title: Abdominal obesity and age-related macular degeneration.
abstract: Evidence for an association between age-related macular degeneration (AMD) and obesity is inconsistent. The authors examined associations between adiposity and AMD prevalence using 21,287 participants from the Melbourne Collaborative Cohort Study aged 40-69 years at baseline (1990-1994). For men, each increase of 0.1 in waist/hip ratio (~1 standard deviation) was associated with a 13% increase in the odds of early AMD (odds ratio = 1.13, 95% confidence interval: 1.01, 1.26; P = 0.03) and a 75% increase in the odds of late AMD (odds ratio = 1.75, 95% confidence interval: 1.11, 2.76; P = 0.02). No other adiposity measure was associated with early AMD for men. Smoking status modified the relation between waist/hip ratio and early AMD (P = 0.05), with no association for former smokers. For women, there were inverse associations with early AMD for all adiposity measures (odds ratios = 0.89-0.93; P = 0.002-0.02), but no associations were observed for late AMD. This study confirms abdominal obesity as an AMD risk factor for men despite a survivorship effect from competing risks in morbidity and mortality. The inverse associations for women may reflect weaker true positive associations with AMD that are insufficient to overcome the survivorship effect. New data are provided on complex interactions between environmental exposures and AMD risk.
authors.affiliation: Centre for Eye Research Australia, University of Melbourne/Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Victoria 3002, Australia. m.adams@pgrad.unimelb.edu.au
authors.forename: Madeleine K M
authors.initials: MK
authors.lastname: Adams
authors.forename: Julie A
authors.initials: JA
authors.lastname: Simpson
authors.forename: Khin Zaw
authors.initials: KZ
authors.lastname: Aung
authors.forename: Galina A
authors.initials: GA
authors.lastname: Makeyeva
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.forename: John
authors.initials: J
authors.lastname: Hopper
authors.forename: Robyn H
authors.initials: RH
authors.lastname: Guymer
authors.forename: Paul N
authors.initials: PN
authors.lastname: Baird
authors.forename: Liubov D
authors.initials: LD
authors.lastname: Robman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia / Q000453:epidemiology; D050218:Body Fat Distribution; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects