Biomedical subjects

Barbara E K Klein

Publications and source records attributed to Barbara E K Klein.

At least 19 recordsLinked to original sources

PubMed2007

Apolipoprotein e gene and age-related maculopathy in older individuals: the cardiovascular health study.

OBJECTIVE: To examine the association between the apolipoprotein E (APOE) gene and age-related maculopathy (ARM) in an older population. METHODS: Two thousand one hundred seventy persons 65 years and older sampled from 4 US communities had ARM signs assessed from retinal photographs using a modified Wisconsin Age-Related Maculopathy Grading System. DNA extracted from blood samples was analyzed for common APOE alleles. RESULTS: After controlling for age, sex, cigarette smoking, and other factors, white participants carrying the epsilon2 allele had an increased risk of late ARM (odds ratio, 2.53 [95% confidence interval, 1.08-5.90]) while carriers of the epsilon4 allele had a lower risk of late ARM (odds ratio, 0.69 [95% confidence interval, 0.19-2.50]). There were too few late ARM cases in African American individuals for analysis. CONCLUSION: APOE polymorphism is associated with late ARM in older white persons 65 years and older. Consistent with previous studies, the APOE epsilon2 allele is associated with a significant increased risk of late ARM development, whereas the epsilon4 allele may confer some protection.

Black or African American↗

PubMed2007

Identification of novel genetic loci for intraocular pressure: a genomewide scan of the Beaver Dam Eye Study.

OBJECTIVE: To identify genetic loci that control intraocular pressure (IOP). METHODS: We performed a genomewide scan of IOP, using 486 pedigrees ascertained through a population-based cohort, the Beaver Dam Eye Study. Linkage analysis was performed using the modified Haseman-Elston regression models and variance components linkage analysis. RESULTS: Seven regions of interest were identified on chromosomes 2, 5, 6, 7, 12, 15, and 19. The novel linkage region on chromosome 19p had an empirical multipoint P value of 6.1 x 10(-5). Two of the regions (2 and 19) were especially interesting since each has been identified as a potential linkage region for blood pressure. CONCLUSIONS: The results of this genomewide scan provide evidence that a quantitative trait locus may influence elevated IOP and may colocalize with blood pressure loci. These loci may control systemic pressure reflected in the eye and vascular system. CLINICAL RELEVANCE: Glaucoma is a leading cause of blindness in the world, and the identification of genes that contribute to this disease is essential. Elevated IOP is a principal risk factor for primary open-angle glaucoma and an intriguing quantitative trait that may strongly influence the development of disease.

Adult↗

PubMed2007

Confirmation of linkage to ocular refraction on chromosome 22q and identification of a novel linkage region on 1q.

OBJECTIVE: To localize genes influencing ocular refraction in subjects in the Beaver Dam Eye Study. Previous studies establish that myopia clusters within families and linkage to myopia has been demonstrated on 2q, 4q, 12q, 17q, 18q, 22q, and Xq. Few studies have examined genetic effects across the entire range of refraction, though linkages to 1p, 3q, 4q, 8p, and 11p have been reported, and our previous analysis of the Beaver Dam Eye Study demonstrated substantial heritability for refraction (68%). METHODS: We conducted nonparametric sibling-pair and genome-wide linkage analyses on spherical equivalent adjusting for age, education, and nuclear sclerosis, in 834 sibling pairs in 486 extended pedigrees. RESULTS: We identified a novel region of suggestive linkage on 1q (multipoint, P<.00019) and replicated the 22q region (multipoint, P = .0033) previously linked to myopia. Additionally, there was some evidence of linkage to 7p (multipoint, P = .0023). CONCLUSION: Refraction is a complex trait influenced by both genes and environment. Our work confirms a previously reported linkage region on 22q and identifies 2 novel regions of linkage on 1q and 7p. CLINICAL RELEVANCE: Further, genetic research is needed to finemap this trait to identify the causative gene. Modifying the actions of such a gene might lead to a reduction in the risk of refractive error.

