Sang Jun Park1, Ju Hyun Lee2, Se Joon Woo1, Se Woong Kang3, Kyu Hyung Park4. 1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 3. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: jiani4@snu.ac.kr.
Abstract
OBJECTIVE: To investigate the association between age-related macular degeneration (AMD) and 5 heavy metallic elements (lead, mercury, cadmium, manganese, and zinc). DESIGN: A cross-sectional study using a complex, stratified, multistage, probability cluster survey. PARTICIPANTS: Participants of the Korean National Health and Nutrition Examination Survey from 2008 to 2011. METHODS: Using a standardized protocol, AMD was determined by fundus photograph grading. Blood concentrations of lead, mercury, cadmium, manganese, and zinc were measured. Associations between AMD and these 5 elements were estimated using logistic regression analyses (LRAs). The distributions of the 5 metallic elements in blood were analyzed, and the same set of LRAs estimating the association between AMD and logarithmic-transformed blood concentrations of the 5 elements were also conducted. MAIN OUTCOME MEASURES: Association between AMD and 5 heavy metals. RESULTS: Lead was positively associated with both early AMD and late AMD in all LRAs. Mercury and cadmium also had a positive association with late AMD in all LRAs, but not with early AMD. In contrast, manganese and zinc had an inverse association with late AMD in all LRAs. Manganese and zinc were not associated with early AMD. Using logarithmic-transformed blood concentrations for each metallic element, the LRAs showed similar results compared with those of the LRAs using nontransformed blood concentrations, despite the skewed distribution of these metallic elements in the blood. CONCLUSIONS: This study suggests that the toxic heavy metals (lead, mercury, and cadmium) may negatively influence late AMD, whereas essential heavy metals (manganese and zinc) may favorably influence late AMD. Lead may widely affect the pathogenesis of both early and late AMD.
OBJECTIVE: To investigate the association between age-related macular degeneration (AMD) and 5 heavy metallic elements (lead, mercury, cadmium, manganese, and zinc). DESIGN: A cross-sectional study using a complex, stratified, multistage, probability cluster survey. PARTICIPANTS: Participants of the Korean National Health and Nutrition Examination Survey from 2008 to 2011. METHODS: Using a standardized protocol, AMD was determined by fundus photograph grading. Blood concentrations of lead, mercury, cadmium, manganese, and zinc were measured. Associations between AMD and these 5 elements were estimated using logistic regression analyses (LRAs). The distributions of the 5 metallic elements in blood were analyzed, and the same set of LRAs estimating the association between AMD and logarithmic-transformed blood concentrations of the 5 elements were also conducted. MAIN OUTCOME MEASURES: Association between AMD and 5 heavy metals. RESULTS: Lead was positively associated with both early AMD and late AMD in all LRAs. Mercury and cadmium also had a positive association with late AMD in all LRAs, but not with early AMD. In contrast, manganese and zinc had an inverse association with late AMD in all LRAs. Manganese and zinc were not associated with early AMD. Using logarithmic-transformed blood concentrations for each metallic element, the LRAs showed similar results compared with those of the LRAs using nontransformed blood concentrations, despite the skewed distribution of these metallic elements in the blood. CONCLUSIONS: This study suggests that the toxic heavy metals (lead, mercury, and cadmium) may negatively influence late AMD, whereas essential heavy metals (manganese and zinc) may favorably influence late AMD. Lead may widely affect the pathogenesis of both early and late AMD.
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Authors: Si Hyung Lee; Eun Min Kang; Gyu Ah Kim; Seung Woo Kwak; Joon Mo Kim; Hyoung Won Bae; Gong Je Seong; Chan Yun Kim Journal: PLoS One Date: 2016-10-21 Impact factor: 3.240
Authors: Kyung Chul Yoon; Won Choi; Hyo Seok Lee; Sang-Duck Kim; Seung-Hyun Kim; Chan Yun Kim; Ki Ho Park; Young Jeung Park; Seung-Hee Baek; Su Jeong Song; Jae Pil Shin; Suk-Woo Yang; Seung-Young Yu; Jong Soo Lee; Key Hwan Lim; Kyung Won Oh; Se Woong Kang Journal: Korean J Ophthalmol Date: 2015-11-25
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