Dataset Information

Associations between depression and anxiety symptoms and retinal vessel caliber in adolescents and young adults.

ABSTRACT: Previous longitudinal studies suggest that depression and anxiety are associated with risk for cardiovascular disease. The aim of the present study was to test whether an association between depression and anxiety symptoms and retinal vessel caliber, an indicator of subclinical cardiovascular risk, is apparent as early as adolescence and young adulthood.Participants were 865 adolescents and young adults who participated in the Brisbane Longitudinal Twin Study and the Twin Eye Study in Tasmania. Participants completed an assessment of depression/anxiety symptoms (the Somatic and Psychological Health Report) when they were 16.5 years old (mean age), and they underwent retinal imaging, on average, 2.5 years later (range, 2 years before to 7 years after the depression/anxiety assessment). Retinal vessel caliber was assessed using computer software.Depression and anxiety symptoms were associated with wider retinal arteriolar caliber in this sample of adolescents and young adults (? = 0.09, p = .016), even after adjusting for other cardiovascular risk factors (? = 0.08, p = .025). Multiple regression analyses revealed that affective symptoms of depression/anxiety were associated with retinal vessel caliber independently of somatic symptoms.Depression and anxiety symptoms are associated with measurable signs in the retinal microvasculature in early life, suggesting that pathological microvascular mechanisms linking depression/anxiety and cardiovascular disease may be operative from a young age.

SUBMITTER: Meier MH

PROVIDER: S-EPMC4290848 | biostudies-literature | 2014 Nov-Dec

REPOSITORIES: biostudies-literature

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Associations between depression and anxiety symptoms and retinal vessel caliber in adolescents and young adults.

Meier Madeline H MH Gillespie Nathan A NA Hansell Narelle K NK Hewitt Alex W AW Hickie Ian B IB Lu Yi Y MacGregor Stuart S Medland Sarah E SE Sun Cong C Wong Tien Y TY Wright Margaret J MJ Zhu Gu G Martin Nicholas G NG Mackey David A DA

Psychosomatic medicine 20141101 9

<h4>Objective</h4>Previous longitudinal studies suggest that depression and anxiety are associated with risk for cardiovascular disease. The aim of the present study was to test whether an association between depression and anxiety symptoms and retinal vessel caliber, an indicator of subclinical cardiovascular risk, is apparent as early as adolescence and young adulthood.<h4>Methods</h4>Participants were 865 adolescents and young adults who participated in the Brisbane Longitudinal Twin Study an ...[more]

PMID: 25373892

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Project description:BackgroundPrevious studies have shown that growing up with rheumatic conditions can fuel dissatisfaction and psychological distress, which in turn affects disease self-management and treatment adherence. Primary objective of this study was to estimate the prevalence of anxiety and depression symptoms in adolescents and young adults (AYA) with juvenile idiopathic arthritis (JIA) and to identify correlates of conspicuous screening results.MethodsInitiated as part of the COACH multicenter observational study, outpatients aged 12 to 21 years participating in the National Pediatric Rheumatological Database (NPRD) were prospectively screened for mental health using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale-7 (GAD-7).ResultsData from 1,150 adolescents with JIA (mean age 15.6 ± 2.2 years; mean disease duration 7.2 ± 4.9 years, 69% female, 43% oligoarthritis, 26% polyarthritis) were analysed. Overall, 32.7% (n = 316) of AYA showed conspicuous screening results, of whom 30.4% reported clinically relevant suicidal or self-harm thoughts. About 19% of screened patients showed moderate to severe depressive or anxious symptoms. AYA with conspicuous screening results were older (15.8 vs. 15.2 years; p < 0.0001), more often female (81% vs. 64%; p < 0.0001) and more often overweight (25% vs. 17%; p = 0.006). They had higher disease activity (physician global assessment on NRS 0-10; 1.7 vs. 1.2; p < 0.0001), more functional limitations (CHAQ; 0.44 vs. 0.14; <0.0001) and rated their health status worse (NRS 0-10; 3.5 vs. 1.8; p < 0.0001) than AYA with inconspicuous screening results. Females (OR 2.33 [CI 1.53-3.56]; p < 0.0001), older age (OR 1.09 [CI 1.01-1.18]; p = 0.026), patients with more functional limitations (OR 3.36 [CI 1.98-5.72]; p < 0.0001), and patients with worse subjective health status (OR 1.17 [CI 1.07-1.27]; p < 0.0001) were more likely to have a conspicuous screening result. Regular sports participation was associated with a lower likelihood of conspicuous screening result (OR 0.69 [CI 0.49-0.98]; p = 0.039).ConclusionsA large-scale outpatient screening of AYA with JIA in Germany shows a high prevalence of anxiety and depression symptoms. The need for routine screening for early detection of mental health problems became apparent.

