Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration: The atherosclerosis risk in communities study

Amy E. Millen; Jing Nie; Julie A. Mares; Pamela L. Lutsey; Michael J. Lamonte; Stacy M. Meuer; Michelle W. Sahli; Christopher A. Andrews; Barbara E.K. Klein; Ronald Klein

doi:10.1167/iovs.18-25945

Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration: The atherosclerosis risk in communities study

Amy E. Millen, Jing Nie, Julie A. Mares, Pamela L. Lutsey, Michael J. Lamonte, Stacy M. Meuer, Michelle W. Sahli, Christopher A. Andrews, Barbara E.K. Klein, Ronald Klein

Epidemiology

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

PURPOSE. To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentrations at visit 2 (1990–1992) and the 18-year incidence of age-related macular degeneration (AMD) between visit 3 (1993–1995) and visit 5 (2011–2013). METHODS. This prospective analysis was conducted in a subset of participants (n = 1225) from the Atherosclerosis Risk in Communities Study. We evaluated the incidence of any, early, and late AMD from visit 3 to 5. The 25(OH)D concentrations were assessed in 2012–2013 by using stored serum from visit 2. Retinal fundus photographs taken at both visits were graded side by side to determine the incidence of AMD. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for incident AMD outcomes during 18 years of follow-up (1993–1995 to 2011–2013) by tertile of 25(OH)D adjusted for age, race, and smoking status. P for linear trend was estimated by using continuous 25(OH)D concentrations. Sensitivity analyses applied inverse probability weights to account for selection to have eye photographs, death, and loss to follow-up. RESULTS. There was a decreased odds of any incident AMD (n = 139) and large, soft drusen (n = 80) in 25(OH)D tertile 3 versus 1, with OR (95% CI) = 0.57 (0.36–0.90), P trend = 0.11 and with 0.52 (0.28–0.93), P trend = 0.18, respectively. Applying sampling weights attenuated these results to 0.66 (0.38–1.16), P trend = 0.32 (any incident AMD) and 0.54 (0.27–1.09), P trend = 0.36 (large, soft drusen), respectively, suggesting these associations may be biased by loss to follow-up and sampling for retinal photographs at visit 5. No statistically significant results were observed with pigmentary abnormalities (n = 46) or incident late AMD (n = 26). CONCLUSIONS. High 25(OH)D concentrations, approximately >70 nM, may be associated with decreased odds of incident early AMD.

Original language	English (US)
Pages (from-to)	1362-1371
Number of pages	10
Journal	Investigative Ophthalmology and Visual Science
Volume	60
Issue number	5
DOIs	https://doi.org/10.1167/iovs.18-25945
State	Published - Apr 2019

Bibliographical note

Funding Information:
The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA).

Funding Information:
This work was previously presented as a poster at the Experimental Biology Annual Meeting, San Diego, California, United States, April 2–6, 2016. The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA). Supported by the NIH National Institute on Aging Grant No. R01 AG041776, NIH National Heart, Lung, and Blood Institute (NHLBI) Grant No. R01 HL103706, and the NIH Office of Dietary Supplements Grant No. R01 HL103706-S1 and an unrestricted grant from Research to Prevent Blindness. The Atherosclerosis Risk in Communities Study has been funded in whole or in part with federal funds from the NHLBI contracts (contract Nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I), R01HL087641, R01HL086694; National Human Genome Research Institute contract U01HG004402; and NIH contract HHSN268200625226C. Infrastructure was partly supported by Grant Number UL1RR025005, a component of the National Institutes of Health and NIH Roadmap for Medical Research. Neurocognitive data are collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, National Institute of Neurological Disorders and Stroke [NINDS], National Institute on Aging [NIA], National Institute on Deafness and Other Communication Disorders [NIDCD]), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI.

Publisher Copyright:
© 2019 The Authors.

Keywords

25-hydroxyvitamin D
Cohort studies
Epidemiology
Macular degeneration
Retinal diseases
Vitamin D

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Millen, A. E., Nie, J., Mares, J. A., Lutsey, P. L., Lamonte, M. J., Meuer, S. M., Sahli, M. W., Andrews, C. A., Klein, B. E. K., & Klein, R. (2019). Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration: The atherosclerosis risk in communities study. Investigative Ophthalmology and Visual Science, 60(5), 1362-1371. https://doi.org/10.1167/iovs.18-25945

Millen, AE, Nie, J, Mares, JA, Lutsey, PL, Lamonte, MJ, Meuer, SM, Sahli, MW, Andrews, CA, Klein, BEK & Klein, R 2019, 'Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration: The atherosclerosis risk in communities study', Investigative Ophthalmology and Visual Science, vol. 60, no. 5, pp. 1362-1371. https://doi.org/10.1167/iovs.18-25945

