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C. DelCourt, M.-N. Delyfer, M.-B. Rougier, J. Colin, F. Malet, M. Le Goff, J.-F. Dartigues, P. Barberger-Gateau, J.-F. Korobelnik; Past Plasma Lipids, Apolipoprotein E4 Polymorphism and the Risk for Age-Related Maculopathy: The Alienor Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):275.
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Lipid metabolism may be implicated in the aetiology of age-related maculopathy (ARM). In the present study, we investigate the associations of ARM with plasma lipids and apoliprotein E (ApoE) polymorphism.
The Alienor Study is a population-based epidemiological study on nutrition and age-related eye diseases. 963 subjects were recruited from September 2006 to May 2008 in Bordeaux (France). ApoE polymorphism and plasma lipids were determined in 889 subjects (92.3 %), from blood collected in 1999-2001. 816 of 889 (91.8 %) had gradable photographs and were classified in 5 exclusive stages (worse eye): neovascular ARM (stage 4, n= 23); geographic atrophy (stage 3, n=23); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (stage 2, n=87); large soft distinct drusen alone or pigment abnormalities alone (stage 1, n=150); stage 0 (n=533). Associations were estimated using polytomous logistic regression, after adjustment for age and gender.
Subjects with high HDL-cholesterol were at higher risk of any ARM (OR= 1.26, 95 % confidence interval (CI): 1.08 - 1.47 for 1-SD increase, p= 0.004). The associations were similar with the different stages of ARM (OR ranging from 1.12 to 1.57). Total- and LDL-cholesterol and triglycerides were not significantly associated with any ARM. ApoE4 (at least one allele) tended to be associated with decreased risk of any ARM (OR=0.71, 95 % CI : 0.47 - 1.06 , p=0.09) and showed similar associations with the different stages of ARM (OR ranging from 0.22 to 0.99). There was a significant interaction with age (p=0.06) : apoE4 was not significantly associated with any ARM in subjects younger than 80 years (OR= 1.03, 95 % CI: 0.61 - 1.73 , p=0.90), but was significantly associated with decreased risk in subjects older than 80 years (OR=0.39, 95 % CI: 0.21 - 0.74, p=0.004). There was no statistical interaction of HDL with apoE4 and the association of any ARM with HDL persisted after further adjustment for apoE4, Complement Factor H Y402H polymorphism and smoking (OR= 1.28, 95 % CI : 1.09 - 1.50 for 1 SD increase, p=0.003).
In this population-based study, HDL-cholesterol measured 7 years before the eye examination was strongly associated with the risk of ARM, while apoE4 polymorphism was associated with decreased risk, but only in subjects aged more than 80 years.
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