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Body Mass Index and the Incidence of Visually Significant Age-Related Maculopathy in Men
Debra A. Schaumberg, ScD, MPH;
William G. Christen, ScD;
Susan E. Hankinson, ScD;
Robert J. Glynn, PhD
Arch Ophthalmol. 2001;119:1259-1264.
Background Reports have suggested relationships of body weight with age-related
maculopathy (ARM), particularly its nonneovascular (dry) forms, but results
are inconsistent and prospective data are scarce.
Objective To examine prospectively relationships of body mass index (BMI; calculated
as weight in kilograms divided by the square of height in meters) with visually
significant dry and neovascular ARM during an average of 14.5 years of follow-up.
Methods Incident ARM was assessed by medical record confirmation of self-reported
ARM among the 21 121 men participating in the Physicians' Health Study
who (1) were followed up for at least 7 years, (2) were free of visually significant
ARM at baseline, and (3) had information on BMI and cigarette smoking. We
used proportional hazards regression models to estimate rate ratios (RRs)
and 95% confidence intervals (CIs) for visually significant dry ARM (256 cases)
and neovascular ARM (84 cases) within 4 categories of BMI: lean (<22.0),
normal (22.0-24.9), overweight (25.0-29.9), and obese ( 30.0).
Results Adjusting for age, randomized aspirin and beta carotene assignments,
and cigarette smoking, the incidence for visually significant dry ARM was
lowest in men with a normal BMI. Compared with these men, the RRs (95% CIs)
were as follows: 1.43 (1.01-2.04) for lean, 1.24 (0.93-1.66) for overweight,
and 2.15 (1.35-3.45) for obese men. Although there was no significant relationship
of BMI with the diagnosis of neovascular ARM, due to the small number of cases
these analyses could not rule out an important relationship.
Conclusions Obesity is a risk factor for visually significant ARM in men, in particular
for dry ARM. However, the relationship of BMI with dry ARM appears to be J-shaped,
and the leanest individuals also appear to be at increased risk.
From the Division of Preventive Medicine (Drs Schaumberg, Christen,
and Glynn) and Channing Laboratory (Dr Hankinson), Brigham and Women's Hospital,
Harvard Medical School, and Departments of Epidemiology (Dr Hankinson) and
Biostatistics (Dr Glynn), Harvard School of Public Health, Boston, Mass.
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