moderate and high CVH groups had a 39% (odds ratio (OR) 0.61, 95% confidence intervals (CI) 0.43-0.87, P- value = 0.01) and 56% (OR 0.44, 95%CI 0.25-0.77, P- value < 0.001) lower odds of developing retinopathy compared to the low CVH group. The RCS model indicates a significant non-linear relationship between CVH and retinopathy. The WQS regression analysis suggests that blood glucose (47.65%) and blood pressure (19.41%) have the highest weights in relation to retinopathy. Mediation analysis suggests that serum albumin partially mediates the relationship between LE8 scores and retinopathy.

Conclusion: This study demonstrates a significant negative correlation between overall cardiovascular health measured by LE8 scores and retinopathy. Public health strategies that promote achieving optimal cardiovascular health indicators may help reduce the burden of retinal microvascular diseases.

Keywords: Cardiovascular Health (CVH); Life's Essential 8 (LE8); NHANES; Retinopathy.