Lipids play important role in early phase of age-related macular disease
Age-related macular degeneration (AMD) is strongly associated with high-density lipoprotein (HDL) cholesterol and triglycerides, with the magnitude of effect being higher for early disease and related to drusen size and area, a study has found.
Researchers looked at 30,953 individuals aged ≥50 years participating in the E3 consortium and 1,530 participants from the Rotterdam Study. Data examined included AMD features (graded per eye on fundus photographs using the Rotterdam Classification) and blood lipid measurements in E3, and lipid subfractions identified by the Nightingale biomarker platform in Rotterdam.
In regression models corrected for potential confounders, HDL was associated with an elevated risk of AMD (adjusted odds ratio [OR) per 1 mmol/L increase, 1.21; 95 percent CI, 1.14–1.29). Conversely, triglycerides showed a protective association (adjusted OR per 1 mmol/L increase, 0.94; 0.91–0.97).
Both lipids were associated with drusen size, such that higher HDL raised the odds of larger drusen while higher triglycerides reduced the odds. The relationship observed for low-density lipoprotein (LDL) cholesterol only reached statistical significance with early AMD (p=0.045).
In terms of lipid subfractions, the concentration of extra-large HDL particles showed the most prominent association with AMD (adjusted OR, 1.24; 1.10–1.40).
The association of the CETP risk variant (rs17231506) with AMD was in agreement with increased-HDL levels (p=7.7x10-7), but LIPC risk variants (rs2043085, rs2070895) showed an inverse association (p=1.0x10-6 and 1.6x10-4).
Despite the presence of several limitations, findings of the present study contribute to the understanding of AMD pathogenesis, researchers said. More studies are needed to determine whether systemic lipids directly influence AMD or represent lipid metabolism in the retina.