Changes in abdominal obesity and age-related macular degeneration: the atherosclerosis risk in communities study

OBJECTIVE: To examine the association between changes in waist-hip ratio (WHR), a measure of abdominal obesity, and age-related macular degeneration (AMD). METHODS: A total of 12 515 persons from a population-based cohort study, aged 45 to 64 years in 1987 to 1989, were followed up over 6 years. The percentage change in WHR during follow-up was ranked into sex-specific deciles; an increase in WHR was defined as the top 10% of change and a decrease in WHR as the bottom 10%. The association of increased or decreased WHR and presence of AMD at follow-up was determined using logistic regression adjusting for potential confounders. RESULTS: The average change in WHR was an increase of 2%, ranging from a decrease of 44% to an increase of 102%. A decrease in WHR of 3% or more was associated with 29% lower odds of any AMD (odds ratio = 0.71; 95% confidence interval, 0.52-0.97). This effect was most pronounced among obese participants at baseline, where a decrease in WHR was associated with 59% lower odds of AMD (odds ratio = 0.41; 95% confidence interval, 0.20-0.82). CONCLUSIONS: Middle-aged persons who had a 3% or greater reduction in WHR over time were less likely to have AMD, particularly among those who were initially obese.