氧化型低密度脂蛋白与年龄相关性黄斑变性的发生。
Oxidized Low-density Lipoprotein and the Incidence of Age-related Macular Degeneration.
机构信息
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
出版信息
Ophthalmology. 2019 May;126(5):752-758. doi: 10.1016/j.ophtha.2018.12.026. Epub 2018 Dec 17.
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 4972 people from the BDES (aged 43-84 years and living in Beaver Dam, Wisconsin in 1988) seen during at least 1 of 6 examination phases at approximately 5-year intervals between 1988 and 2016.
METHODS
A 50% random sample of participants (N = 2468) was selected for ox-LDL measurements. Stored frozen specimens from every examination phase were processed using an enzyme-linked immunosorbent assay from a single batch. All available intervals were included for a person, resulting in 6586 person-visits.
MAIN OUTCOME MEASURES
Age-related macular degeneration 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 (standard deviation) level of ox-LDL was 75.3 (23.1) U/L at the baseline examination. When 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 per 10 U/L ox-LDL was 1.03, 95% confidence interval 0.98,1.09). Furthermore, ox-LDL was not associated with worsening anywhere along the AMD severity scale, nor with 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.
目的
在人群为基础的比弗大坝眼研究（BDES）中，在 25 年的时间内，研究血清氧化低密度脂蛋白（ox-LDL）胆固醇与年龄相关性黄斑变性（AMD）发病之间的关系。
设计
观察性前瞻性队列研究。
参与者
共有 4972 名来自 BDES（年龄 43-84 岁，1988 年居住在威斯康星州比弗大坝）的参与者，在 1988 年至 2016 年期间，每隔 5 年进行 6 次检查，至少参加了一次。
方法
选择 50%的参与者（N=2468）进行 ox-LDL 测量。从每个检查阶段的冷冻标本中提取并使用单批酶联免疫吸附测定法进行处理。每个人的所有可用间隔都包含在内，总共进行了 6586 次人访。
主要观察结果
使用威斯康星州年龄相关性黄斑病变分级系统评估年龄相关性黄斑变性，并使用 5 级严重程度量表定义严重程度。每次检查时使用最差眼的严重程度进行分析。使用多状态马尔可夫（MSM）模型同时评估 ox-LDL 与所有 AMD 转变的关系，包括任何 AMD 的发病率、晚期 AMD 的发病率以及 AMD 在 25 年研究期间的恶化和改善。
结果
基线检查时 ox-LDL 的平均（标准差）水平为 75.3（23.1）U/L。在调整年龄、性别、ARMS2 和 CFH 风险等位基因以及检查阶段后，一个时期开始时的 ox-LDL 与任何 AMD 的发病率无统计学显著相关性（每增加 10 U/L ox-LDL 的危险比为 1.03，95%置信区间 0.98，1.09）。此外，ox-LDL 与 AMD 严重程度任何地方的恶化都没有关系，也与晚期 AMD 的发病率无关。在用他汀类药物使用史、吸烟状况、体重指数和心血管疾病史调整后，ox-LDL 与任何 AMD 的发病率或 AMD 的恶化之间仍然没有关系（未显示数据）。
结论
我们的研究结果没有提供统计学上有意义的证据表明 ox-LDL 与 AMD 疾病发展或 AMD 恶化之间存在关系。
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