Klinik Araştırma
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EVALUATION OF THE ATHEROSCLEROTIC RISK FACTORS IN AGE RELATED MACULAR DEGENERATION PATIENTS

Yıl 2012, Cilt: 6 Sayı: 3, 141 - 145, 25.12.2012

Öz

Purpose: To investigate the possible role of atherosclerotic risk factors in age related macular degeneration (AMD) patients.
Materials and Method: Thirty patients diagnosed as AMD were included in the study. The control group was made up with the patients who referred for refractive examination. To assess the blood cholesterol levels, antecubital venous blood samples were obtained from all of the patients. Cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) levels in the samples were determined for lipid profile. Anamnesis for cigarette smoking, hypertension and for the presence of diabetes mellitus, previous cerebrovascular event (CVE) and myocardial infarction (Ml) were obtained.
Results: There was no statistically significant difference between patients with SMD (18 male 12 female , mean age: 70,3±7.06) and the control group (18 male 12 female, mean age:68,06±6.8) in terms of age (p=0.21), distribution of sex (p=0.79), presence of diabetes mellitus (p=0.09) hypertension (p=0.59) and history of Ml (p=0.77), of CVE (p=0.55) and frequency of smoking (p=0.17).The LDL, HDL and total cholesterol levels were not also significantly different between the groups. (the p levels : 0.23, 0.19, 0.16 respectively).
Conclusion: The risk factors for atherosclerosis; i.e. serum lipid profile, cigarette smoking, presence of diabetes and hypertension and history of Ml and CVE were not found to be significantly different in patients with SMD as compared to the control group. However the small number of cases for such an epidemiological study and the genetic variations in lipoprotein receptors in local tissue may affect the results.

Kaynakça

  • 1. Hawkins BS, Bird A, Klein R, West SK. Epidemiology of age-related macular degeneration. Mol Vis 1999; 5: 26.
  • 2. Edwards AO, Malek G. Molecular genetics of AMD and current animal models. Angiogenesis 2007; 10: 119-132.
  • 3. Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye 2005; 19:935-944.
  • 4. Klein R, Klein BE, Tomany SC, Cruick- 8 shanks KJ. The association of cardiovascular disease with the long-term incidence of age-related maculopathy: the Beaver Dam Eye study. Ophtalmol-ogy 2003;110:1273-80.
  • 5. Tan JS, Mitchell P, Smith W, Wang J J. Cardiovascular risk factors and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study. Ophthalmology
  • 6.Schwartz CJ, Valente AJ, Sprague EA, Kelley JL, Nerem RM. The pathogenesis of atherosclerosis: an overview. Clin Cardiol 1991; 14: 11-16.
  • 7. Broekhuyse RM. Lipids in tissues of the eye. VII. Changes in concentration and composition of sphingomyelins, cholesterol esters and other lipids in aging sclera. Biochim Biophys Acta 1972;280:637-645.
  • 8. Ashraf F, Cogan DG, Kruth HS. Apolipoprotein A-l and B distribution in the human cornea. Invest Ophthalmol Vis Sci 1993;34:3574-3578.
  • 9. Gaynor PM, Zhang WY, Salehizadeh B, Pettiford B, Kruth HS. Cholesterol accumulation in human cornea: evidence that extracellular cholesteryl ester-rich lipid particles deposit independently of foam cells. J Lipid Res 1996;37:1849-1861.
  • 10. Malek G, Li CM, Guidry C, Medeiros NE, Curcio CA. Apolipoprotein B in cholesterol-containing drusen and basal deposits of human eyes with age related maculopathy. Am J Pathol 2003; 162:413^125.
  • 11. Abdelsalam A, Del Priore L, Zarbin MA. Drusen in age-related macular degeneration: pathogenesis, natural course, and laser photocoagulation photocoagulation-induced regression. Surv Ophthalmol 1999;44:1-29.
  • 12. Green WR. Histopathology of age-related macular degeneration. Mol Vis 1999;5:27.
  • 13. Spaide RF, Ho-Spaide WC, Browne RW, Armstrong D. Characterization of peroxidized lipids in Bruch’s membrane. Retina 1999;19:141-147.
  • 14. Cousins SW, Espinosa-Heidmann DG, Alexandridou A, Sall J, Dubovy S, Csaky K. The role of aging, high fat diet and blue light exposure in an experimental mouse model for basal laminar deposit formation. Exp Eye Res 2002;75:543-553.
  • 15. Olofsson SO and Boren J, “Apolipoprotein B: a clinically important apolipoprotein which assembles atherogenic lipoproteins and promotes the development of atherosclerosis. J Int Med 2005;258:395-410.
  • 16. Van Leeuwen R, Klaver CCW, Vinger-ling JR et al. Cholesterol and age-related macular degeneration: is there a link? Am J Ophthalmol 2004;137:750-752.
  • 17. Abalain JH, Carre JL, Leglise D et al. Is age-related macular degeneration associated with serum lipoprotein and lipoparticle levels? Clinica Chimica Acta 2002;326:97-104.
  • 18. Hyman L, Schachat AP, He Q, and Leske MC. Hypertension, cardiovascular disease, and age-related macular degeneration: Age-Related Macular Degeneration Risk Factors Study Group. Arch Ophthalmol 2000; 118: 351-358.
  • 19. Yaylalı Arı S, Akçakaya Ardagil A, Acar H, Sönmez A, Aydın N, Erbil H. Yaşa Bağlı Maküla Dejeneresansı Gelişiminde Serum Kan Lipid Profilinin Rolü. Retina-Vitreus 2007;15:189-192.
  • 20. Sezgin S, Birinci H, Birinci A, Öge İ, Erkan D. Yaşa Bağlı Makula Dejenerasyonunda Risk Faktörleri. Retina - Vit-reus2003; 11 : 159-163.
  • 21. Hackam DG, Anand SS. Emerging risk factors for atherosclerotic vascular disease: a critical review of the evidence. JAMA 2003;290:932-40.
  • 23. Klaver CC, Assink JJ, van Leeuwen R, et al. Incidence and progression rates of age-related maculopathy (the Rotterdam Study). Invest Ophthamol Vis Sci 2001;42:2237-2241
  • 24. Haines JL, Schnetz-Boutaud N, Schmidt S, Scott WK, Agarwal A, Postel EA, Olson L, Kenealy SJ, Hauser M, Gilbert JR, and Pericak-Vance MA. Functional Candidate Genes in Age-Related Macular Degeneration: Significant Association with VEGF, VLDLR, and LRP6. Invest Ophthalmol Vis Sci 2006;47:329-335.

