Progression of Age-Related Macular Degeneration: Prospective Assessment of C-Reactive Protein, Interleukin 6, and Other Cardiovascular Biomarkers
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.
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The association of cardiovascular disease and its risk factors with AMD has not been consistently reproduced.
“The association of cardiovascular disease and its risk factors with AMD have not been consistently reproduced (26, 127, 136, 153).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [136]
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- Authors
- Seddon, J. M.
- Affiliations
- Massachusetts Eye and Ear Infirmary (US)
- Corresponding author
- Seddon, Johanna M.
- ORCID
- Seddon, Johanna M.
- Venue
- Archives of Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 2005-06-01
- Volume
- 123
- Issue
- 6
- Pages
- 774
- ISSN
- 0003-9950 (ISSN-L)
- OpenAlex
- W1983873751
- Semantic Scholar
- a58b894814cb6bcc6b48cc3cc5dbe75878dfcde2
- Cited by
- 354
- References
- 47
- Citations by year
- 2026: 2 · 2025: 15 · 2024: 11 · 2023: 10 · 2022: 8 · 2021: 16 · 2020: 13 · 2019: 14 · 2018: 17 · 2017: 21 · 2016: 20 · 2015: 23 · 2014: 22 · 2013: 16 · 2012: 24
- FWCI
- 21.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Eye Institute (EY013834, R01EY013982, EY013982, R01EY013834)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- age-related macular degeneration, disease progression, cardiovascular biomarkers, C-reactive protein, interleukin-6, VCAM-1, ICAM-1, apolipoprotein B, lipoprotein(a), inflammation, lipid biomarkers, dry age-related macular degeneration, older adults
- MeSH terms
- Aged, Aged, 80 and over, C-Reactive Protein, Cardiovascular Diseases, Female, Humans, Macular Degeneration, Male, Middle Aged, Prospective Studies, Risk Factors, Biomarkers, Interleukin-6, Lipoprotein(a), Disease Progression, Intercellular Adhesion Molecule-1, Vascular Cell Adhesion Molecule-1, Receptors, Tumor Necrosis Factor, Type II
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