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Body Mass Index and the Incidence of Visually Significant Age-Related
Maculopathy in Men
Background Reports have suggested relationships of body weight with age-related maculopathy (ARM), particularly its nonneovascular (dry) forms, but results
are inconsistent and prospective data are scarce.Objective To examine prospectively relationships of body mass index (BMI; calculated as weight in kilograms divided by the
square of height in meters) with visually significant dry and neovascular ARM during an average of 14.5 years of follow-up. Methods Incident ARM was assessed by
medical record confirmation of self-reported ARM among the 21 121 men participating in the Physicians' Health Study who (1) were followed up for at least 7 years, (2) were free of
visually significant ARM at baseline, and (3) had information on BMI and cigarette smoking. We used proportional hazards regression models to estimate rate ratios (RRs) and 95%
confidence intervals (CIs) for visually significant dry ARM (256 cases) and neovascular ARM (84 cases) within 4 categories of BMI: lean (<22.0), normal (22.0-24.9), overweight
(25.0-29.9), and obese (30.0). Results Adjusting for age, randomized aspirin and beta carotene assignments, and cigarette smoking, the incidence for visually significant dry
ARM was lowest in men with a normal BMI. Compared with these men, the RRs (95% CIs) were as follows: 1.43 (1.01-2.04) for lean, 1.24 (0.93-1.66) for overweight, and 2.15 (1.35-3.45)
for obese men. Although there was no significant relationship of BMI with the diagnosis of neovascular ARM, due to the small number of cases these analyses could not rule out an
important relationship. Conclusions Obesity is a risk factor for visually significant ARM in men, in particular for dry ARM. However, the relationship of BMI with dry ARM
appears to be J-shaped, and the leanest individuals also appear to be at increased risk. Arch Ophthalmol. 2001;119:1259-1265
Author/Article Information
From the Division of Preventive Medicine (Drs
Schaumberg, Christen, and Glynn) and Channing Laboratory (Dr Hankinson), Brigham and Women's Hospital, Harvard Medical School, and Departments of Epidemiology (Dr Hankinson) and
Biostatistics (Dr Glynn), Harvard School of Public Health, Boston, Mass.
Corresponding author: Debra A. Schaumberg, ScD, MPH, Division of Preventive Medicine, Brigham and
Women's Hospital, 900 Commonwealth Ave E, Boston, MA 02215 (e-mail: dschaumberg@rics.bwh.harvard.edu).
Accepted for publication February 12, 2001. |
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