McGwin Gerald, Xie Aiyuan, Owsley Cynthia
Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294-0009, USA.
Ophthalmology. 2005 Mar;112(3):488-94. doi: 10.1016/j.ophtha.2004.10.027.
To evaluate the association between cholesterol-lowering medications and age-related macular degeneration (AMD).
Case-control study.
The Atherosclerosis Risk in Communities study is a prospective, population-based, cohort study conducted in 4 communities across the United States. A total of 15792 individuals aged 45 to 65 years were enrolled between 1987 and 1989; fundus photographs were added to the study protocol at the 6-year follow-up (1993-1995). Cases were subjects who were identified as having AMD after applying a standard definition to their fundus photographs; controls did not have AMD.
The use of cholesterol-lowering medications at any time during the study was determined and compared between cases and controls, adjusting for the potentially confounding effect of demographic, behavioral, and medical characteristics.
Presence of AMD and the use of cholesterol-lowering medications.
A total of 871 AMD cases and 11,717 controls were identified. Of the AMD cases, 11% made use of cholesterol-lowering medications, as compared with 12.3% of controls (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.71-1.11). Adjusting for the confounding influence of age, gender, and race revealed a statistically significant relationship between AMD and use of cholesterol-lowering medications (OR, 0.79; 95% CI, 0.63-0.99).
The results of this study add to the growing body of evidence that cholesterol-lowering medications may reduce the risk of developing AMD. Additional research is needed to document the mechanism responsible for this association. A clinical trial of the impact of statins on AMD deserves consideration.
评估降胆固醇药物与年龄相关性黄斑变性（AMD）之间的关联。
病例对照研究。
社区动脉粥样硬化风险研究是一项在美国4个社区进行的前瞻性、基于人群的队列研究。1987年至1989年间共招募了15792名年龄在45至65岁之间的个体；在6年随访期（1993 - 1995年）时，眼底照片被纳入研究方案。病例是指对其眼底照片应用标准定义后被确定患有AMD的受试者；对照则未患AMD。
确定研究期间任何时间使用降胆固醇药物的情况，并在病例和对照之间进行比较，同时对人口统计学、行为和医学特征的潜在混杂效应进行校正。
AMD的存在情况以及降胆固醇药物的使用情况。
共识别出871例AMD病例和11717名对照。在AMD病例中，11%使用了降胆固醇药物，而对照中这一比例为12.3%（比值比[OR]，0.89；95%置信区间[CI]，0.71 - 1.11）。对年龄、性别和种族的混杂影响进行校正后，AMD与降胆固醇药物的使用之间存在统计学显著关系（OR，0.79；95% CI，0.63 - 0.99）。
本研究结果进一步补充了越来越多的证据，表明降胆固醇药物可能降低患AMD的风险。需要更多研究来证实这种关联的机制。他汀类药物对AMD影响的临床试验值得考虑。
