Fitton Catherine A, Quigley Madeleine M R, Belch Jill J F
Division of Molecular & Clinical Medicine, Mailbox 1, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK.
BMC Ophthalmol. 2025 Feb 10;25(1):67. doi: 10.1186/s12886-025-03868-5.
Age-related macular degeneration (AMD) is a major cause of vision loss worldwide. This study aimed to assess risk factors for wet AMD by two methods: assessing risk factors measured in the Scottish Heart Health Extended Cohort (SHHEC), and to systematically review the literature.
Eighteen thousand one hundred seven volunteers were recruited to SHHEC between 1984-1995, with risk factor data collected on recruitment. Hospital records were linked to study data up to 2017 and survival analysis was used to analyse risk factors and wet AMD. Literature published between 2000-2023 was searched for studies assessing risk factors for wet AMD, resulting in 5,503 papers. Following review, 7 studies were included in the systematic review.
Within the SHHEC data, 231 cases of wet AMD were reported. Increasing age (Hazard Ratio (HR) 10.51; 99% Confidence Interval (CI) 4.78-23.11) and smoking (HR 1.67; 99% CI 1.17-2.38) were significantly associated with an increased risk of wet AMD. Increased dietary intake of vitamin K (HR 0.56; 99% CI 0.34-0.94) was associated with a decreased risk of wet AMD. According to a systematic review, smoking, high Body mass index, heavy alcohol intake, increased systolic blood pressure, increased pulse pressure, and high levels of C-reactive protein and serum triglycerides in the blood may be associated with an increased risk of wet AMD. However, the studies provide mixed evidence and no conclusive results.
We have demonstrated that increasing age and smoking are high-risk factors for the development of wet AMD, while vitamin K is associated with a reduced risk of wet AMD.
年龄相关性黄斑变性（AMD）是全球视力丧失的主要原因。本研究旨在通过两种方法评估湿性AMD的危险因素：评估在苏格兰心脏健康扩展队列（SHHEC）中测量的危险因素，并对文献进行系统综述。
1984年至1995年间，18107名志愿者被招募到SHHEC，招募时收集了危险因素数据。医院记录与截至2017年的研究数据相关联，并使用生存分析来分析危险因素和湿性AMD。检索了2000年至2023年间发表的文献，以寻找评估湿性AMD危险因素的研究，共检索到5503篇论文。经过评审，7项研究被纳入系统综述。
在SHHEC数据中，报告了231例湿性AMD病例。年龄增长（风险比（HR）10.51；99%置信区间（CI）4.78-23.11）和吸烟（HR 1.67；99%CI 1.17-2.38）与湿性AMD风险增加显著相关。饮食中维生素K摄入量增加（HR 0.56；99%CI 0.34-0.94）与湿性AMD风险降低相关。根据系统综述，吸烟、高体重指数、大量饮酒、收缩压升高、脉压升高以及血液中高浓度的C反应蛋白和血清甘油三酯可能与湿性AMD风险增加有关。然而，这些研究提供的证据不一，没有得出确凿的结果。
我们已经证明，年龄增长和吸烟是湿性AMD发生的高风险因素，而维生素K与湿性AMD风险降低有关。
