Abstract | PURPOSE: Unhealthy lifestyles have been associated with increased odds for age-related macular degeneration (AMD). Whether this association is modified by genetic risk for AMD is unknown and was investigated. DESIGN: Interactions between healthy lifestyles AMD risk genotypes were studied in relation to the prevalence of AMD, assessed 6 years later. PARTICIPANTS: Women 50 to 79 years of age in the Carotenoids in Age-Related Eye Disease Study with exposure and AMD data (n=1663). METHODS: Healthy lifestyle scores (0-6 points) were assigned based on Healthy Eating Index scores, physical activity (metabolic equivalent of task hours/week), and smoking pack years assessed in 1994 and 1998. Genetic risk was based on Y402H in complement factor H (CFH) and A69S in age-related maculopathy susceptibility locus 2 (ARMS2). Additive and multiplicative interactions in odds ratios were assessed using the synergy index and a multiplicative interaction term, respectively. MAIN OUTCOME MEASURES: AMD presence and severity were assessed from grading of stereoscopic fundus photographs taken in 2001-2004. AMD was present in 337 women, 91% of whom had early AMD. RESULTS: The odds of AMD were 3.3 times greater (95% confidence interval [CI], 1.8-6.1) in women with both low healthy lifestyle score (0-2) and high-risk CFH genotype (CC), relative to those who had low genetic risk (TT) and high healthy lifestyle scores (4-6). There were no significant additive (synergy index [SI], 1.08; 95% CI, 0.70-1.67) or multiplicative (Pinteraction=0.94) interactions in the full sample. However, when limiting the sample to women with stable diets before AMD assessment (n=728) the odds for AMD associated with low healthy lifestyle scores and high-risk CFH genotype were strengthened (odds ratio, 4.6; 95% CI, 1.8-11.6) and the synergy index was significant (SI, 1.34; 95% CI, 1.05-1.70). Adjusting for dietary lutein and zeaxanthin attenuated, and therefore partially explained, the joint association. There were no significant additive or multiplicative interactions for ARMS2 and lifestyle score. CONCLUSIONS: Having unhealthy lifestyles and 2 CFH risk alleles increased AMD risk (primarily in the early stages), in an or additive or greater (synergistic) manner. However, unhealthy lifestyles increased AMD risk regardless of AMD risk genotype.
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Authors | Kristin J Meyers, Zhe Liu, Amy E Millen, Sudha K Iyengar, Barbara A Blodi, Elizabeth Johnson, D Max Snodderly, Michael L Klein, Karen M Gehrs, Lesley Tinker, Gloria E Sarto, Jennifer Robinson, Robert B Wallace, Julie A Mares |
Journal | Ophthalmology
(Ophthalmology)
Vol. 122
Issue 11
Pg. 2286-94
(Nov 2015)
ISSN: 1549-4713 [Electronic] United States |
PMID | 26354764
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- ARMS2 protein, human
- CFH protein, human
- Proteins
- Zeaxanthins
- Complement Factor H
- Lutein
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Topics |
- Aged
- Alleles
- Complement Factor H
(genetics)
- Diet
- Feeding Behavior
- Female
- Genotyping Techniques
- Health Status Indicators
- Humans
- Life Style
- Lutein
(blood)
- Macular Degeneration
(blood, genetics, prevention & control)
- Middle Aged
- Odds Ratio
- Polymorphism, Single Nucleotide
- Prevalence
- Proteins
(genetics)
- Risk Factors
- Women's Health
- Zeaxanthins
(blood)
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