Document Detail


C-reactive protein and the incidence of macular degeneration: pooled analysis of 5 cohorts.
MedLine Citation:
PMID:  23392454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
IMPORTANCE: This study adds to the evidence that elevated levels of high-sensitivity C-reactive protein (hsCRP) predict future risk of age-related macular degeneration (AMD). This information might shed light on underlying pathological mechanisms involving inflammation and could be of clinical utility in the identification of persons at high risk of AMD who may benefit from increased adherence to lifestyle recommendations, eye examination schedules, and therapeutic protocols.
OBJECTIVE: To investigate the relationship between hsCRP and future risk of AMD in US men and women.
DESIGN: Pooled analysis of prospective nested case-control data from the Women's Health Study and 4 other cohorts, the Physicians' Health Study, Women's Antioxidant and Folic Acid Cardiovascular Study, Nurses' Health Study, and Health Professionals Follow-up Study.
SETTING: A prospective nested case-control study within 5 large cohorts.
PARTICIPANTS: Patients were initially free of AMD. We prospectively identified 647 incident cases of AMD and selected age- and sex-matched controls for each AMD case (2 controls for each case with dry AMD or 3 controls for each case of neovascular AMD). MAIN OUTCOME MEASURES We measured hsCRP in baseline blood samples. We used conditional logistic regression models to examine the relationship between hsCRP and AMD and pooled findings using meta-analytic techniques.
RESULTS: After adjusting for cigarette smoking status, participants with high (>3 mg/L) compared with low (<1 mg/L) hsCRP levels had cohort-specific odds ratios (ORs) for incident AMD ranging from 0.94 (95% CI, 0.58-1.51) in the Physicians' Health Study to 2.59 (95% CI, 0.58-11.67) in the Women's Antioxidant and Folic Acid Cardiovascular Study. After testing for heterogeneity between studies (Q = 5.61; P = .23), we pooled findings across cohorts and observed a significantly increased risk of incident AMD for high vs low hsCRP levels (OR, 1.49; 95% CI, 1.06-2.08). Risk of neovascular AMD was also increased among those with high hsCRP levels (OR, 1.84; 95% CI, 1.14-2.98).
CONCLUSIONS AND RELEVANCE: Overall, these pooled findings from 5 prospective cohorts add further evidence that elevated levels of hsCRP predict greater future risk of AMD. This information might shed light on underlying mechanisms and could be of clinical utility in the identification of persons at high risk of AMD who may benefit from increased adherence to lifestyle recommendations, eye examination schedules, and therapeutic protocols.
Authors:
Vinod P Mitta; William G Christen; Robert J Glynn; Richard D Semba; Paul M Ridker; Eric B Rimm; Susan E Hankinson; Debra A Schaumberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JAMA ophthalmology     Volume:  131     ISSN:  2168-6173     ISO Abbreviation:  JAMA Ophthalmol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-12     Completed Date:  2013-06-05     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  101589539     Medline TA:  JAMA Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood*
C-Reactive Protein / metabolism*
Case-Control Studies
Cohort Studies
Female
Geographic Atrophy / blood,  epidemiology*
Humans
Incidence
Male
Meta-Analysis as Topic
Middle Aged
Odds Ratio
Prospective Studies
Questionnaires
Risk Factors
Wet Macular Degeneration / blood,  epidemiology*
Grant Support
ID/Acronym/Agency:
CA047988/CA/NCI NIH HHS; CA34944/CA/NCI NIH HHS; CA40360/CA/NCI NIH HHS; CA49449/CA/NCI NIH HHS; CA87969/CA/NCI NIH HHS; EY009611/EY/NEI NIH HHS; EY013834/EY/NEI NIH HHS; EY017362/EY/NEI NIH HHS; EY06633/EY/NEI NIH HHS; HL043851/HL/NHLBI NIH HHS; HL046959/HL/NHLBI NIH HHS; HL26490/HL/NHLBI NIH HHS; HL34595/HL/NHLBI NIH HHS; HL35464/HL/NHLBI NIH HHS; P01 CA087969/CA/NCI NIH HHS; R01 CA047988/CA/NCI NIH HHS; R01 EY006633/EY/NEI NIH HHS; R01 EY009611/EY/NEI NIH HHS; R01 EY013834/EY/NEI NIH HHS; R01 HL035464/HL/NHLBI NIH HHS; R01 HL043851/HL/NHLBI NIH HHS; U01 CA049449/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein
Comments/Corrections

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