Abstract
Purpose: :
To evaluate the correlation of early middle age total cholesterol level with age-related maculopathy (ARM) status evaluated 40 years later.
Methods: :
Blood samples were taken in 1968 from 113 finnish male executives to evaluate cardiovascular risk profiles.Repeat cholesterol analysis was done in 2003. AMR status was graded from fundus photographs taken in 2007. Patients with at least large drusen or extensive medium size drusen at least in one eye were graded as AMR subjects.The patients were genotyped for the ARM risk SNPs of the CFH, LOC387715 and C3 genes.
Results: :
Mean age of the subjects at the time of AMR grading was 79 years. 34 (30%) of the subjects had ARM. The mean cholesterol values in ARM and non-ARM subjects were 6.21 (SD=1.71) and 5.71 (1.25), p=0.75. When analyzed within genotype, the chlolesterol levels were significantly higher in ARM subjects with the CFH heterozygous risk genotype and in the LOC 387715 and C3 homozygous low-risk genotypes. In samples taken in 2003, no significant differences were observed in corresponding groups.
Conclusions: :
This cohort is homogenous in relation to gender and social class and the baseline samples are taken more than 20 years before the statin-era, allowing an efficient analysis of cholesterol as a risk factor for ARM. Elevated cholesterol levels seem to contribute to the pathogenesis of ARM when the genetic risk is low, but the effect may be obscured in subjects with a high genetic risk load. Early middle age cholesterol level appears to be more associated with later ARM than cholesterol levels in old age.
Keywords: age-related macular degeneration • lipids • drusen