title: Association between Blood Lead Levels and Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To investigate the association between blood lead levels and prevalence of age-related macular degeneration (AMD).
  
  
  METHODS
  A nationwide population-based cross-sectional study included 4,933 subjects aged over 40 years who participated in the 2008-2012 Korean National Health and Nutrition Examination Survey, and for whom fundus photographs were available. All participants underwent a standardized interview, evaluation of blood lead concentration, and a comprehensive ophthalmic examination. Digital fundus photographs (45°) were taken of both eyes under physiological mydriasis. All fundus photographs were graded using an international classification and grading system.
  
  
  RESULTS
  Mean blood lead levels were 3.15 μg/dL in men and 2.27 μg/dL in women (P < 0.001). After adjusting for potential confounders including age, gender, smoking status, total cholesterol levels, triglyceride levels, heart problems and strokes, the adjusted odds ratio (OR) in women for any AMD was 1.86 (95% Confidence Interval [CI], 1.03-3.36) and for early AMD was 1.92 (95% CI, 1.06-3.48), for those in the highest quintile of lead level compared with the lowest quintile. In men, however, blood lead level was not significantly associated with AMD.
  
  
  CONCLUSIONS
  Blood lead levels were higher in men, but were only associated with AMD in women. Increased levels of blood lead may be involved in the pathogenesis of AMD development in women.
authors.affiliation: Department of Ophthalmology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
authors.forename: Ho Sik
authors.initials: HS
authors.lastname: Hwang
authors.affiliation: Seoul St. Mary's Eye Hospital, Suwon, Korea.
authors.forename: Seung Bum
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
authors.forename: Donghyun
authors.initials: D
authors.lastname: Jee
mesh_terms: D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D008268:Macular Degeneration / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D017678:Sex Distribution
chemical_list: D007854:Lead