Serum carboxymethyllysine, an advanced glycation end product, and age-related macular degeneration: the Age, Gene/Environment Susceptibility-Reykjavik Study.
IMPORTANCE Advanced glycation end products have been implicated in the pathogenesis of age-related macular degeneration (AMD). OBJECTIVE To investigate the relationship between serum carboxymethyllysine (CML), a major circulating advanced glycation end product, and AMD in older adults. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of a population-based sample of 4907 older adults (aged ≥66 years) in the Age, Gene/Environment Susceptibility-Reykjavik Study in Iceland. EXPOSURES Serum CML and risk factors for AMD. MAIN OUTCOMES AND MEASURES Early or late AMD, assessed through fundus images taken through dilated pupils using a 45° digital camera and grading for drusen size, type, area, increased retinal pigment, retinal pigment epithelial depigmentation, neovascular lesions, and geographic atrophy using the modified Wisconsin Age-Related Maculopathy Grading System. RESULTS Of the 4907 participants, 1025 (20.9%) had early AMD and 276 (5.6%) had late AMD. Mean (SD) serum CML concentrations among adults with no AMD, early AMD, and late AMD (exudative AMD and pure geographic atrophy) were 618.8 (195.5), 634.2 (206.4), and 638.4 (192.0) ng/mL, respectively (to convert to micromoles per liter, multiply by 0.00489; P = .07). Log serum CML (per 1-SD increase) was not associated with any AMD (early and late AMD) (odds ratio = 0.97; 95% CI, 0.90-1.04; P = .44) or with late AMD (odds ratio = 0.94; 95% CI, 0.82-1.08; P = .36) in respective multivariable logistic regression models adjusting for age, sex, body mass index, smoking, and renal function. CONCLUSIONS AND RELEVANCE Higher serum CML concentration had no significant cross-sectional association with prevalent AMD in this large population-based cohort of older adults in Iceland.
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Richard D
RD
Semba
Division of Epidemiology and Clinical Research, National Eye Institute, Bethesda, Maryland.
Mary Frances
MF
Cotch
Icelandic Heart Association, Reykjavik, Iceland4Department of Medicine, University of Iceland, Reykjavik, Iceland.
Vilmundur
V
Gudnason
Icelandic Heart Association, Reykjavik, Iceland.
Gudny
G
Eiríksdottir
Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland.
Tamara B
TB
Harris
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Kai
K
Sun
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison.
Ronald
R
Klein
Department of Medicine, University of Iceland, Reykjavik, Iceland7Department of Ophthalmology, Landspitali University Hospital, Reykjavik, Iceland.
Fridbert
F
Jonasson
Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland.
Luigi
L
Ferrucci
Moran Center for Translational Medicine, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City.
Debra A
DA
Schaumberg
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D059647:Gene-Environment Interaction; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D016015:Logistic Models; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008268:Macular Degeneration / Q000097:blood* / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology
D017127:Glycation End Products, Advanced; C048496:N(6)-carboxymethyllysine; D008239:Lysine