Association of metabolic syndrome with abnormalities of bulbar conjunctival vessels

Goda Miniauskienė, Vytautas Jašinskas

Clinic of Eye Diseases, Kaunas University of Medicine, Lithuania

Key words: metabolic syndrome; bulbar conjunctival vessels; conjunctival index; risk factors.

Summary. Aim. To examine and evaluate the relationships of the metabolic syndrome and abnormalities of bulbar conjunctival vessels among middle-aged Kaunas population.

Material and methods. Analysis was performed on 383 asymptomatic persons aged 38–39 years (170 men and 212 women). Metabolic syndrome was defined using criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). For determination of abnormalities in bulbar conjunctiva vessels and microcirculation, each participant underwent noncontact slit lamp examination. The changes of vessel walls and bloodstream, extravasal alterations were evaluated, and conjunctival index was calculated.

Results. Metabolic syndrome was present in 10.7% of individuals. Persons with metabolic syndrome had a 2.35-point higher conjunctival index compared to the controls (P=0.003). After evaluation of various components of metabolic syndrome to conjunctival index, it was determined that the greatest change in the means of conjunctival index was due to hyperglycemia (P=0.02) and central obesity (P=0.05). Metabolic syndrome was related to venular dilatation (OR=3.78; 95% CI, 1.86–7.72), arteriolar narrowing (OR=1.98; 95% CI, 0.97–4.09), decreased arteriolar-venular ratio (OR=2.35; 95% CI, 1.13–4.98), and increased venular tortuosity (OR=2.24; 95% CI, 1.06–4.82). Multiple logistic analysis revealed that venular dilatation (OR=3.38; 95% CI, 1.43–7.99) and arteriolar narrowing (OR=2.22; 95% CI, 0.98-5.01) were significant factors in the prognosis of metabolic syndrome.

Conclusions. Metabolic syndrome was significantly related to abnormalities of bulbar conjunctival vessels such as venular dilatation, arteriolar narrowing, decreased arteriolar-venular ratio, and increased venular tortuosity. Both conjunctival index and individual conjunctival microvascular changes may be prognostic factors for metabolic syndrome, but long-term studies on associations between metabolic syndrome and changes of bulbar conjunctival vessels are needed.

Correspondence to G. Miniauskienė, Clinic of Eye Diseases, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: goda_min@delfi.lt

Received 22 October 2007, accepted 8 February 2008