Gedtal Miguel, Woodside Jayne, Wright David, Rayman Margaret, Hogg Ruth Esther
Queen's University Belfast, Belfast, UK.
University of Surrey, Surrey, UK.
BMJ Open Ophthalmol. 2024 Jul 31;9(1):e001505. doi: 10.1136/bmjophth-2023-001505.
Current literature reveals an association between anthropometric measures of adiposity (AnthM) and age-related macular degeneration (AMD), but few have explored the disease association with imaging methods. This study aimed to explore the relationship between AMD status and dual-energy X-ray absorptiometry measures (DEXAMs) among a representative sample of the US population, and compare the association with AnthM.
Using a representative sample in the National Health and Nutrition Examination Study 2005-2006 (n=1632), DEXAMs across the whole body and waist (ie, android), and relative fat distributions (eg, percentage fat, android-to-total body ratio) were analysed between no AMD (baseline) and any AMD. Bivariate analyses across AMD status were similarly performed for AnthM (ie, body mass index, waist circumference and skinfold thicknesses) and potential confounders (ie, demographics and health-related variables). Significant adiposity measures were analysed using logistic regression, adjusting for confounders.
The participants in the sample were aged 40-69 years, were majority female (52%) and mainly Caucasian (76.5%). Bivariate analysis revealed having any AMD had positive significant associations with android-to-total fat ratio and subscapular skinfold thickness (SSFT). Other AnthM and DEXAMs were not significant. After adjusting age, gender and prescription of cholesterol-lowering medicine, only SSFT remained significantly associated.
SSFT represents an independent risk factor for AMD presence compared with other AnthM and DEXAMs. SSFT is an established method of measuring fat under the skin (ie, subcutaneous fat). Hence, subcutaneous fat may be more relevant in explaining the adiposity-AMD link due to physiological properties specific to the tissue. Limitations include the restricted age range and low numbers of participants with late AMD.
当前文献揭示了肥胖的人体测量指标（AnthM）与年龄相关性黄斑变性（AMD）之间的关联，但很少有人用成像方法探讨这种疾病关联。本研究旨在探讨美国人群代表性样本中AMD状态与双能X线吸收测定法测量值（DEXAMs）之间的关系，并比较其与AnthM的关联。
使用2005 - 2006年美国国家健康与营养检查调查中的代表性样本（n = 1632），分析无AMD（基线）和患有任何AMD者的全身及腰部（即男性型）DEXAMs以及相对脂肪分布（如脂肪百分比、男性型与全身比例）。对AnthM（即体重指数、腰围和皮褶厚度）和潜在混杂因素（即人口统计学和健康相关变量）进行类似的AMD状态二元分析。使用逻辑回归分析显著的肥胖测量指标，并对混杂因素进行调整。
样本中的参与者年龄在40 - 69岁之间，大多数为女性（52%），主要是白种人（76.5%）。二元分析显示，患有任何AMD与男性型与总脂肪比例及肩胛下皮褶厚度（SSFT）呈显著正相关。其他AnthM和DEXAMs不显著。在调整年龄、性别和降胆固醇药物处方后，只有SSFT仍具有显著相关性。
与其他AnthM和DEXAMs相比，SSFT是AMD存在的独立危险因素。SSFT是一种已确立的测量皮下脂肪（即皮下脂肪）的方法。因此，由于该组织特有的生理特性，皮下脂肪可能在解释肥胖与AMD的关联方面更具相关性。局限性包括年龄范围受限以及晚期AMD参与者数量较少。