YAŞA BAĞLI MAKULA DEJENERESANSI OLGULARINDA ATEROSKLEROTİK RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Yıl 2012, Cilt: 6 Sayı: 3, 141 - 145, 25.12.2012

Öz

Amaç: Yaşa bağlı makula dejeneresansı (YBMD) olgularında aterosklerotik risk faktörlerinin hastalık üzerindeki muhtemel rolünü araştırmak.
Metod: Çalışmaya YBMD tamlı 30 hasta dahil edildi. Kontrol grubu, refraksiyon muayenesi için başvuran 30 hasta ile oluşturuldu. Tüm hastalardan, kan lipid kolesterol düzeylerini tayin etmek için, antekübital venöz kan örneği alındı. Alınan örneklerde lipid profili için kolesterol, yüksek yoğunluklu lipoproteinlerin (HDL) ve düşük yoğunluklu lipoproteinlerin (LDL) düzeyleri belirlendi. Sigara kullanımı, hipertansiyon (HT) ve diyabetes mellitus (DM) varlığı ile geçirilmiş serebrovaküler olay (SVO) ve miyokard infarktüsü (MI) ile ilgili anamnez alındı.
Bulgular: Yaşa bağlı makula dejeneresansı olan olgularla (18’i erkek 12’si kadın, yaş ortalaması 70,3±7.06) kontrol grubu (18’i erkek 12’si kadın, yaş ortalaması 68,06±6.8) arasında yaş ortalaması (p=0.21) ve cinsiyet dağılımı (p=0.79) açısından istatistiksel açıdan anlamlı bir fark yoktu. Diyabet (p=0.09) ve hipertansiyon (p=0.59) varlığı, MI (p=0.77), SVO (p=0.55) öyküleri ve sigara kullanımı sıklığı (p=0.17) açısından gruplar arasında anlamlı fark saptanmadı.
İki grup arasında LDL, HDL, ve total kolesterol düzeyleri açısından istatistiksel anlamlı fark bulunamadı (sırasıyla p değerleri 0.23, 0.19, 0.16 ).
Tartışma: Çalışmamızda değerlendirilen ve aterosklerozda başlıca risk faktörlerini teşkil eden serum lipid profili, sigara kullanımı, HT ve DM varlığı, MI ve SVO olay öyküsü açısından YBMD grubu ile kontrol grubu arasında anlamlı fark bulunmamıştır. Ancak olgu sayısının bu tip bir epidemiyolojik çalışma için az olması ve lokal doku lipoprotein reseptöründeki genetik varyasyonlar sonucu etkileyebilir.