Adult↗

PubMed2006

Retinal vein occlusion and vascular mortality: pooled data analysis of 2 population-based cohorts.

PURPOSE: To assess the association of retinal vein occlusion (RVO) with cardiovascular and cerebrovascular mortality. DESIGN: Pooled data from 2 population-based cohort studies. PARTICIPANTS: At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons aged 43 to 86 years (from 1988-1990) and the Blue Mountains Eye Study (BMES) examined 3654 persons aged 49 to 97 years (from 1992 to 1994). METHODS: Retinal vein occlusion was assessed from retinal photographs. Vascular deaths were determined using either death certificates (BDES) or the Australian National Death Index (BMES). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). MAIN OUTCOME MEASURE: Vascular (cardiovascular and cerebrovascular) mortality was determined. RESULTS: Of 8384 baseline participants, 96 (1.14%) had RVO at baseline (BDES, n = 38; BMES, n = 58). Over 12 years, 1312 (15.7%) died of cardiovascular-related conditions and 341 (4.1%) died of cerebrovascular-related conditions. Age-standardized vascular mortality rates were 26.0% and 5.3%, respectively, in persons with RVO and 17.1% and 4.5%, respectively, in those without RVO. After adjusting for age, gender, body mass index, hypertension, diabetes, smoking, glaucoma, and study site, RVO was not associated with cardiovascular-related mortality (HR, 1.2; 95% CI, 0.8-1.8) or cerebrovascular-related mortality (HR, 0.9; 95% CI, 0.4-2.1) among participants of all ages. However, in persons aged less than 70 years, baseline RVO was associated with higher cardiovascular mortality (combined BDES and BMES: HR, 2.5; 95% CI, 1.2-5.2; BDES: HR, 2.5; 95% CI, 0.9-6.9; BMES: HR, 2.1; 95% CI, 0.7-6.8). CONCLUSIONS: Retinal vein occlusion in persons aged 43 to 69 years may signal a doubling of the risk of cardiovascular mortality.

Adult↗

PubMed2006

Relationship between low-normal blood pressure and kidney disease in type 1 diabetes.

Current recommendations, largely based on studies in type 2 diabetes, suggest lower target blood pressures (BPs) for individuals with diabetes than for the general population. However, the effect of lower BP on renal outcomes in type 1 diabetes is uncertain. In a population-based cohort of type 1 diabetes adults (mean age: 33.1 years) based in Wisconsin, of which the distribution of baseline BP was in the low-normal range, we examined the relationship between decreasing categories of systolic and diastolic BP and the 16-year incidence of proteinuria (n=232 of 604) and estimated glomerular filtration rate of <60 mL/min/1.73 m(2) (n=158 of 547). Decreasing BP categories had lower relative risk (RR) of developing incident proteinuria (RR comparing decreasing quartiles of systolic BP: 1.00, 0.76, 0.58, 0.73; P for trend=0.03; RR comparing decreasing quartiles of diastolic BP: 1.00, 0.81, 0.66, 0.42; P for trend <0.0001) and incident estimated glomerular filtration rate <60 mL/min/1.73 m(2) (RR comparing decreasing quartiles of systolic BP: 1.00, 0.83, 0.61, 0.65; P for trend=0.03; RR comparing decreasing quartiles of diastolic BP: 1.00, 0.84, 0.82, 0.43; P for trend=0.001). These associations were independent of glycemic control and several putative confounding factors. Subjects with either systolic BP <120 mm Hg or diastolic BP <70 mm Hg had significantly lower RR (95% confidence interval) of incident proteinuria (0.63 [0.48 to 0.82]) and incident estimated glomerular filtration rate <60 mL/min/1.73 m(2) (0.60 [0.43 to 0.82]); corresponding population-attributable risks for these outcomes were 26.7% and 29.5%, respectively. Our study suggests that lower BP levels, even below the accepted normal range, are protective against kidney disease in adults with type 1 diabetes. Interventional trials are desirable to clarify the clinical significance of this association.

