Retinal Vascular Tortuosity and Diameter Associations with Adiposity and Components of Body Composition

Robyn J. Tapp, Christopher G. Owen, Sarah A. Barman, Roshan A. Welikala, Paul J. Foster, Peter H. Whincup, David P. Strachan, Alicja R. Rudnicka

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
28 Downloads (Pure)


Objective: The aim of this study was to assess whether adiposity or body composition relates to microvascular characteristics of the retina, indicative of cardiometabolic function. Methods: A fully automated QUARTZ software processed retinal images from 68,550 UK Biobank participants (aged 40-69 years). Differences in retinal vessel diameter and tortuosity with body composition measures from the Tanita analyzer were obtained by using multilevel regression analyses adjusted for age, sex, ethnicity, clinic, smoking, and Townsend deprivation index. Results: Venular tortuosity and diameter increased by approximately 2% (P < 10 −300) and 0.6 μm (P < 10 −6), respectively, per SD increase in BMI, waist circumference index, waist-hip ratio, total body fat mass index, and fat-free mass index (FFMI). Venular associations with adiposity persisted after adjustment for FFMI, whereas associations with FFMI were weakened by FMI adjustment. Arteriolar diameter (not tortuosity) narrowing with FFMI was independent of adiposity (−0.6 μm; −0.7 to −0.4 μm per SD increment of FFMI), while adiposity associations with arteriolar diameter were largely nonsignificant after adjustment for FFMI. Conclusions: This demonstrates, on an unprecedented scale, that venular tortuosity and diameter are more strongly associated with adiposity, whereas arteriolar diameter relates more strongly to fat-free mass. Different attributes of the retinal microvasculature may reflect distinct roles of body composition and fatness on the cardiometabolic system.

Original languageEnglish
Pages (from-to)1750-1760
Number of pages11
Issue number9
Early online date29 Jul 2020
Publication statusPublished - 1 Sept 2020
Externally publishedYes

Bibliographical note

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


Dive into the research topics of 'Retinal Vascular Tortuosity and Diameter Associations with Adiposity and Components of Body Composition'. Together they form a unique fingerprint.

Cite this