4.4 Article

Early middle age cholesterol levels and the association with age-related macular degeneration

Journal

ACTA OPHTHALMOLOGICA
Volume 99, Issue 7, Pages E1063-E1069

Publisher

WILEY
DOI: 10.1111/aos.14774

Keywords

age‐ related macular degeneration; cardiovascular risk factors; drusen; genetics; lipids

Categories

Funding

  1. Silmasaatio Foundation (Helsinki, Finland)

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The study found that high systemic total cholesterol in early middle age may be associated with the initial development of age-related macular degeneration, particularly in patients who later develop large drusen. Lipid values measured in 2011 showed no associations after correction for other factors.
Purpose To examine whether serum cholesterol in early middle age is associated with age-related macular degeneration (AMD) later in life. Methods A group of Helsinki Businessmen Study (HBS) participants (n = 209) were recruited for the study. Total cholesterol (TC), triglyceride and body mass index (BMI) were measured at the HBS baseline visit in 1964-1973. Lipid subfractions, BMI, smoking status and statin use were recorded in 2011 and fundus photographs graded for AMD in 2005-2012. The subjects were genotyped for the main AMD risk single nucleotide polymorphisms (SNPs). Results TC measured at baseline 1964-1973 was significantly higher in subjects later developing intermediate or late AMD (6.67 mmol/l versus 6.20 mmol/l, p = 0.024) or with drusen size of >= 125 mu m (6.68 mmol/l versus 6.21 mmol/l, p = 0.030) compared with the rest of the study population. TC, LDL and TG values at follow-up 2011 were lower in subjects with AMD compared to those without, whereas HDL levels showed no difference. In multivariate analysis, baseline TC associated with intermediate or late AMD (OR 1.59, p = 0.004) and drusen size >= 125 mu m (OR 1.57, p = 0.006) when corrected for age, BMI, AMD risk SNPs and smoking. Lipid values measured 2011 had no associations after correction. Conclusions High systemic total cholesterol in early middle age may have a role in the initial development of AMD, especially in patients later developing large drusen.

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