Relationships of body fat level and distribution to age–related maculopathy in the Carotenoids in Age–Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative

Abstract

Abstract: : Purpose: We evaluated relationships of body fat level and distribution in a preliminary sample of CAREDS participants to the prevalence of age–related maculopathy (ARM). Methods: At CAREDS baseline (2001–03), ARM was assessed by stereoscopic fundus photographs in women age 50 and older (N=1512), who had low and high dietary lutein plus zeaxanthin intakes at the Women’s Health Initiative (WHI) baseline (1994–97). The presence of five ARM lesions in the worse eye was used for analyses. Body mass index(BMI) (kg/m²) and waist–hip ratio (WHR) at WHI baseline were used to determine body fat level and distribution, respectively. Odds ratios (OR) were computed adjusting for other potential ARM risk factors (age, smoking, family history of ARM, hormone use and high dose antioxidant supplement use > 10 years). In women ages 53–86 years, 204 had large drusen, 136 had pigmentary abnormalities, 309 had overall early ARM, 158 had retinal pigment epithelial (RPE) abnormalities and 40 had late ARM. Results: High BMI (≥ 35) compared with normal BMI (22.5 to 25) was associated with a higher prevalence of pigmentary abnormalities, adjusted OR 2.2 [95% Confidence Interval (CI) 1.1–4.3]. ORs for large drusen, overall early ARM, and RPE abnormalities were in the same direction, but not significant. WHR in the highest compared to lowest quartile was associated with RPE abnormalities, adjusted OR 1.7 [95%CI 1.0–2.8]. Associations for pigmentary abnormalities and late ARM are in the same direction, but not significant. Associations using the final population sample (N∼2000) are underway and will be reported. Conclusions:We found high BMI compared to normal BMI to be related to pigmentary abnormalities and high WHR compared to low WHR to be related to RPE abnormalities. BMI may be associated with early ARM lesions whereas WHR may be more associated with late ARM lesions.

Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment