Alcohol Consumption and the Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

Centre for Eye Research Australia, The University of Melbourne, Victoria, Australia.
American Journal of Ophthalmology (Impact Factor: 3.87). 05/2008; 145(4):707-715. DOI: 10.1016/j.ajo.2007.12.005
Source: PubMed


To review systematically the evidence currently available on alcohol consumption and the risk of age-related macular degeneration (AMD).
Systematic review and meta-analysis of observational studies.
Seven databases were searched systematically with no limits on the year or language of publication for prospective cohort studies. References identified from pertinent reviews and articles also were retrieved. Two reviewers independently searched the above databases and selected the studies using prespecified standardized criteria. These criteria included appropriate adjustment for age and smoking in the analysis. Of the 441 studies identified initially, five cohort studies met the selection criteria. Data extraction and study quality evaluation were performed independently by two reviewers and results were pooled quantitatively using meta-analytic methods.
The five cohort studies included 136,946 people, among whom AMD developed in 1923 (1,513 early and 410 late). Pooled results showed that heavy alcohol consumption was associated with an increased risk of early AMD (pooled odds ratio, 1.47; 95% confidence interval, 1.10 to 1.95), whereas the association between heavy alcohol consumption and risk of late AMD was inconclusive. There were insufficient data to evaluate a dose-response association between alcohol consumption and AMD or the association between moderate alcohol consumption and AMD.
Heavy alcohol consumption (more than three standard drinks per day) is associated with an increased risk of early AMD. Although this association seems to be independent of smoking, residual confounding effects from smoking cannot be excluded completely.

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Available from: Elaine W Chong, Oct 10, 2015
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    • "Moderate alcohol consumption is a protective factor in cardiovascular disease [22] and has been suggested to be protective for AMD [23], while heavy alcohol consumption has been associated with an increased risk of AMD [24]. The current study results support the beneficial effect of regular alcohol consumption on cardiovascular disease (lower mean BMI, slightly elevated HDLC, and decreased total triglyceride levels). "
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    ABSTRACT: Purpose: To evaluate the role of nutritional factors, serum lipids, and lipoproteins in late age-related macular degeneration (late AMD). Methods: Intake of red meat, fruit, fish, vegetables, and alcohol, smoking status, and body mass index (BMI) were ascertained questionnaire-based in 1147 late AMD cases and 1773 controls from the European Genetic Database. Serum levels of lipids and lipoproteins were determined. The relationship between nutritional factors and late AMD was assessed using logistic regression. Based on multivariate analysis, area-under-the-curve (AUC) was calculated by receiver-operating-characteristics (ROC). Results: In a multivariate analysis, besides age and smoking, obesity (odds ratio (OR): 1.44, P = 0.014) and red meat intake (daily: OR: 2.34, P = 8.22 × 10(-6); 2-6x/week: OR: 1.67, P = 7.98 × 10(-5)) were identified as risk factors for developing late AMD. Fruit intake showed a protective effect (daily: OR: 0.52, P = 0.005; 2-6x/week: OR: 0.58, P = 0.035). Serum lipid and lipoprotein levels showed no significant association with late AMD. ROC for nutritional factors, smoking, age, and BMI revealed an AUC of 0.781. Conclusion: Red meat intake and obesity were independently associated with increased risk for late AMD, whereas fruit intake was protective. A better understanding of nutritional risk factors is necessary for the prevention of AMD.
    BioMed Research International 07/2014; 2014:413150. DOI:10.1155/2014/413150 · 3.17 Impact Factor
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    • "In the African region, it is estimated that about 2.4% of deaths and 2.1% of DALYs lost are attributed to alcohol use and AUD (Rehm et al. 2009). Adverse effects of alcohol use include increased risk of infectious diseases such as HIV/AIDS and TB, and chronic non-communicable diseases (NCD) (Makimoto & Higuchi 1999; Horn-Ross et al. 2004; WHO 2004; Ahmed et al. 2006; Chen et al. 2008; Chong et al. 2008; Brooks et al. 2009; Genkinger et al. 2009; Brandish & Sheron 2010; Kahl et al. 2010; Patra et al. 2010; Stroffolini et al. 2010), as well as intentional and unintentional injuries, and social problems such as domestic violence, unemployment and decreased work productivity (Gmel & Rehm 2003; Fisher et al. 2007; Kalichman et al. 2007; Rehm et al. 2009; Zaleski et al. 2010; Abbey 2011; Aldridge-Gerry et al. 2011). "
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    ABSTRACT: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population.
    Tropical Medicine & International Health 01/2014; 19(4). DOI:10.1111/tmi.12267 · 2.33 Impact Factor
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    • "Our results also showed association of hypertension with levels of CCL24 in the AMD patients analyzed, but the difference between smoker/nonsmoker and alcoholic/nonalcohlic AMD patients was not significant. Hypertension may increase the oxidative stress known to be associated with AMD resulting in expression of CCL24 in choroidal endothelial cells and its ligands in RPE (Chong et al., 2008). Notwithstanding AMD as an eye disorder , the analysis of serum is consistent with several previous reports in both retina and brain (Sharma et al., 2009; Baas et al., 2010; Vinish et al., 2010). "
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    ABSTRACT: Recently, eotaxin-CCR3 was reported to play an important role in choroidal neovascularization (CNV) development and was documented to be superior than vascular endothelial growth factor-A treatment when tested in CNV animals. As eotaxin studies are lacking in the human age-related macular degeneration (AMD) patients, we sought to determine whether eotaxin-2 (CCL24) has any association with inflammatory processes that occur in CNV. CCL24 levels were determined by enzyme linked immunosorbant assay (ELISA) after normalization to total serum protein and levels of ELISA were correlated to various risk factors in about 133 AMD patients and 80 healthy controls. The CCL24 levels were significantly higher in wet AMD patients as compared with dry AMD and normal controls. There was a significant difference when compared among wet AMD patients (i.e., minimally classic, predominantly classic, and occult). We also report significant difference in the CCL24 levels of Avastin-treated and untreated AMD patients. This study shows that CCL24 levels were found to be significantly increased in AMD patients despite Avastin treatment as compared with normal controls and those without Avastin, indicating that CCL24 may have an association with CNV and may be an important target to validate future therapeutic approaches in AMD in tandem with Avastin treatment.
    DNA and cell biology 10/2012; 31(11):1618-27. DOI:10.1089/dna.2012.1786 · 2.06 Impact Factor
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