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Smoking, obesity multiply genetic risk of AMD, study finds

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The likelihood of developing age-related macular degeneration conferred by genetics is multiplied by the presence of modifiable risk factors, a large study found. Cigarette smoking and obesity increased the risk of developing AMD in subjects who had gene variants that have been identified as risk factors for the disease in previous studies.

"The existence of interactions with modifiable lifestyle factors may provide further impetus for screening individuals who are at potentially greater risk," the study authors said in a press release from the Journal of American Medical Association. "Knowledge of the substantial risk of AMD among individuals homozygous for either or both of these major AMD-associated variants might help motivate these individuals to stop smoking, lose weight, modify other risk factors and have regular eye examinations."

Debra A. Schaumberg, ScD, OD, MPH, and colleagues at Harvard Medical School, prospectively compared 457 patients with AMD to 1,072 age- and sex-matched control subjects in the Nurses' Health Study and the Health Professionals Follow-up Study. The researchers sought to determine whether variants in complement factor H (CFH) and the predicted gene LOC387715 interacted with modifiable risk factors to increase the risk of AMD.

The researchers found that subjects who had mutant alleles of both genes were 50 times more likely to develop AMD. Subjects with two mutant alleles of CFH were 3.92 times more likely to develop AMD than control subjects. In those who smoked, risk increased to 8.69 times that of non-smoking control subjects. In subjects who were obese, risk increased 12 times as compared to non-obese controls.

For subjects with two mutant alleles of LOC387715, risk increased by 6.33 times for non-smokers and by 22.47 times for smokers, compared to the control group.

The genetic risk levels were not affected by other suspected risk factors for AMD, including regular aspirin use, fruit intake, fatty acid ratios or alcohol consumption, according to the release.

The study is published in the January issue of Archives of Ophthalmology.