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Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers.
Arch Ophthalmol 2005; 123(6):774-82AO

Abstract

BACKGROUND

Age-related macular degeneration (AMD) and cardiovascular disease share common risk factors. Inflammatory biomarkers, including C-reactive protein (CRP), interleukin 6 (IL-6), soluble tumor necrosis factor alpha receptor 2, soluble intercellular and vascular adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1), and lipid biomarkers, including lipoprotein(a) and apolipoprotein B, have all been associated with cardiovascular disease. We previously found an association between AMD and CRP in a cross-sectional analysis, but the prospective relationships between AMD, CRP, and the other cardiovascular disease markers are unknown.

OBJECTIVE

To test the hypothesis that baseline cardiovascular disease biomarkers are associated with subsequent increased risk for progression of AMD.

DESIGN, SETTING, AND PARTICIPANTS

This prospective cohort study involved 251 participants aged 60 years and older who had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least one eye at baseline. The AMD status was assessed by standardized grading of fundus photographs, and stored fasting blood specimens obtained at baseline were analyzed for levels of the various biomarkers. The average follow-up time was 4.6 years.

MAIN OUTCOME MEASURES

Relationship between biomarkers and incidence rates of progression of AMD.

RESULTS

Comparing the highest quartile with the lowest quartile, CRP was associated with progression of AMD, with a multivariate adjusted relative risk (RR) of 2.10 (95% confidence interval [CI], 1.06-4.18; P for trend, .046) controlling for body mass index, smoking, and other cardiovascular variables and a multivariate adjusted RR of 2.02 (95% CI, 1.00-4.04; P for trend, .06) controlling additionally for antioxidant nutrients. Interleukin 6 was also related to progression of AMD, with a multivariate adjusted RR of 1.81 (95% CI, 0.97-3.36; P for trend, .03). Comparing the highest quartile with the lowest quartile, the effect estimates for vascular cell adhesion molecule 1 (multivariate adjusted RR, 1.94) and apolipoprotein B (adjusted RR, 1.39) were in the positive direction but were not statistically significant (P for trend, .08 and .24, respectively). The CRP and IL-6 levels were both significantly related to higher body mass index and current smoking.

CONCLUSIONS

Higher levels of the systemic inflammatory markers CRP and IL-6 are independently associated with progression of AMD.

Authors+Show Affiliations

Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15955978

Citation

Seddon, Johanna M., et al. "Progression of Age-related Macular Degeneration: Prospective Assessment of C-reactive Protein, Interleukin 6, and Other Cardiovascular Biomarkers." Archives of Ophthalmology (Chicago, Ill. : 1960), vol. 123, no. 6, 2005, pp. 774-82.
Seddon JM, George S, Rosner B, et al. Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers. Arch Ophthalmol. 2005;123(6):774-82.
Seddon, J. M., George, S., Rosner, B., & Rifai, N. (2005). Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers. Archives of Ophthalmology (Chicago, Ill. : 1960), 123(6), pp. 774-82.
Seddon JM, et al. Progression of Age-related Macular Degeneration: Prospective Assessment of C-reactive Protein, Interleukin 6, and Other Cardiovascular Biomarkers. Arch Ophthalmol. 2005;123(6):774-82. PubMed PMID: 15955978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers. AU - Seddon,Johanna M, AU - George,Sarah, AU - Rosner,Bernard, AU - Rifai,Nader, PY - 2005/6/16/pubmed PY - 2005/6/24/medline PY - 2005/6/16/entrez SP - 774 EP - 82 JF - Archives of ophthalmology (Chicago, Ill. : 1960) JO - Arch. Ophthalmol. VL - 123 IS - 6 N2 - BACKGROUND: Age-related macular degeneration (AMD) and cardiovascular disease share common risk factors. Inflammatory biomarkers, including C-reactive protein (CRP), interleukin 6 (IL-6), soluble tumor necrosis factor alpha receptor 2, soluble intercellular and vascular adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1), and lipid biomarkers, including lipoprotein(a) and apolipoprotein B, have all been associated with cardiovascular disease. We previously found an association between AMD and CRP in a cross-sectional analysis, but the prospective relationships between AMD, CRP, and the other cardiovascular disease markers are unknown. OBJECTIVE: To test the hypothesis that baseline cardiovascular disease biomarkers are associated with subsequent increased risk for progression of AMD. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study involved 251 participants aged 60 years and older who had some sign of nonexudative AMD and visual acuity of 20/200 or better in at least one eye at baseline. The AMD status was assessed by standardized grading of fundus photographs, and stored fasting blood specimens obtained at baseline were analyzed for levels of the various biomarkers. The average follow-up time was 4.6 years. MAIN OUTCOME MEASURES: Relationship between biomarkers and incidence rates of progression of AMD. RESULTS: Comparing the highest quartile with the lowest quartile, CRP was associated with progression of AMD, with a multivariate adjusted relative risk (RR) of 2.10 (95% confidence interval [CI], 1.06-4.18; P for trend, .046) controlling for body mass index, smoking, and other cardiovascular variables and a multivariate adjusted RR of 2.02 (95% CI, 1.00-4.04; P for trend, .06) controlling additionally for antioxidant nutrients. Interleukin 6 was also related to progression of AMD, with a multivariate adjusted RR of 1.81 (95% CI, 0.97-3.36; P for trend, .03). Comparing the highest quartile with the lowest quartile, the effect estimates for vascular cell adhesion molecule 1 (multivariate adjusted RR, 1.94) and apolipoprotein B (adjusted RR, 1.39) were in the positive direction but were not statistically significant (P for trend, .08 and .24, respectively). The CRP and IL-6 levels were both significantly related to higher body mass index and current smoking. CONCLUSIONS: Higher levels of the systemic inflammatory markers CRP and IL-6 are independently associated with progression of AMD. SN - 0003-9950 UR - https://www.unboundmedicine.com/medline/citation/15955978/Progression_of_age_related_macular_degeneration:_prospective_assessment_of_C_reactive_protein_interleukin_6_and_other_cardiovascular_biomarkers_ L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/archopht.123.6.774 DB - PRIME DP - Unbound Medicine ER -