Klein Ronald, Myers Chelsea E, Buitendijk Gabriëlle H S, Rochtchina Elena, Gao Xiaoyi, de Jong Paulus T V M, Sivakumaran Theru A, Burlutsky George, McKean-Cowdin Roberta, Hofman Albert, Iyengar Sudha K, Lee Kristine E, Stricker Bruno H, Vingerling Johannes R, Mitchell Paul, Klein Barbara E K, Klaver Caroline C W, Wang Jie Jin
Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Am J Ophthalmol. 2014 Sep;158(3):513-24.e3. doi: 10.1016/j.ajo.2014.05.027. Epub 2014 May 28.
To describe associations of serum lipid levels and lipid pathway genes to the incidence of age-related macular degeneration (AMD).
Meta-analysis.
setting: Three population-based cohorts. population: A total of 6950 participants from the Beaver Dam Eye Study (BDES), Blue Mountains Eye Study (BMES), and Rotterdam Study (RS). observation procedures: Participants were followed over 20 years and examined at 5-year intervals. Hazard ratios associated with lipid levels per standard deviation above the mean or associated with each additional risk allele for each lipid pathway gene were calculated using random-effects inverse-weighted meta-analysis models, adjusting for known AMD risk factors. main outcome measures: Incidence of AMD.
The average 5-year incidences of early AMD were 8.1%, 15.1%, and 13.0% in the BDES, BMES, and RS, respectively. Substantial heterogeneity in the effect of cholesterol and lipid pathway genes on the incidence and progression of AMD was evident when the data from the 3 studies were combined in meta-analysis. After correction for multiple comparisons, we did not find a statistically significant association between any of the cholesterol measures, statin use, or serum lipid genes and any of the AMD outcomes in the meta-analysis.
In a meta-analysis, there were no associations of cholesterol measures, history of statin use, or lipid pathway genes to the incidence and progression of AMD. These findings add to inconsistencies in earlier reports from our studies and others showing weak associations, no associations, or inverse associations of high-density lipoprotein cholesterol and total cholesterol with AMD.
描述血清脂质水平和脂质代谢途径基因与年龄相关性黄斑变性(AMD)发病率之间的关联。
荟萃分析。
研究背景:三项基于人群的队列研究。研究对象:来自比弗代姆眼病研究(BDES)、蓝山眼病研究(BMES)和鹿特丹研究(RS)的总共6950名参与者。观察程序:对参与者进行了20年的随访,并每隔5年进行一次检查。使用随机效应逆加权荟萃分析模型计算与高于均值每标准差的脂质水平相关或与每个脂质代谢途径基因的每个额外风险等位基因相关的风险比,并对已知的AMD风险因素进行调整。主要观察指标:AMD的发病率。
在BDES、BMES和RS中,早期AMD的平均5年发病率分别为8.1%、15.1%和13.0%。当将三项研究的数据合并进行荟萃分析时,胆固醇和脂质代谢途径基因对AMD发病率和进展的影响存在显著异质性。在进行多重比较校正后,我们在荟萃分析中未发现任何胆固醇测量指标、他汀类药物使用情况或血清脂质基因与任何AMD结局之间存在统计学显著关联。
在一项荟萃分析中,胆固醇测量指标、他汀类药物使用史或脂质代谢途径基因与AMD的发病率和进展之间没有关联。这些发现增加了我们的研究以及其他研究早期报告中的不一致性,这些报告显示高密度脂蛋白胆固醇和总胆固醇与AMD之间存在弱关联、无关联或负关联。