Purchase this article with an account.
M. K. M. Adams, L. D. Robman, J. A. Simpson, K. Z. Aung, G. A. Makeyeva, G. G. Giles, D. R. English, R. H. Guymer, P. N. Baird; Abdominal Obesity - Not BMI - Increases Risk of Late AMD in Men. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4540.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Previous studies have provided conflicting evidence of the association between adiposity measures, most using BMI, and age related macular degeneration (AMD). Using five different adiposity measures we explored their association with AMD in a large Australian cohort study.
Bilateral non-mydriatic digital retinal photos from 21,132 participants of the Melbourne Collaborative Cohort Study, aged 48 - 86 years at time of photography, were graded according to AMD phenotype. Polytomous logistic regression, adjusting for smoking status, ethnicity and age, was used to assess associations between AMD and each of the five adiposity measures: body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), fat mass (FM), and body fat percentage (FP). BMI, WHR and WC were obtained from direct measurements. FM and FP were estimated from bioelectric impedance analysis.
Only the two measures of abdominal obesity were associated with an increase in risk for men for late AMD (WHR (scaled per 0.1): Odds Ratio 1.72, 95% Confidence Interval: 1.1-2.7, P= 0.018, WC (per 10cm): OR 1.4, CI 1.06 - 1.86, P=0.017) but no associations were observed with early AMD. For women, an increase in all adiposity measures was observed to be moderately protective for early AMD, whereas none of the adiposity measures were associated with late AMD. Overall for both sexes there was a weak negative association with higher BMI (>30) and early AMD (OR 0.83 CI: 0.71-0.97 P=0.017).
Contrary to other studies, BMI was not associated with an increase in AMD risk. Our results indicate abdominal obesity is of greater importance than BMI, FM or FP in the risk of late AMD for men. The apparent weak protective effect from BMI >30, and for all adiposity measures for women, may reflect survival bias, as obesity is strongly associated with increased mortality. This bias may attenuate estimates of association across all AMD studies.
This PDF is available to Subscribers Only