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Serum Cholesterol, Cholesterol-lowering Medication and Incident Age-related Maculopathy. The Rotterdam Study
1de Jong P. T. V. M., 2van Leeuwen R., 3Vingerling J. R., 2Hofman A., 2Stricker B. H. C.,
1The Netherlands Ophthalmic Research Institute, Academic Medical Center (Amsterdam)
2Department of Epidemiology and Biostatistics, Erasmus MC (Rotterdam)
3Department of Ophthalmology, Erasmus MC (Rotterdam)
Purpose: To study the associations between serum cholesterol levels (SCLs) and the incidence of age-related maculopathy (iARM), as well as the allegedly lower risk of iARM in users of some SCL-lowering medications.
Methods: Fundus color transparencies gradable for presence of iARM were available of at least one eye of 3435 participants from the population-based Rotterdam Study. Mean age was 65.7 years and mean follow-up 6.5 (SD 0.4) years. At baseline and follow-up SCLs of total and HDL cholesterol were measured. Medication use was assessed by interview at baseline and afterwards by continuous registration of prescription data for each participant from the pharmacies in the vicinity. Cox' proportional hazards regression analysis was used for associations between SCLs and iARM both in a continuous as in a categorical way. The duration of SCL-lowering medication use also was studied with a time-dependant categorical variable in four groups: 0, 0-1, 1-23, 24 or more months.
Results: At baseline 2.8% of subjects was using lipid-lowering medication, at follow-up 14% had used them. iARM was present in 267 (7.3%) participants. There was no association between SCLs of total cholesterol or of a proxy for LDL cholesterol and iARM. SCLs for HDL cholesterol were associated with iARM as a continuous but not as a categorical variable. Use of SCL-lowering medication had no effect on iARM, either at baseline or (cumulative) exposure per subject.
Conclusions: If lipids play a role in the pathogenesis of ARM this is not reflected in the SCLs at baseline or in the effect of SCL-lowering medications.