Adult↗

PubMed2006

Frailty and age-related cataract.

OBJECTIVE: To determine whether there is an association between age-related cataract and frailty that persists after controlling for visual acuity (VA) and comorbid conditions. DESIGN: Cross-sectional. PARTICIPANTS: Two thousand three hundred seventy Beaver Dam Eye Study cohort members at 10-year (third) examination with cataract information. Ninety-nine percent of the population was Caucasian. METHODS: Medical history, blood pressures, height, weight, measures of frailty, and lens photographs were obtained during the study evaluation. Lens photographs were graded according to standardized protocols. MAIN OUTCOME MEASURES: Four of frailty (gait time, peak expiratory flow rate, handgrip strength, chair stand) and an index combining all 4 measures. RESULTS: After controlling for age, age squared, comorbidity index, pack-years, sedentary lifestyle, education, and VA, nuclear cataract in women was not associated significantly with any frailty measures; in men, nuclear cataract was associated with slower gait time (P = 0.01) and a poorer frailty index score (P = 0.01) in multivariable analyses. Cortical cataract was associated in women with a lower peak expiratory flow rate (P<0.01) and in men with weaker handgrip strength (P = 0.02) and a poorer frailty index score (P</=0.01) in multivariable analyses. Posterior subcapsular cataract in women was associated significantly with a lower peak expiratory flow rate (P = 0.01). Nuclear and cortical cataract add significant information in explaining frailty index scores in men. CONCLUSIONS: Three common types of age-related cataract are associated with some measures of frailty independent of VA and systemic comorbidities. It is possible that age-related cataract may be an indicator of general functional decline in older adults.

Adult↗

PubMed2006

Retinal vascular caliber in persons with type 2 diabetes: the Wisconsin Epidemiological Study of Diabetic Retinopathy: XX.

PURPOSE: To describe retinal vascular caliber and correlates in people with type 2 diabetes. DESIGN: Population-based study. PARTICIPANTS: Thirteen hundred seventy persons diagnosed to have diabetes at or after 30 years of age in an 11-county area in south central Wisconsin from 1980 to 1982. METHODS: Retinal photographs of 7 standard fields were taken; light box grading was done to determine retinopathy severity. Computer-assisted grading was done from a digitized image of field 1 to determine the central retinal arteriolar equivalent (CRAE; arteriolar caliber) and central retinal venular equivalent (CRVE; venular caliber). MAIN OUTCOME MEASURES: Retinal arteriolar and venular calibers. RESULTS: In multivariable analyses in persons with panretinal photocoagulation excluded, while controlling for refractive error, CRAE was associated independently with age (per 10 years, beta = -2.0 microm), mean arterial blood pressure (BP) (per 10 mmHg, beta = -2.2 microm), smoking status (current vs. never smoked, beta = 5.6 microm), and intraocular pressure (IOP) (per 1 mmHg, beta = 0.2 microm). The CRVE was associated independently with age (per 10 years, beta = -2.5 microm), mean arterial BP (per 10 mmHg, beta = -2.1 microm), smoking status (current vs. never smoked, beta = 11.6 microm), pack-years smoked (per 10 pack-years, beta = 1.0 microm), body mass index (per kg/m2, beta = 0.3 mm), pulse rate (per 10 beats/minute, beta = 1.5 microm), retinopathy severity (per 1 level, beta = 1.05 microm), and IOP (per 10 mmHg, beta = -0.5 microm). Smaller CRAEs and CRVEs were found in eyes with panretinal photocoagulation treatment than in eyes without such treatment. CONCLUSIONS: In persons with type 2 diabetes, variations in retinal vascular caliber are related to various systemic and ocular factors. Understanding these relationships may provide further insights into early retinal vascular changes in diabetes.

