Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen,Denmark.
The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev,Denmark.
J Clin Endocrinol Metab. 2021 Jun 16;106(7):e2749-e2758. doi: 10.1210/clinem/dgab095.
To enable prevention and treatment of age-related macular degeneration (AMD), understanding risk factors for AMD is important.
We tested the hypotheses that elevated plasma apolipoprotein A1 and high-density lipoprotein (HDL) cholesterol and low levels of low-density lipoprotein (LDL) cholesterol are associated with increased risk of AMD.
From the Danish general population, we studied 106 703 and 16 032 individuals in the Copenhagen General Population Study (CGPS) and the Copenhagen City Heart Study (CCHS) with median follow-up of 9 and 32 years, respectively.The main outcome measures were 1787 AMD in CGPS and 206 in CCHS.
Higher concentrations of plasma apolipoprotein A1 and HDL cholesterol, and lower concentrations of LDL cholesterol, were associated with higher risk of AMD in CGPS. After multifactorial adjustment, individuals in the highest versus lowest quartile of plasma apolipoprotein A1 and HDL cholesterol had hazard ratios for AMD of 1.40 (95% CI: 1.20-1.63) and 1.22 (1.03-1.45). Corresponding hazard ratios for individuals in the lowest versus highest quartile of LDL cholesterol were 1.18 (1.02-1.37). Per 100 mg/dL higher plasma apolipoprotein A1, 1 mmol/L (39 mg/dL) higher HDL, and 1 mmol/L (39 mmol/L) lower LDL cholesterol, the hazard ratios for AMD were 1.53(1.31-1.80), 1.19 (1.07-1.32), and 1.05 (1.00-1.11), respectively, with similar results across strata of different risk factors. Higher concentrations of HDL cholesterol were also associated with higher risk of AMD in the CCHS.
Elevated plasma apolipoprotein A1 and HDL cholesterol and lower LDL cholesterol are associated with increased risk of AMD.
为了能够预防和治疗年龄相关性黄斑变性（AMD），了解 AMD 的风险因素非常重要。
我们检验了以下假设，即血浆载脂蛋白 A1 和高密度脂蛋白（HDL）胆固醇升高以及低密度脂蛋白（LDL）胆固醇降低与 AMD 风险增加相关。
我们从丹麦普通人群中，分别在哥本哈根普通人群研究（CGPS）和哥本哈根城市心脏研究（CCHS）中对 106703 人和 16032 人进行了研究，中位随访时间分别为 9 年和 32 年。主要结局指标为 CGPS 中的 1787 例 AMD 和 CCHS 中的 206 例 AMD。
CGPS 中，血浆载脂蛋白 A1 和 HDL 胆固醇浓度较高，LDL 胆固醇浓度较低，与 AMD 风险升高相关。经过多因素校正后，血浆载脂蛋白 A1 和 HDL 胆固醇最高四分位数与最低四分位数个体的 AMD 发生风险比分别为 1.40（95%CI：1.20-1.63）和 1.22（1.03-1.45）。LDL 胆固醇最低四分位数与最高四分位数个体的 AMD 发生风险比为 1.18（1.02-1.37）。血浆载脂蛋白 A1 每升高 100mg/dL、HDL 每升高 1mmol/L（39mg/dL）、LDL 每降低 1mmol/L（39mmol/L），AMD 的发生风险比分别为 1.53（1.31-1.80）、1.19（1.07-1.32）和 1.05（1.00-1.11），且在不同危险因素的分层中，结果相似。CCHS 中 HDL 胆固醇浓度较高也与 AMD 风险升高相关。
血浆载脂蛋白 A1 和 HDL 胆固醇升高以及 LDL 胆固醇降低与 AMD 风险增加相关。