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abstract = "PURPOSE. To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentrations at visit 2 (1990–1992) and the 18-year incidence of age-related macular degeneration (AMD) between visit 3 (1993–1995) and visit 5 (2011–2013). METHODS. This prospective analysis was conducted in a subset of participants (n = 1225) from the Atherosclerosis Risk in Communities Study. We evaluated the incidence of any, early, and late AMD from visit 3 to 5. The 25(OH)D concentrations were assessed in 2012–2013 by using stored serum from visit 2. Retinal fundus photographs taken at both visits were graded side by side to determine the incidence of AMD. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for incident AMD outcomes during 18 years of follow-up (1993–1995 to 2011–2013) by tertile of 25(OH)D adjusted for age, race, and smoking status. P for linear trend was estimated by using continuous 25(OH)D concentrations. Sensitivity analyses applied inverse probability weights to account for selection to have eye photographs, death, and loss to follow-up. RESULTS. There was a decreased odds of any incident AMD (n = 139) and large, soft drusen (n = 80) in 25(OH)D tertile 3 versus 1, with OR (95% CI) = 0.57 (0.36–0.90), P trend = 0.11 and with 0.52 (0.28–0.93), P trend = 0.18, respectively. Applying sampling weights attenuated these results to 0.66 (0.38–1.16), P trend = 0.32 (any incident AMD) and 0.54 (0.27–1.09), P trend = 0.36 (large, soft drusen), respectively, suggesting these associations may be biased by loss to follow-up and sampling for retinal photographs at visit 5. No statistically significant results were observed with pigmentary abnormalities (n = 46) or incident late AMD (n = 26). CONCLUSIONS. High 25(OH)D concentrations, approximately >70 nM, may be associated with decreased odds of incident early AMD.",

keywords = "25-hydroxyvitamin D, Cohort studies, Epidemiology, Macular degeneration, Retinal diseases, Vitamin D",

author = "Millen, {Amy E.} and Jing Nie and Mares, {Julie A.} and Lutsey, {Pamela L.} and Lamonte, {Michael J.} and Meuer, {Stacy M.} and Sahli, {Michelle W.} and Andrews, {Christopher A.} and Klein, {Barbara E.K.} and Ronald Klein",

note = "Funding Information: The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA). Funding Information: This work was previously presented as a poster at the Experimental Biology Annual Meeting, San Diego, California, United States, April 2–6, 2016. The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA). Supported by the NIH National Institute on Aging Grant No. R01 AG041776, NIH National Heart, Lung, and Blood Institute (NHLBI) Grant No. R01 HL103706, and the NIH Office of Dietary Supplements Grant No. R01 HL103706-S1 and an unrestricted grant from Research to Prevent Blindness. The Atherosclerosis Risk in Communities Study has been funded in whole or in part with federal funds from the NHLBI contracts (contract Nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I), R01HL087641, R01HL086694; National Human Genome Research Institute contract U01HG004402; and NIH contract HHSN268200625226C. Infrastructure was partly supported by Grant Number UL1RR025005, a component of the National Institutes of Health and NIH Roadmap for Medical Research. Neurocognitive data are collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, National Institute of Neurological Disorders and Stroke [NINDS], National Institute on Aging [NIA], National Institute on Deafness and Other Communication Disorders [NIDCD]), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI. Publisher Copyright: {\textcopyright} 2019 The Authors.",

year = "2019",

month = apr,

doi = "10.1167/iovs.18-25945",

language = "English (US)",

volume = "60",

pages = "1362--1371",

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TY - JOUR

T1 - Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration

T2 - The atherosclerosis risk in communities study

AU - Millen, Amy E.

AU - Nie, Jing

AU - Mares, Julie A.

AU - Lutsey, Pamela L.

AU - Lamonte, Michael J.

AU - Meuer, Stacy M.

AU - Sahli, Michelle W.

AU - Andrews, Christopher A.

AU - Klein, Barbara E.K.