Adult↗

PubMed2006

Statin use and incident nuclear cataract.

CONTEXT: Statins are widely prescribed for their lipid-lowering effects but also have putative antioxidant properties. Oxidative stress is believed to play a role in the development of nuclear cataract, but little is known regarding the relationship of statin use and cataract incidence. OBJECTIVE: To evaluate the relationship of use of statins and incident cataract in adults in a midwestern community in the United States. DESIGN, SETTING, AND PARTICIPANTS: The Beaver Dam Eye Study, an observational, longitudinal, population-based study of age-related eye disease in Beaver Dam, Wis. There were 1299 persons who were seen at the third examination in 1998-2000, had gradable photographs in both eyes, and were deemed to be at risk of developing nuclear cataract within 5 years. MAIN OUTCOME MEASURE: Five-year incidence of cataract with respect to statin use. Cataracts were graded from photographs taken through the participant's dilated pupil. RESULTS: A total of 210 persons developed incident nuclear cataract in the interval from 1998-2000 to 2003-2005. Five-year incidence of nuclear cataract was 12.2% in statin users compared with 17.2% in nonusers (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.36-0.84), controlling for age. When only never smokers without diabetes were assessed, the age-, lipid level-, and sex-adjusted OR was 0.40 (95% CI, 0.18-0.90). Five-year incidence of cortical cataract was 9.9% in statin users and 7.5% in nonusers (OR, 1.28; 95% CI, 0.79-2.08); posterior subcapsular cataract occurred in 3.0% of statin users and 3.4% of nonusers (OR, 0.82; 95% CI, 0.39-1.71). CONCLUSION: Statin use in a general population appears to be associated with lower risk of nuclear cataract, the most common type of age-related cataract.

Adult↗

PubMed2006

The association among smoking, heavy drinking, and chronic kidney disease.

Several factors for chronic kidney disease (CKD), including diabetes, hypertension, and obesity, are described consistently in the literature; studies describing modifiable lifestyle factors, including smoking and consumption of alcohol, are sparse, sometimes contradictory. The authors examined the factors associated with CKD in a population-based cohort in Wisconsin, with emphasis on smoking and consumption of alcohol. CKD was defined as an estimated glomerular filtration rate of less than 60 ml/minute per 1.73 m(2) from serum creatinine. The authors performed two analyses: 1) cross-sectional analysis among 4,898 persons with prevalent CKD (n = 324) as the outcome of interest and 2) longitudinal analysis among 3,392 CKD-free persons at baseline, with 5-year incident CKD (n = 114) between 1993 and 1995 as the outcome of interest. Smoking and heavy drinking, defined as consumption of four or more servings of alcohol per day, were associated with CKD, independent of several important confounders. Compared with that among never smokers, the odds ratio of developing CKD was 1.12 (95% confidence interval (CI): 0.63, 2.00) among former smokers and 1.97 (95% CI: 1.15, 3.36) among current smokers. Heavy drinking was associated with CKD, with an odds ratio of 1.99 (95% CI: 0.99, 4.01). Joint exposure to both current smoking and heavy drinking was associated with almost fivefold odds of developing CKD compared with their absence (odds ratio = 4.93, 95% CI: 2.45, 9.94). Smoking and consumption of four or more servings of alcohol per day are associated with CKD.

Adult↗

PubMed2006

Retinal arteriolar emboli and long-term mortality: pooled data analysis from two older populations.

