PURPOSE To examine the relationship between serum oxidized low-density lipoprotein (ox-LDL) cholesterol and the incidence of age-related macular degeneration (AMD) over a 25-year period in a sample of persons from the population-based Beaver Dam Eye Study (BDES). DESIGN Observational prospective cohort study. PARTICIPANTS A total of 4972 people from the BDES (aged 43-84 years and living in Beaver Dam, Wisconsin in 1988) seen during at least 1 of 6 examination phases at approximately 5-year intervals between 1988 and 2016. METHODS A 50% random sample of participants (N = 2468) was selected for ox-LDL measurements. Stored frozen specimens from every examination phase were processed using an enzyme-linked immunosorbent assay from a single batch. All available intervals were included for a person, resulting in 6586 person-visits. MAIN OUTCOME MEASURES Age-related macular degeneration was assessed using the Wisconsin Age-related Maculopathy Grading System, and severity was defined using a 5-step severity scale. The severity of the worse eye at each examination was used for analyses. A multi-state Markov (MSM) model was fit to simultaneously assess the ox-LDL relationship to all AMD transitions, including incidence of any AMD, incidence of late AMD, and worsening and improvement of AMD over the 25 years of the study. RESULTS The mean (standard deviation) level of ox-LDL was 75.3 (23.1) U/L at the baseline examination. When adjusting for age, sex, ARMS2 and CFH risk alleles, and examination phase, the ox-LDL at the beginning of a period was not statistically significantly associated with the incidence of any AMD (hazard ratio per 10 U/L ox-LDL was 1.03, 95% confidence interval 0.98,1.09). Furthermore, ox-LDL was not associated with worsening anywhere along the AMD severity scale, nor with incidence of late AMD. The lack of relationships of ox-LDL to the incidence of any AMD or worsening of AMD remained after adjustment for history of statin use, smoking status, body mass index, and history of cardiovascular disease (data not shown). CONCLUSIONS Our findings do not provide evidence for statistically significant relationships between ox-LDL and AMD disease development or worsening of AMD.

中文翻译：

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氧化的低密度脂蛋白与年龄相关性黄斑变性的发生率。

目的在以人群为基础的海狸水坝眼研究中，从25岁的人群中检测血清氧化型低密度脂蛋白（ox-LDL）胆固醇与年龄相关性黄斑变性（AMD）发生率之间的关系。 （BDES）。设计观察性前瞻性队列研究。参与者在1988年至2016年之间的6个检查阶段中的至少1个阶段中，至少有6个检查阶段中有来自BDES的4972人（年龄在43-84岁，1988年居住在威斯康星州的海狸水坝）。方法50％随机选择参与者样本（N = 2468）进行ox-LDL测量。使用单批酶联免疫吸附测定法处理每个检查阶段存储的冷冻标本。包括一个人的所有可用时间间隔，导致6586人次访问。主要观察指标：使用威斯康星州年龄相关性黄斑病变分级系统评估年龄相关性黄斑变性，并使用5步严重度量表定义严重性。在每次检查中，对较差眼的严重程度进行分析。在研究的25年中，多状态马尔可夫（MSM）模型适合同时评估ox-LDL与所有AMD过渡的关系，包括任何AMD的发生率，晚期AMD的发生率以及AMD的恶化和改善。结果在基线检查时，ox-LDL的平均（标准差）水平为75.3（23.1）U / L。在调整年龄，性别，ARMS2和CFH风险等位基因以及检查阶段时，开始时的ox-LDL与任何AMD的发生率在统计学上均无显着相关性（每10 U / L ox-LDL的危险比为1.03，95％置信区间0.98、1.09）。此外，ox-LDL与AMD严重程度范围内的任何地方恶化都没有关联，也与晚期AMD的发生率无关。调整他汀类药物使用史，吸烟状况，体重指数和心血管疾病史后，ox-LDL与任何AMD发生率或AMD恶化之间的关系仍然不存在（数据未显示）。结论我们的发现并未为ox-LDL与AMD疾病发展或AMD恶化之间的统计学显着关系提供证据。和心血管疾病的病史（数据未显示）。结论我们的发现并未为ox-LDL与AMD疾病发展或AMD恶化之间的统计学显着关系提供证据。和心血管疾病的病史（数据未显示）。结论我们的发现并未为ox-LDL与AMD疾病发展或AMD恶化之间的统计学显着关系提供证据。