AU - Klein, Ronald

N1 - Funding Information: The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA). Funding Information: This work was previously presented as a poster at the Experimental Biology Annual Meeting, San Diego, California, United States, April 2–6, 2016. The authors thank the staff and participants of the ARIC Study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005, a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research (Bethesda, MD, USA). Supported by the NIH National Institute on Aging Grant No. R01 AG041776, NIH National Heart, Lung, and Blood Institute (NHLBI) Grant No. R01 HL103706, and the NIH Office of Dietary Supplements Grant No. R01 HL103706-S1 and an unrestricted grant from Research to Prevent Blindness. The Atherosclerosis Risk in Communities Study has been funded in whole or in part with federal funds from the NHLBI contracts (contract Nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I), R01HL087641, R01HL086694; National Human Genome Research Institute contract U01HG004402; and NIH contract HHSN268200625226C. Infrastructure was partly supported by Grant Number UL1RR025005, a component of the National Institutes of Health and NIH Roadmap for Medical Research. Neurocognitive data are collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, National Institute of Neurological Disorders and Stroke [NINDS], National Institute on Aging [NIA], National Institute on Deafness and Other Communication Disorders [NIDCD]), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI. Publisher Copyright: © 2019 The Authors.

PY - 2019/4

Y1 - 2019/4

N2 - PURPOSE. To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentrations at visit 2 (1990–1992) and the 18-year incidence of age-related macular degeneration (AMD) between visit 3 (1993–1995) and visit 5 (2011–2013). METHODS. This prospective analysis was conducted in a subset of participants (n = 1225) from the Atherosclerosis Risk in Communities Study. We evaluated the incidence of any, early, and late AMD from visit 3 to 5. The 25(OH)D concentrations were assessed in 2012–2013 by using stored serum from visit 2. Retinal fundus photographs taken at both visits were graded side by side to determine the incidence of AMD. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for incident AMD outcomes during 18 years of follow-up (1993–1995 to 2011–2013) by tertile of 25(OH)D adjusted for age, race, and smoking status. P for linear trend was estimated by using continuous 25(OH)D concentrations. Sensitivity analyses applied inverse probability weights to account for selection to have eye photographs, death, and loss to follow-up. RESULTS. There was a decreased odds of any incident AMD (n = 139) and large, soft drusen (n = 80) in 25(OH)D tertile 3 versus 1, with OR (95% CI) = 0.57 (0.36–0.90), P trend = 0.11 and with 0.52 (0.28–0.93), P trend = 0.18, respectively. Applying sampling weights attenuated these results to 0.66 (0.38–1.16), P trend = 0.32 (any incident AMD) and 0.54 (0.27–1.09), P trend = 0.36 (large, soft drusen), respectively, suggesting these associations may be biased by loss to follow-up and sampling for retinal photographs at visit 5. No statistically significant results were observed with pigmentary abnormalities (n = 46) or incident late AMD (n = 26). CONCLUSIONS. High 25(OH)D concentrations, approximately >70 nM, may be associated with decreased odds of incident early AMD.

AB - PURPOSE. To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentrations at visit 2 (1990–1992) and the 18-year incidence of age-related macular degeneration (AMD) between visit 3 (1993–1995) and visit 5 (2011–2013). METHODS. This prospective analysis was conducted in a subset of participants (n = 1225) from the Atherosclerosis Risk in Communities Study. We evaluated the incidence of any, early, and late AMD from visit 3 to 5. The 25(OH)D concentrations were assessed in 2012–2013 by using stored serum from visit 2. Retinal fundus photographs taken at both visits were graded side by side to determine the incidence of AMD. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for incident AMD outcomes during 18 years of follow-up (1993–1995 to 2011–2013) by tertile of 25(OH)D adjusted for age, race, and smoking status. P for linear trend was estimated by using continuous 25(OH)D concentrations. Sensitivity analyses applied inverse probability weights to account for selection to have eye photographs, death, and loss to follow-up. RESULTS. There was a decreased odds of any incident AMD (n = 139) and large, soft drusen (n = 80) in 25(OH)D tertile 3 versus 1, with OR (95% CI) = 0.57 (0.36–0.90), P trend = 0.11 and with 0.52 (0.28–0.93), P trend = 0.18, respectively. Applying sampling weights attenuated these results to 0.66 (0.38–1.16), P trend = 0.32 (any incident AMD) and 0.54 (0.27–1.09), P trend = 0.36 (large, soft drusen), respectively, suggesting these associations may be biased by loss to follow-up and sampling for retinal photographs at visit 5. No statistically significant results were observed with pigmentary abnormalities (n = 46) or incident late AMD (n = 26). CONCLUSIONS. High 25(OH)D concentrations, approximately >70 nM, may be associated with decreased odds of incident early AMD.

KW - 25-hydroxyvitamin D

KW - Cohort studies

KW - Epidemiology

KW - Macular degeneration

KW - Retinal diseases

KW - Vitamin D

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Serum 25-hydroxyvitamin D concentrations and incidence of age-related macular degeneration: The atherosclerosis risk in communities study

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