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

• Published in: Acta ophthalmologica (Oxford, England) England), 2021-11, Vol.99 (7), p.e1063-e1069
• Main Authors: Kananen, Fabian, Strandberg, Timo, Loukovaara, Sirpa, Immonen, Ilkka
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Distribution; Age Factors; Aged; Aged, 80 and over; age‐related macular degeneration; Biomarkers - blood; Body mass index; cardiovascular risk factors; Cholesterol; Cholesterol - blood; drusen; Finland - epidemiology; Follow-Up Studies; genetics; High density lipoprotein; Humans; Incidence; lipids; Low density lipoprotein; Macular degeneration; Macular Degeneration - blood; Macular Degeneration - epidemiology; Macular Degeneration - genetics; Male; Middle age; Middle Aged; Multivariate analysis; Polymorphism, Single Nucleotide; Population studies; Retrospective Studies; Risk Assessment - methods; Risk Factors; Single-nucleotide polymorphism; Smoking; Time Factors
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.14774

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 µm (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 µm (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.