June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
The Relationship of Macular Pigment Optical Density (MPOD) to Mortality in the Second Carotenoids in Age-Related Eye Disease Study (CAREDS 2), an ancillary study of the Women’s Health Initiative (WHI)
Author Affiliations & Notes
  • Julie A Mares
    Ophthal and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Zhe Liu
    Ophthal and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Robert B. Wallace
    Epidemiology, University of Iowa School of Public Health, Iowa City, Iowa, United States
  • Ronald Gangnon
    Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, United States
  • Billy Hammond
    Psychology, University of Georgia, Athens, Georgia, United States
  • Elizabeth Johnson
    Jean Mayer USDA Human Nutrition Research Center on Aging , Tufts University, Boston, Massachusetts, United States
  • Lesley Tinker
    Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
  • Courtney Blomme
    Ophthal and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Gloria Sarto
    Obstetrics & Gynecology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, United States
  • D.Max Snodderly
    Department of Neuroscience and Department of Nutritional Sciences, The University of Texas, Austin, Texas, United States
  • Footnotes
    Commercial Relationships   Julie Mares, None; Zhe Liu, None; Robert Wallace, None; Ronald Gangnon, None; Billy Hammond, None; Elizabeth Johnson, None; Lesley Tinker, None; Courtney Blomme, None; Gloria Sarto, None; D.Max Snodderly, None
  • Footnotes
    Support  National Institutes of Health, National Eye Institute grants R01EY013018, R01EY016886, R01EY025292, P30EYO16665,National Heart, Lung, and Blood Institute contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C, and an unrestricted departmental grant from the Research to Prevent Blindness,and the Retina Research Foundation
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2982. doi:
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      Julie A Mares, Zhe Liu, Robert B. Wallace, Ronald Gangnon, Billy Hammond, Elizabeth Johnson, Lesley Tinker, Courtney Blomme, Gloria Sarto, D.Max Snodderly; The Relationship of Macular Pigment Optical Density (MPOD) to Mortality in the Second Carotenoids in Age-Related Eye Disease Study (CAREDS 2), an ancillary study of the Women’s Health Initiative (WHI). Invest. Ophthalmol. Vis. Sci. 2017;58(8):2982.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We studied the relation of MPOD to 14-year all-cause and cause-specific mortality, which may be a competing risk for age-related macular degeneration (AMD) in epidemiological studies.

Methods : The dataset included 1,789 women, 55-84 years of age with complete MPOD data at CAREDS baseline (2001-2004), of whom 318 had died through September, 2015. Baseline MPOD, at 0.5 degrees from the central fovea, was assessed by heterochromatic flicker photometry. Deaths and health history were ascertained from Women’s Health Initiative (WHI) annual mailed questionnaires and periodic checks of the National Death Index. Risk factors were assessed from questionnaires, measurements and blood specimens obtained at baseline CAREDS and WHI visits (1994-1998). Hazards ratios for mortality were computed using Cox proportional regression.

Results : Age- adjusted HR (95%CI) for all-cause mortality were 0.59 (0.43,0.83), among women in high vs. low MPOD quintiles. This association was partially explained by three groups of potential shared risk factors for low MPOD and chronic diseases which are common causes of mortality. HR were attenuated to 0.64 (0.45,0.91), after adjusting for dietary and serum L and Z, to 0.72 (0.50, 1.04) when further adjusting for factors related to metabolic syndrome (waist circumference in high quartiles, diabetes, hypertension, elevated triglycerides, and factors related to low HDL [statin-use and the presence of the following risk alleles: GG for BCMO1 rs11645428, AG/GG for SCARB1 rs838879 and CC for ABCA1 rs1929841]), and to 0.74 (0.51, 1.07) when further adjusting for healthy lifestyle score (two points each for low pack-years of smoking, high physical activity levels and high healthy eating index score). HR for cardiovascular disease-mortality (in 83 women) were in the same direction. There were no associations between MPOD and cancer-mortality.

Conclusions : Low levels of MPOD are associated with an increased risk of mortality over 14-years. This association appears to be explained by multiple shared risk factors for low MPOD and common chronic diseases, which are also risk factors for AMD. Differential mortality in women with low vs. high MPOD could bias associations of MPOD with AMD, if unaccounted for.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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