Oxidized Low-Density Lipoprotein and the Incidence of Age-related Macular Degeneration.

Cruickshanks Lab // Kleins Lab // Publications // Dec 21 2018

PubMed ID: 30572074

Author(s): Klein R, Lee KE, Tsai MY, Cruickshanks KJ, Gangnon RE, Klein BEK. Oxidized Low-Density Lipoprotein and the Incidence of Age-related Macular Degeneration. Ophthalmology. 2018 Dec 17. pii: S0161-6420(18)32430-8. doi: 10.1016/j.ophtha.2018.12.026. [Epub ahead of print]

Journal: Ophthalmology, Dec 2018

PURPOSE To examine the relationship between serum oxidized low-density lipoprotein (ox-LDL) cholesterol and the incidence of age-related macular degeneration (AMD) over a 25-year period in a sample of persons from the population-based Beaver Dam Eye Study (BDES).

DESIGN Observational prospective cohort study.

PARTICIPANTS A total of 4,972 people from the BDES (aged 43 to 84 and living in Beaver Dam, Wisconsin in 1988) seen during at least one of six examination phases at approximately 5-year intervals between 1988 and 2016.

METHODS A 50% random sample of participants (N=2,468) was selected for ox-LDL measurements. Stored frozen specimens from every exam phase were processed using an ELISA assay from a single batch. All available intervals were included for a person, resulting in 6,586 person-visits.

MAIN OUTCOME MEASURES AMD was assessed using the Wisconsin Age-related Maculopathy Grading System and severity was defined using a 5-step severity scale. The severity of the worse eye at each examination was used for analyses. A Multi-State Markov (MSM) model was fit to simultaneously assess the ox-LDL relationship to all AMD transitions including incidence of any AMD, incidence of late AMD, and worsening and improvement of AMD over the 25 years of the study.

RESULTS The mean (SD) level of ox-LDL was 75.3 (23.1) U/L at the baseline examination. While adjusting for age, sex, ARMS2 and CFH risk alleles, and examination phase, the ox-LDL at the beginning of a period was not statistically significantly associated with the incidence of any AMD (Hazard Ratio (HR) per 10 U/L ox-LDL was 1.03, 95% Confidence Interval (CI) 0.98,1.09). Further, ox-LDL was not associated with worsening anywhere along the AMD severity scale nor incidence of late AMD. The lack of relationships of ox-LDL to the incidence of any AMD or worsening of AMD remained after adjustment for history of statin use, smoking status, body mass index, and history of cardiovascular disease (data not shown).

CONCLUSIONS Our findings do not provide evidence for statistically significant relationships between ox-LDL and AMD disease development or worsening of AMD.

Copyright © 2018. Published by Elsevier Inc.