Project description:ImportanceMicrovascular phenotypes, which can be assessed using retinal imaging, may be informative about the life course pathogenesis of hearing loss.ObjectiveTo investigate whether differences in retinal vessel caliber (specifically wider venules and narrower arterioles) are associated with hearing threshold and hearing loss in mid-childhood and midlife.Design, setting, and participantsA population-based cross-sectional study (Child Health CheckPoint) was nested within the Longitudinal Study of Australian Children. A total of 1281 children and 1255 attending parents were assessed using retinal microvasculature and air conduction audiometry data at a main assessment center in 7 large cities in Australia.Main outcomes and measuresAir conduction audiometry was used to calculate the high Fletcher index (mean threshold of 1, 2, and 4 kHz), and bilateral hearing loss was defined as a high Fletcher index greater than 15 dB hearing level in the better-hearing ear. Retinal arteriolar and venular caliber were measured from fundus photographs using validated computer-based software. Linear and logistic regression quantified the associations of retinal vessel caliber with hearing threshold and hearing loss, respectively.ResultsOf the 1281 included children (mean age, 11.4 years; 49.1% boys), the mean (SD) high Fletcher index was 7.9 (5.8) dB hearing level. Of the 1255 included adults (mean age, 43.8 years; 86.6% women), the mean (SD) high Fletcher index was 13.0 (6.8) dB hearing level; 109 of 1281 children (8.5%) and 328 of 1255 adults (26.1%) had hearing loss. In adults, each 1-SD (18.6-?m) wider retinal venular caliber (worse) was associated with higher (worse) hearing threshold at lower individual frequencies (eg, 2 kHz: ??=?0.63; 95% CI, 0.10-1.17) and overall high Fletcher index (eg, 2 kHz: ??=?0.52; 95% CI, 0.07-0.96), as well as a 1.20-fold (95% CI, 1.03-1.40) higher odds of hearing loss. In children, patterns of venular associations were similar but smaller and less certain. Narrower retinal arteriolar caliber (worse) was associated with a 1.16-fold (95% CI, 1.00-1.37) higher odds of hearing loss in adults (per 1-SD [14.0-?m] narrower arteriolar caliber) but not in children.Conclusions and relevanceAdverse retinal microvascular characteristics are associated with hearing loss by midlife, with venular associations possibly emerging by age 11 to 12 years. Microvascular health may contribute to the pathogenesis of hearing loss across the life course, warranting replication and mechanistic studies to inform causal inference and prevention efforts.

Project description:PurposeTo compare three commonly used retinal vessel caliber measurement software systems, and propose an algorithm for conversion between measurement systems.MethodsWe used 120 retinal photographs to evaluate the agreement between three commonly used software (Retinal Analysis [RA], Integrative Vessel Analysis [IVAN], and Singapore I Vessel Assessment [SIVA]). Bland-Altman plots were used to evaluate agreement of retinal arteriolar (central retinal artery equivalent, CRAE) and venular (central retinal vein equivalent, CRVE) calibers. Pearson's correlation was used to assess the associations between systemic factors and retinal vessel calibers, and Z-test was used to compare the strength of the correlation coefficients across the three software systems. An algorithm was created to convert measurements, with paired t-test performed to evaluate the differences between SIVA-measured retinal calibers and SIVA-approximates converted from RA- and IVAN-measurements using the algorithm.ResultsDifferences between SIVA- and RA-measured calibers (CRAE: mean difference [MD] = -21.8 ?m, 95% limits of agreement [LOA], -47.3 to 3.7 ?m; CRVE: MD = -7.7 ?m, 95% LOA, -28.0 to 12.6 ?m), SIVA- and IVAN-measured calibers (CRAE: MD = -6.7 ?m, 95% LOA, -23.8 to 10.4 ?m; CRVE: MD = -18.2 ?m 95% LOA, -36.7 to 0.4 ?m) were large. However, the strength of correlations between systemic factors with SIVA-measured retinal calibers was not significantly different to that measured using RA and IVAN (P ? 0.332). SIVA-approximates converted from RA and IVAN measurements using the proposed algorithm was not significantly different from SIVA-measured calibers (P ? 0.20).ConclusionAbsolute measurements of retinal vessel calibers vary between three common software systems but associations with systemic factors were similar.Translational relevanceThe proposed algorithm allowed conversions of RA and IVAN measurements to SIVA-approximates. This conversion is important for future data pooling and establishment of normative values for retinal vascular caliber measurements.

Dataset Information

Associations between depression and anxiety symptoms and retinal vessel caliber in adolescents and young adults.

Publications

Associations between depression and anxiety symptoms and retinal vessel caliber in adolescents and young adults.

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