Abstract
Abstract: :
Purpose:To examine the association of systemic markers of inflammation and endothelial dysfunction with age related maculopathy (ARM). Methods: (1) Nested case–control analysis of prevalent ARM and (2) prospective analyses of incident ARM in a random sample of a population based cohort. Participants included in the nested case–control study were 188 cases with moderate to advanced ARM and 195 controls matched for age, gender, and current smoking status at a baseline examination from 1988 to 1990, and living in Beaver Dam, Wisconsin. Included in the prospective analyses as a random sample of 321 persons were those who participated in a 5 year and/or 10 year follow up. Standardized protocols for blood collection, measurement of markers, administration of a questionnaire, and gradings of stereoscopic color fundus photography to determine ARM were used. Standard univariate and multivariate analyses were performed. Results: In the nested case–control analysis, there were no associations (per quartile increase Odds ratios, (95% CI); and p–value) of serum high sensitivity C–reactive protein (0.95 (0.79,1.14); 0.58), serum amyloid A (1.11 (0.92,1.33), 0.28), white blood cell count (0.97 (0.80,1.17); 0.74) interleukin–6 (0.97 (0.80,1.17;0.74), tumor necrosis factor–α (1.05 (0.86,1.29, 0.61), intracellular adhesion molecule–1 (0.98 (0.81,1.18); 0.83), E–selectin (0.86 (0.72,1.03); 0.10), serum folate (0.94 (0.78,1.12); 0.48), and a positive test for Chlamydia pneumoniae antigen (0.90 (0.60,1.36); 0.61) with ARM. In the prospective analysis, there were no associations of these factors with the incidence or progression of ARM. There was lower power to detect associations with late ARM. Conclusions: Contrary to other reports, we cannot confirm a relationship of markers of inflammation and endothelial dysfunction with ARM. However, our findings do not rule out the possibility of a relationship of these systemic inflammatory factors to the incidence of late ARM. Larger prospective studies examining these relationships may provide further clues to address this hypothesis.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment • inflammation