 |
|
Progression of Age-Related Macular Degeneration
Association With Body Mass Index, Waist Circumference, and Waist-Hip Ratio
Johanna M. Seddon, MD, ScM;
Jennifer Cote, MPH;
Nancy Davis, BS;
Bernard Rosner, PhD
Arch Ophthalmol. 2003;121:785-792.
Background Individuals with early or intermediate stages of age-related macular degeneration (AMD) make up a large and growing segment of our elderly population. To advise these high-risk patients regarding preventive measures, we evaluated anthropomorphic, behavioral, and medical factors associated with progression to the advanced stages of AMD associated with visual loss.
Methods The design was a prospective cohort study in a hospital-based retinal practice. The 261 participants were 60 years or older, with some sign of nonadvanced AMD and visual acuity of 20/200 or better in at least 1 eye. The average follow-up time was 4.6 years, and the total person-years of follow-up was 1198. Factors associated with rates of progression to advanced AMD were assessed by the Cox proportional hazards model.
Outcome Measures Progression to geographic atrophy and neovascular disease.
Results Higher body mass index (calculated as weight in kilograms divided by the square of height in meters) increased the risk for progression to the advanced forms of AMD. Relative risk (RR) was 2.35 (95% confidence interval [CI], 1.27-4.34) for a body mass index of at least 30, and 2.32 (95% CI, 1.32-4.07) for a body mass index of 25 to 29, relative to the lowest category (<25) after controlling for other factors (P = .007 for trend). Higher waist circumference was associated with a 2-fold increased risk for progression (RR for the highest tertile compared with the lowest, 2.04; 95% CI, 1.12-3.72), with a significant trend for increasing risk with a greater waist circumference (P = .02). Higher waist-hip ratio also increased the risk for progression (RR, 1.84; 95% CI, 1.07-3.15) for the highest tertile compared with lowest (P = .02 for trend). More physical activity tended to be associated with a reduced rate of progression (25% reduction for 3 times per week vigorous activity vs none, P = .05 to P = .07). Relative risks for smoking ranged from 1.48 to 1.99, but were not statistically significant.
Conclusions Results provide new information regarding modifiable factors for individuals with the early or intermediate stages of this disease. Overall and abdominal obesity increased the risk for progression to advanced AMD, and more physical activity tended to decrease risk. These preventive measures deserve additional research and greater emphasis.
From the Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston (Dr Seddon and Mss Cote and Davis); and the Departments of Ophthalmology (Dr Seddon) and Medicine (Biostatistics) (Dr Rosner), Harvard Medical School, and the Departments of Epidemiology (Dr Seddon) and Biostatistics (Dr Rosner), Harvard School of Public Health, Boston. The authors have no relevant financial interest in this article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Age-related maculopathy and sunlight exposure evaluated by objective measurement
Hirakawa et al.
Br. J. Ophthalmol. 2008;92:630-634.
ABSTRACT
| FULL TEXT
Association of CFH Y402H and LOC387715 A69S With Progression of Age-Related Macular Degeneration
Seddon et al.
JAMA 2007;297:1793-1800.
ABSTRACT
| FULL TEXT
Hormone Therapy and Age-Related Macular Degeneration: The Women's Health Initiative Sight Exam Study
Haan et al.
Arch Ophthalmol 2006;124:988-992.
ABSTRACT
| FULL TEXT
Cigarette Smoking, Fish Consumption, Omega-3 Fatty Acid Intake, and Associations With Age-Related Macular Degeneration: The US Twin Study of Age-Related Macular Degeneration
Seddon et al.
Arch Ophthalmol 2006;124:995-1001.
ABSTRACT
| FULL TEXT
A 76-year-old man with macular degeneration.
Arroyo
JAMA 2006;295:2394-2406.
FULL TEXT
A study of the relation between body mass index and the incidence of age related macular degeneration
Moeini et al.
Br. J. Ophthalmol. 2005;89:964-966.
ABSTRACT
| FULL TEXT
Progression of Age-Related Macular Degeneration: Prospective Assessment of C-Reactive Protein, Interleukin 6, and Other Cardiovascular Biomarkers
Seddon et al.
Arch Ophthalmol 2005;123:774-782.
ABSTRACT
| FULL TEXT
Complement Factor H Polymorphism and Age-Related Macular Degeneration
Edwards et al.
Science 2005;308:421-424.
ABSTRACT
| FULL TEXT
The US Twin Study of Age-Related Macular Degeneration: Relative Roles of Genetic and Environmental Influences
Seddon et al.
Arch Ophthalmol 2005;123:321-327.
ABSTRACT
| FULL TEXT
Macular Pigment and Percentage of Body Fat
Nolan et al.
IOVS 2004;45:3940-3950.
ABSTRACT
| FULL TEXT
Prospective Study of Intake of Fruits, Vegetables, Vitamins, and Carotenoids and Risk of Age-Related Maculopathy
Cho et al.
Arch Ophthalmol 2004;122:883-892.
ABSTRACT
| FULL TEXT
Extremely Discordant Sib-Pair Study Design to Determine Risk Factors for Neovascular Age-Related Macular Degeneration
DeAngelis et al.
Arch Ophthalmol 2004;122:575-580.
ABSTRACT
| FULL TEXT
Association Between C-Reactive Protein and Age-Related Macular Degeneration
Seddon et al.
JAMA 2004;291:704-710.
ABSTRACT
| FULL TEXT
Progression of Age-Related Macular Degeneration: Association With Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake
Seddon et al.
Arch Ophthalmol 2003;121:1728-1737.
ABSTRACT
| FULL TEXT
|
