Abstract
BACKGROUND: Conflicting evidence exists on the association between ageing and obesity. Retinal age derived from fundus images has been validated as a novel biomarker of ageing. In this study, we aim to investigate the association between different anthropometric phenotypes based on body mass index (BMI) and waist circumference (WC) and the retinal age gap (retinal age minus chronological age). METHODS: A total of 35,550 participants with BMI, WC and qualified retinal imaging data available were included to investigate the association between anthropometric groups and retinal ageing. Participants were stratified into 7 different body composition groups based on BMI and WC (Normal-weight/Normal WC, Overweight/Normal WC, Mild obesity/Normal WC, Normal-weight/High WC, Overweight/High WC, Mild obesity/High WC, and Severe obesity/High WC). Linear regression and logistic regression models were fitted to investigate the association between the seven anthropometric groups and retinal age gap as continuous and categorical outcomes, respectively. RESULTS: A total of 35,550 participants (55.6% females) with a mean age 56.8 ± 8.04 years were included in the study. Individuals in the Overweight/High WC, Mild obesity/High WC and Severe obesity/High WC groups were associated with an increase in the retinal age gap, compared with those in the Normal Weight/Normal WC group (β = 0.264, 95% CI: 0.105-0.424, P =0.001; β = 0.226, 95% CI: 0.082-0.371, P = 0.002; β = 0.273, 95% CI: 0.081-0.465, P = 0.005; respectively) in fully adjusted models. Similar findings were noted in the association between the anthropometric groups and retinal ageing process as a categorical outcome. CONCLUSION: A significant positive association exists between central obesity and accelerated ageing indexed by retinal age gaps, highlighting the significance of maintaining a healthy body shape.