Associations of Cumulative Adulthood, Childhood and Lifelong Insulin With Adulthood Retinal Microvasculature

Year: 2024

Type: article

Abstract: CONTEXT: Exogenous insulin is reported to have both vasodilatory and vasoconstrictive effects on microvasculature. Little is known about the associations of long-term endogenous insulin exposure with microvasculature. OBJECTIVE: To test the hypothesis that long-term exposure to high insulin levels in childhood and adulthood is associated with adverse changes in retinal microvasculature in adulthood in a population without diabetes. METHODS: We analyzed data derived from the longitudinal Cardiovascular Risk in Young Finns Study. The first cross-sectional study was conducted in 1980, and participants were followed for 31 years from childhood to adulthood with frequent follow-up visits. Fundus photos were taken in 2011, and microvascular outcome measures were derived in participants at the age of 34 to 49 years (n = 1684). After exclusion of individuals with diabetes or missing insulin measures, 1166 participants formed the population of the present study. Cumulative exposure as the area under the curve (AUC) for adulthood (10-year exposure between 2001 and 2011) and childhood (exposure between ages 6-18 years) insulin and other cardiovascular risk factors were determined. Additionally, adulthood and childhood cumulative AUCs were summarized to construct lifelong AUCs. RESULTS: Higher adulthood, childhood, and lifelong exposure for cumulative insulin was associated with decreased retinal arteriolar diameter when adjusted for age and sex and further for cumulative conventional cardiovascular risk factors. CONCLUSION: Cumulative childhood, adulthood, and lifelong insulin are associated with decreased retinal arteriolar diameter in adulthood in a population of participants without diabetes, independently of conventional cardiovascular risk factors.

Source: The Journal of Clinical Endocrinology & Metabolism

DOI: 10.1210/clinem/dgae865

Authors: Oskari Repo, Markus Juonala, Suvi P Rovio, Juha Mykkänen, Jaakko Nevalainen, Mika Kähönen, Terho Lehtimäki, Tomi P Laitinen, Jorma Viikari, Olli Raitakari, Robyn Tapp, Katja Pahkala

Institutions: University of Turku, Turku University Hospital, Tampere University, University of Tampere, Tampere University Hospital, Fimlab (Finland), University of Eastern Finland, Kuopio University Hospital, The University of Melbourne, Coventry University

Language: English

Topic: Retinal Diseases and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,938

Funders: Foundation for Cardiovascular Research, Yrjö Jahnssonin Säätiö, European Commission, Kela, Academy of Finland, Suomen Kulttuurirahasto, Jane ja Aatos Erkon Säätiö, Juho Vainion Säätiö, Signe ja Ane Gyllenbergin Säätiö, Emil Aaltosen Säätiö, Sydäntutkimussäätiö, Sigrid Juséliuksen Säätiö, Tampereen Tuberkuloosisäätiö, Diabetesliitto, Paavo Nurmen Säätiö, Tays, Syöpäsäätiö, Suomen kliinisen kemian yhdistys, European Research Council

OpenAlex ID: W4405349338