Kaynakça

  • 1. Hawkins BS, Bird A, Klein R, West SK. Epidemiology of age-related macular degeneration. Mol Vis 1999; 5: 26.
  • 2. Edwards AO, Malek G. Molecular genetics of AMD and current animal models. Angiogenesis 2007; 10: 119-132.
  • 3. Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye 2005; 19:935-944.
  • 4. Klein R, Klein BE, Tomany SC, Cruick- 8 shanks KJ. The association of cardiovascular disease with the long-term incidence of age-related maculopathy: the Beaver Dam Eye study. Ophtalmol-ogy 2003;110:1273-80.
  • 5. Tan JS, Mitchell P, Smith W, Wang J J. Cardiovascular risk factors and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study. Ophthalmology
  • 6.Schwartz CJ, Valente AJ, Sprague EA, Kelley JL, Nerem RM. The pathogenesis of atherosclerosis: an overview. Clin Cardiol 1991; 14: 11-16.
  • 7. Broekhuyse RM. Lipids in tissues of the eye. VII. Changes in concentration and composition of sphingomyelins, cholesterol esters and other lipids in aging sclera. Biochim Biophys Acta 1972;280:637-645.
  • 8. Ashraf F, Cogan DG, Kruth HS. Apolipoprotein A-l and B distribution in the human cornea. Invest Ophthalmol Vis Sci 1993;34:3574-3578.
  • 9. Gaynor PM, Zhang WY, Salehizadeh B, Pettiford B, Kruth HS. Cholesterol accumulation in human cornea: evidence that extracellular cholesteryl ester-rich lipid particles deposit independently of foam cells. J Lipid Res 1996;37:1849-1861.
  • 10. Malek G, Li CM, Guidry C, Medeiros NE, Curcio CA. Apolipoprotein B in cholesterol-containing drusen and basal deposits of human eyes with age related maculopathy. Am J Pathol 2003; 162:413^125.
  • 11. Abdelsalam A, Del Priore L, Zarbin MA. Drusen in age-related macular degeneration: pathogenesis, natural course, and laser photocoagulation photocoagulation-induced regression. Surv Ophthalmol 1999;44:1-29.
  • 12. Green WR. Histopathology of age-related macular degeneration. Mol Vis 1999;5:27.
  • 13. Spaide RF, Ho-Spaide WC, Browne RW, Armstrong D. Characterization of peroxidized lipids in Bruch’s membrane. Retina 1999;19:141-147.
  • 14. Cousins SW, Espinosa-Heidmann DG, Alexandridou A, Sall J, Dubovy S, Csaky K. The role of aging, high fat diet and blue light exposure in an experimental mouse model for basal laminar deposit formation. Exp Eye Res 2002;75:543-553.
  • 15. Olofsson SO and Boren J, “Apolipoprotein B: a clinically important apolipoprotein which assembles atherogenic lipoproteins and promotes the development of atherosclerosis. J Int Med 2005;258:395-410.
  • 16. Van Leeuwen R, Klaver CCW, Vinger-ling JR et al. Cholesterol and age-related macular degeneration: is there a link? Am J Ophthalmol 2004;137:750-752.
  • 17. Abalain JH, Carre JL, Leglise D et al. Is age-related macular degeneration associated with serum lipoprotein and lipoparticle levels? Clinica Chimica Acta 2002;326:97-104.
  • 18. Hyman L, Schachat AP, He Q, and Leske MC. Hypertension, cardiovascular disease, and age-related macular degeneration: Age-Related Macular Degeneration Risk Factors Study Group. Arch Ophthalmol 2000; 118: 351-358.
  • 19. Yaylalı Arı S, Akçakaya Ardagil A, Acar H, Sönmez A, Aydın N, Erbil H. Yaşa Bağlı Maküla Dejeneresansı Gelişiminde Serum Kan Lipid Profilinin Rolü. Retina-Vitreus 2007;15:189-192.
  • 20. Sezgin S, Birinci H, Birinci A, Öge İ, Erkan D. Yaşa Bağlı Makula Dejenerasyonunda Risk Faktörleri. Retina - Vit-reus2003; 11 : 159-163.
  • 21. Hackam DG, Anand SS. Emerging risk factors for atherosclerotic vascular disease: a critical review of the evidence. JAMA 2003;290:932-40.
  • 23. Klaver CC, Assink JJ, van Leeuwen R, et al. Incidence and progression rates of age-related maculopathy (the Rotterdam Study). Invest Ophthamol Vis Sci 2001;42:2237-2241
  • 24. Haines JL, Schnetz-Boutaud N, Schmidt S, Scott WK, Agarwal A, Postel EA, Olson L, Kenealy SJ, Hauser M, Gilbert JR, and Pericak-Vance MA. Functional Candidate Genes in Age-Related Macular Degeneration: Significant Association with VEGF, VLDLR, and LRP6. Invest Ophthalmol Vis Sci 2006;47:329-335.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Göz Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Fatma Yülek

Yayımlanma Tarihi 25 Aralık 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 6 Sayı: 3

Kaynak Göster

APA Yülek, F. (2012). YAŞA BAĞLI MAKULA DEJENERESANSI OLGULARINDA ATEROSKLEROTİK RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ. Türk Tıp Dergisi, 6(3), 141-145.

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