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• W2127640418 abstract "HomeHypertensionVol. 53, No. 4Response to Birth Factors and Retinal Vascular Caliber in a Twin Study Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBResponse to Birth Factors and Retinal Vascular Caliber in a Twin Study Cong Sun Anne-Louise Ponsonby Alex W. Hewitt David A. Mackey Cong SunCong Sun Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia Search for more papers by this author Anne-Louise PonsonbyAnne-Louise Ponsonby Murdoch Children’s Research Institute, University of Melbourne, Melbourne, Australia, Menzies Institute, University of Tasmania, Tasmania, Australia Search for more papers by this author Alex W. HewittAlex W. Hewitt Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia Search for more papers by this author David A. MackeyDavid A. Mackey Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia, Discipline of Medicine, University of Tasmania, Tasmania, Australia Search for more papers by this author Originally published2 Mar 2009https://doi.org/10.1161/HYPERTENSIONAHA.109.129551Hypertension. 2009;53:e29–e30Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: March 2, 2009: Previous Version 1 We thank Cheung1 for his interest in our article and, in particular, for highlighting the issues relating to the use of birth size as a sensitive marker of fetal growth restriction and its relationship with retinal vascular caliber.The prevalence of prematurity is relatively high in twins compared with singletons, and, as such, we used birth weight for gestational score under the 10th percentile as a proxy for fetal growth restriction in our analysis. Although we could not adequately analyze birth weight relative to gestation in this study, because few twins had low birth weight for gestation and the majority of the twin pairs (67%) were concordant for birth weight by gestational scores, such analytic issues highlight the value of within-pair analyses. This method provides greater precision in controlling for gestation in a study of this size than other methods, such as adjusting for gestation in the regression analysis, because of collinearity between birth weight and gestation.In addition, we observed that the association between gestation and retinal arteriolar caliber did not persist after adjusting for birth weight. Consistent with this finding, another study reported recently that low birth anthropometry, not prematurity, was linked to elevated blood pressure.2 Clearly, additional support is required to confirm the associations identified in our relatively small study.Finally, we thank Cheung1 for his suggestion to include more direct measures of ocular magnification (eg, axial length) in the analysis rather than optic disc area. The reason that we included optic disc area in our models is that it has been suggested to be associated with both birth size and retinal vascular caliber,3,4 and the measurement of optic disc itself is affected by ocular magnification effect. Nevertheless, we repeated our analyses using the Bengtsson formula5 to obtain magnification-corrected arteriolar caliber, and the results remained unchanged, and thus, magnification effect is unlikely to influence the reported associations (Table). Table. Associations Between Birth Length and Magnification-Corrected Arteriolar Caliber in Total Sample and by ZygosityParameterMean (95% CI) Change in Arteriolar Caliber per 5-cm Decrease in Birth Length, μmMZ+DZ (n=266)PMZ (n=98, 49 Pairs)PDZ (n=168, 84 Pairs)PLinear mixed-regression models were used. MZ indicates monozygotic; DZ, dizygotic; βc, common regression coefficient.*Data were adjusted for age, sex, alcohol consumption, maternal smoking, prematurity, and optic disc area.†Data were further adjusted for body mass index and mean arterial blood pressure.‡Likelihood ratio test of heterogeneity of between- and within-pair effects was used (βB and βw).βc−5.00 (−8.78 to −1.22)*0.009−5.84 (−11.31 to −0.37)*0.04−4.43 (−9.52 to 0.66)*0.09−7.50 (−11.65 to −3.35)†<0.001−7.60 (−13.26 to −1.93)†0.009−8.66 (−13.98 to −3.35)†0.001βw−6.34 (−10.49 to −2.18)*0.003−6.63 (−12.46 to −0.79)*0.03−5.70 (−11.38 to −0.01)*0.05−9.50 (−14.29 to −4.72)†<0.001−7.55 (−17.06 to 1.97)†0.12−10.50 (−16.65 to −4.35)†0.001βB−4.50 (−8.29 to −0.71)*0.02−5.48 (−11.26 to −0.30)*0.06−4.03 (−9.05 to 0.98)*0.12−7.36 (−11.48 to −3.25)†<0.001−7.62 (−14.52 to 0.72)†0.03−8.93 (−14.23 to −3.63)†0.001Test for difference‡…0.12…0.58…0.250.110.990.26Sources of FundingThis research work was supported by the Ophthalmic Research Institute of Australia, Foundation for Children Australia, National Health and Medical Research Council, Canberra Australia (project grant 350415), and the Clifford Craig Medical Research Trust. C.S. is the recipient of a National Health and Medical Research Council postgraduate scholarship. D.A.M. is the recipient of the Pfizer Australia Senior Research Fellowship.DisclosuresNone.1 Cheung N. Birth factors and retinal vascular caliber in a twin study. Hypertension. 2009; 53: e28.LinkGoogle Scholar2 Liew G, Wang JJ, Mitchell P. Which is the better marker for susceptibility to disease later in life–low birthweight or prematurity? Arch Dis Child. 2008; 93: 450.CrossrefMedlineGoogle Scholar3 Cheung N, Tong L, Tikellis G, Saw SM, Mitchell P, Wang JJ, Wong TY. Relationship of retinal vascular caliber with optic disc diameter in children. Invest Ophthalmol Vis Sci. 2007; 48: 4945–4948.CrossrefMedlineGoogle Scholar4 Hellstrom A, Hard AL, Chen Y, Niklasson A, Albertsson-Wikland K. Ocular fundus morphology in preterm children. Influence of gestational age, birth size, perinatal morbidity, and postnatal growth. Invest Ophthalmol Vis Sci. 1997; 38: 1184–1192.MedlineGoogle Scholar5 Bengtsson B, Krakau CE. Correction of optic disc measurements on fundus photographs. Graefes Arch Clin Exp Ophthalmol. 1992; 230: 24–28.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails April 2009Vol 53, Issue 4 Advertisement Article InformationMetrics https://doi.org/10.1161/HYPERTENSIONAHA.109.129551 Originally publishedMarch 2, 2009 PDF download Advertisement SubjectsEpidemiologyImagingPeripheral Vascular Disease" @default.
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• W2127640418 title "Response to Birth Factors and Retinal Vascular Caliber in a Twin Study" @default.
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