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A.G. Tan, K.H. C. Wu, J.J. Wang, E. Rochtchina, E.J. Favaloro, A. Williams, P. Mitchell, Blue Mountains Eye Study; Systemic Inflammatory Markers, Haemostatic Factors and Age–Related Maculopathy: A Population–Based Case–Control Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2704.
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To investigate the association between systemic inflammatory markers, haemostatic factors and age–related maculopathy (ARM).
A nested case–control study in the Blue Mountains Eye Study (BMES) cross–section II population (n=3509, 75% of BMES I survivors and 85.2% of newly eligible residents) included 159 early and 38 late ARM cases and 433 controls matched for age, gender and smoking status. ARM was assessed from retinal photographs using the Wisconsin ARM grading system. Serum markers assessed included high–sensitivity C–reactive protein (hsCRP), interleukin–6 (IL–6), soluble intercellular adhesion molecule–1 (sICAM–1), white cell count (WCC) with differentials, von Willebrand factor antigen (vWF:Ag), collagen binding assay (vWF:CB), plasminogen activator inhibitor–1 (PAI–1), homocysteine and fibrinogen. Mean comparisons were made after adjusting for age, sex, BMI, current smoking, hypertension, history of stroke and cardiovascular events. Serum markers were assessed continuously (per SD) for associations with ARM, after adjustment.
A significantly lower mean level of basophils was found in participants with any ARM (mean 0.03 vs 0.04 x 109 cells/L in controls, p=0.007). Likelihood of having late (OR 0.6, CI 0.4–1.0) or early (OR 0.8, CI 0.6–0.9) was reduced per SD increase in basophils. A higher mean level of neutrophils (4.34 vs 3.78 x 109 cells/L, p=0.01) and monocytes (0.56 vs 0.47x109 cells/L, p=0.004) was found in subjects with late but not early ARM, compared to controls. Likelihood of late ARM increased per SD increase in neutrophils (OR 1.3, CI 0.96–1.8) and monocytes (OR 1.4, CI 1.0–1.8). Mean sICAM–1 was higher in subjects with late (437.0 vs 388.8 ng/ml, per SD OR 1.3 CI 0.98–1.7) and early ARM (397.7 ng/ml, OR 1.04, CI 0.86–1.26). Mean PAI–1 level was higher in participants with early (86.8 vs 82.7 ng/ml, p=0.04, per SD OR 1.2 CI 1.0–1.4) and late ARM (91.3 ng/ml, p=0.02, OR 1.3 CI 0.9–1.9). No significant associations were found for other markers assessed and either early or late ARM.
In this population–based nested case–control study we could not demonstrate a consistent pattern of significant association between haemostatic factors or inflammatory markers, including CRP, and the prevalence of either early or late–stage ARM.
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