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Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio.
Arch Ophthalmol 2003; 121(6):785-92AO

Abstract

BACKGROUND

Individuals with early or intermediate stages of age-related macular degeneration (AMD) make up a large and growing segment of our elderly population. To advise these high-risk patients regarding preventive measures, we evaluated anthropomorphic, behavioral, and medical factors associated with progression to the advanced stages of AMD associated with visual loss.

METHODS

The design was a prospective cohort study in a hospital-based retinal practice. The 261 participants were 60 years or older, with some sign of nonadvanced AMD and visual acuity of 20/200 or better in at least 1 eye. The average follow-up time was 4.6 years, and the total person-years of follow-up was 1198. Factors associated with rates of progression to advanced AMD were assessed by the Cox proportional hazards model.

OUTCOME MEASURES

Progression to geographic atrophy and neovascular disease.

RESULTS

Higher body mass index (calculated as weight in kilograms divided by the square of height in meters) increased the risk for progression to the advanced forms of AMD. Relative risk (RR) was 2.35 (95% confidence interval [CI], 1.27-4.34) for a body mass index of at least 30, and 2.32 (95% CI, 1.32-4.07) for a body mass index of 25 to 29, relative to the lowest category (<25) after controlling for other factors (P =.007 for trend). Higher waist circumference was associated with a 2-fold increased risk for progression (RR for the highest tertile compared with the lowest, 2.04; 95% CI, 1.12-3.72), with a significant trend for increasing risk with a greater waist circumference (P =.02). Higher waist-hip ratio also increased the risk for progression (RR, 1.84; 95% CI, 1.07-3.15) for the highest tertile compared with lowest (P =.02 for trend). More physical activity tended to be associated with a reduced rate of progression (25% reduction for 3 times per week vigorous activity vs none, P =.05 to P =.07). Relative risks for smoking ranged from 1.48 to 1.99, but were not statistically significant.

CONCLUSIONS

Results provide new information regarding modifiable factors for individuals with the early or intermediate stages of this disease. Overall and abdominal obesity increased the risk for progression to advanced AMD, and more physical activity tended to decrease risk. These preventive measures deserve additional research and greater emphasis.

Authors+Show Affiliations

Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114, USA. johanna_seddon@meei.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12796248

Citation

Seddon, Johanna M., et al. "Progression of Age-related Macular Degeneration: Association With Body Mass Index, Waist Circumference, and Waist-hip Ratio." Archives of Ophthalmology (Chicago, Ill. : 1960), vol. 121, no. 6, 2003, pp. 785-92.
Seddon JM, Cote J, Davis N, et al. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol. 2003;121(6):785-92.
Seddon, J. M., Cote, J., Davis, N., & Rosner, B. (2003). Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Archives of Ophthalmology (Chicago, Ill. : 1960), 121(6), pp. 785-92.
Seddon JM, et al. Progression of Age-related Macular Degeneration: Association With Body Mass Index, Waist Circumference, and Waist-hip Ratio. Arch Ophthalmol. 2003;121(6):785-92. PubMed PMID: 12796248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. AU - Seddon,Johanna M, AU - Cote,Jennifer, AU - Davis,Nancy, AU - Rosner,Bernard, PY - 2003/6/11/pubmed PY - 2003/6/20/medline PY - 2003/6/11/entrez SP - 785 EP - 92 JF - Archives of ophthalmology (Chicago, Ill. : 1960) JO - Arch. Ophthalmol. VL - 121 IS - 6 N2 - BACKGROUND: Individuals with early or intermediate stages of age-related macular degeneration (AMD) make up a large and growing segment of our elderly population. To advise these high-risk patients regarding preventive measures, we evaluated anthropomorphic, behavioral, and medical factors associated with progression to the advanced stages of AMD associated with visual loss. METHODS: The design was a prospective cohort study in a hospital-based retinal practice. The 261 participants were 60 years or older, with some sign of nonadvanced AMD and visual acuity of 20/200 or better in at least 1 eye. The average follow-up time was 4.6 years, and the total person-years of follow-up was 1198. Factors associated with rates of progression to advanced AMD were assessed by the Cox proportional hazards model. OUTCOME MEASURES: Progression to geographic atrophy and neovascular disease. RESULTS: Higher body mass index (calculated as weight in kilograms divided by the square of height in meters) increased the risk for progression to the advanced forms of AMD. Relative risk (RR) was 2.35 (95% confidence interval [CI], 1.27-4.34) for a body mass index of at least 30, and 2.32 (95% CI, 1.32-4.07) for a body mass index of 25 to 29, relative to the lowest category (<25) after controlling for other factors (P =.007 for trend). Higher waist circumference was associated with a 2-fold increased risk for progression (RR for the highest tertile compared with the lowest, 2.04; 95% CI, 1.12-3.72), with a significant trend for increasing risk with a greater waist circumference (P =.02). Higher waist-hip ratio also increased the risk for progression (RR, 1.84; 95% CI, 1.07-3.15) for the highest tertile compared with lowest (P =.02 for trend). More physical activity tended to be associated with a reduced rate of progression (25% reduction for 3 times per week vigorous activity vs none, P =.05 to P =.07). Relative risks for smoking ranged from 1.48 to 1.99, but were not statistically significant. CONCLUSIONS: Results provide new information regarding modifiable factors for individuals with the early or intermediate stages of this disease. Overall and abdominal obesity increased the risk for progression to advanced AMD, and more physical activity tended to decrease risk. These preventive measures deserve additional research and greater emphasis. SN - 0003-9950 UR - https://www.unboundmedicine.com/medline/citation/12796248/full_citation L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/vol/121/pg/785 DB - PRIME DP - Unbound Medicine ER -