High-sensitivity C-reactive protein, other markers of inflammation, and the incidence of macular degeneration in women.
OBJECTIVE
To investigate whether high-sensitivity C-reactive protein (hsCRP) and other biomarkers of inflammation predict age-related macular degeneration (AMD).


METHODS
We measured hsCRP, soluble intercellular adhesion molecule-1 (sICAM-1), and fibrinogen levels in baseline plasma samples from 27 687 participants with a mean age of 54.6 years and initially free of AMD in the Women's Health Study. We prospectively ascertained 150 cases of AMD with vision loss of 20/30 or worse in the affected eye by self-report confirmed with review of medical records during 275 852 person-years of follow-up (mean = 10 years) and used proportional hazards models to examine the relationship between these biomarkers and AMD.


RESULTS
After adjustment for multiple risk factors, the hazard ratio (HR) (95% confidence interval [CI]) of AMD, contrasting the highest vs lowest quintile of hsCRP, was 3.09 (1.39-6.88) (P trend = .02). In similar models, the HR (95% CI) for sICAM-1 was 1.87 (0.97-3.58) (P trend = .07). The relationship between fibrinogen and AMD was J-shaped, with an HR (95% CI) of 2.01 (1.07-3.75) for women in the highest fifth vs second fifth.


CONCLUSIONS
Elevated circulating levels of hsCRP, sICAM-1, and fibrinogen precede the development of visually significant AMD in women, providing further support for the hypothesis that inflammation may play a role in AMD.
Schaumberg
Debra A
DA
Division of Preventive Medicine, 900 Commonwealth Ave E, Boston, MA 02215, USA. dschaumberg@rics.bwh.harvard.edu
Christen
William G
WG
Buring
Julie E
JE
Glynn
Robert J
RJ
Rifai
Nader
N
Ridker
Paul M
PM
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008268:Macular Degeneration / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein