Association of Smoking, Alcohol Consumption, Blood Pressure, Body Mass Index, and Glycemic Risk Factors With Age-Related Macular Degeneration

Abstract

IMPORTANCE Advanced age-related macular degeneration (AMD) is a leading cause of blindness in Western countries. Causal, modifiable risk factors need to be identified to develop preventive measures for advanced AMD.OBJECTIVE To assess whether smoking, alcohol consumption, blood pressure, body mass index, and glycemic traits are associated with increased risk of advanced AMD. DESIGN, SETTING, PARTICIPANTSThis study used 2-sample mendelian randomization. Genetic instruments composed of variants associated with risk factors at genome-wide significance (P < 5 × 10 −8 ) were obtained from published genome-wide association studies. Summary-level statistics for these instruments were obtained for advanced AMD from the International AMD Genomics Consortium 2016 data set, which consisted of 16 144 individuals with AMD and 17 832 control individuals. Data were analyzed from July 2020 to September 2021.EXPOSURES Smoking initiation, smoking cessation, lifetime smoking, age at smoking initiation, alcoholic drinks per week, body mass index, systolic and diastolic blood pressure, type 2 diabetes, glycated hemoglobin, fasting glucose, and fasting insulin. MAIN OUTCOMES AND MEASURESAdvanced AMD and its subtypes, geographic atrophy (GA), and neovascular AMD.RESULTS A 1-SD increase in logodds of genetically predicted smoking initiation was associated with higher risk of advanced AMD (odds ratio [OR], 1.26; 95% CI, 1.13-1.40; P < .001), while a 1-SD increase in logodds of genetically predicted smoking cessation (former vs current smoking) was associated with lower risk of advanced AMD (OR, 0.66; 95% CI, 0.50-0.87; P = .003). Genetically predicted increased lifetime smoking was associated with increased risk of advanced AMD (OR per 1-SD increase in lifetime smoking behavior, 1.32; 95% CI, 1.09-1.59; P = .004). Genetically predicted alcohol consumption was associated with higher risk of GA (OR per 1-SD increase of log-transformed alcoholic drinks per week, 2.70; 95% CI, 1.48-4.94; P = .001). There was insufficient evidence to suggest that genetically predicted blood pressure, body mass index, and glycemic traits were associated with advanced AMD. CONCLUSIONS AND RELEVANCEThis study provides genetic evidence that increased alcohol intake may be a causal risk factor for GA. As there are currently no known treatments for GA, this finding has important public health implications. These results also support previous observational studies associating smoking behavior with risk of advanced AMD, thus reinforcing existing public health messages regarding the risk of blindness associated with smoking.

Práticas Interprofissionais De Preceptores Vinculados a Uma Universidade Pública Da Região Norte

“…Qualidade de vida de hipertensos acompanhados em Unidade Básica de Saúde de Porto Velho -RO desenvolvimento da doença (KUAN et al, 2021;NAN et al, 2021). Tais fatores de risco associados ocasionam efeito cumulativo, constituindo o cenário para desfechos de saúde negativos e aumento da taxa de mortalidade por eventos cardiovasculares agudos.…”

Causal Associations of Obesity With Achilles Tendinopathy: A Two-Sample Mendelian Randomization Study

“…Genetic instruments for lipid traits, including LDL-C, TG, and HDL-C, were obtained from a GWAS dataset of 35 biomarkers from the UKB ( 24 , 25 ). IVs of type 2 diabetes were obtained from a meta-analysis of datasets from the DIAbetes Genetics Replication and Meta-analysis (DIAGRAM), Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, and UKB as previously reported ( 12 , 26 ). Genetically determined chronic kidney disease (CKD) was proxied using the SNPs from the dataset of the CKDGen Consortium ( 27 , 28 ).…”

“…Mendelian randomization (MR) can infer causality between exposure and disease outcomes by using genetic variants as instrumental variables ( 11 ). Genetic variants that are strongly associated with exposure should also be associated with outcome if causality exists between exposure and outcome ( 12 ). MR is based on the random assignment of genetic variation during meiosis, which makes MR studies less affected by residual confounding than conventional observational studies ( 13 ).…”

“…MR is based on the random assignment of genetic variation during meiosis, which makes MR studies less affected by residual confounding than conventional observational studies ( 13 ). Furthermore, MR studies are less subject to reverse causality because the genetic variants are fixed at birth and normally cannot be modulated by the outcomes ( 12 ).…”

Genetic Association Analysis of Anti-VEGF Treatment Response in Neovascular Age-Related Macular Degeneration

“…Age-related macular degeneration (AMD) is a multifactorial disease with late-onset affecting central vision of millions of people worldwide [ 1 ]. Disease risk is known to be conferred by environmental factors, such as smoking or ageing, as well as by genetic predisposition [ 2 , 3 ]. In its early stages, AMD often remains unnoticed by the patient, while progression to late-stage forms can lead to gradual or rapid vision loss.…”