BACKGROUND AND PURPOSE: To assess the relationship between retinal arteriolar emboli and mortality in older people. METHODS: Pooled data from 2 population-based cohort studies. At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons 43 to 86 years of age (1988 to 1990), and the Blue Mountains Eye Study (BMES) examined 3654 persons 49 to 97 years of age (1992 to 1994). Retinal arteriolar emboli were assessed by grading retinal photographs using standardized methods. Deaths and causes of death were determined from death certificates or Australian National Death Index. Cox regression models were used to estimate mortality hazard ratios (HRs) associated with emboli, adjusting for age, gender, body mass index, hypertension, diabetes, smoking, serum total cholesterol, high-density lipoprotein cholesterol, study site, and past histories of stroke, angina, and acute myocardial infarct. RESULTS: Of 8580 baseline participants, 8384 (98%) had retinal photographs available, and 111 showed retinal arteriolar emboli (BDES n=61; BMES n=50). Over 10 to 12 years, 2506 participants (30%) died, including 344 (4%) from stroke-related and 1315 (16%) from cardiovascular causes. The cumulative mortality rates were higher in participants with than without emboli (all-cause 56% versus 30%; stroke-related 12% versus 4.0%; cardiovascular 30% versus 16%). The increased mortality risk associated with emboli was independent of age, gender, other vascular risk factors, and past histories of stroke or heart disease for all-cause (multivariate-adjusted HR, 1.3; CI, 1.0 to 1.8) and stroke-related mortality (HR, 2.0; CI, 1.1 to 3.8) but not for cardiovascular mortality (HR, 1.2; CI, 0.8 to 1.7). CONCLUSIONS: Our pooled data from 2 older populations suggest that retinal emboli predict a modest increase in all-cause and stroke-related mortality independent of cardiovascular risk factors.

Adult↗

PubMed2006

The relationship of optic disk cupping to retinal vein occlusion: the Beaver Dam Eye Study.

PURPOSE: To examine the association between optic disk cupping and retinal vein occlusion (RVO). DESIGN: Prospective epidemiologic study. METHODS: setting: Population-based prospective study in Beaver Dam, Wisconsin. study population: Adults aged 43 to 86 years at baseline (n = 4926). observation procedures: Optic disk cupping and RVO were determined from retinal photographs. A standardized medical examination and questionnaire were administered. main outcome measure: Ten-year cumulative incidence of RVO. RESULTS: There were 58 persons who developed incident RVO at 5 (n = 31) or 10 (n = 27) years after the baseline examination. Those sustaining RVO were older, had higher intraocular pressure (IOP), and were more likely to have definite or probable glaucoma at the baseline examination. The odds of having an incident RVO increased with increasing cup-to-disk ratio at baseline (odds ratio [OR] = 1.29/0.1 increase in cup-to-disk ratio, 95% confidence interval 1.07, 1.56), while controlling for age, systolic blood pressure, current smoking, diabetes status, and IOP. A similar OR was found after excluding those with glaucoma. Excluding persons with central (as opposed to branch) vein occlusion did not have a significant effect on the OR. CONCLUSION: Cup-to-disk ratio is a significant predictor of risk of incident RVO.

Adult↗

PubMed2006

Genome-wide linkage study of retinal vessel diameters in the Beaver Dam Eye Study.

Retinal vessels can be observed noninvasively and provide a window to microvascular systems elsewhere in the body. Generalized retinal arteriolar narrowing can represent structural changes resulting from persistent high blood pressure. However, data from recent studies also suggest that generalized retinal arteriolar narrowing might precede hypertension and contribute to its pathogenesis. To determine whether vessel diameters in the eye are genetically determined, we conducted a genome-wide linkage scan on retinal vessel diameters (central retinal artery equivalent and central retinal vein equivalent) using data from the Beaver Dam Eye Study. There were 7 regions on 5 chromosomes (3q28, 5q35, 7q21, 7q32, 11q14, 11q24, and 17q11) showing linkage signals at the nominal multipoint significance level of 0.01 for either covariate-unadjusted or -adjusted central retinal artery equivalent; there were 7 regions on 6 chromosomes (1p36, 6p25, 6q14, 8q21, 11p15, 13q34, and 14q21) showing linkage signals at the nominal multipoint significance level of 0.01 for either covariate-unadjusted or -adjusted central retinal vein equivalent. The linkage results for retinal vessel diameters indicate genetic contributions that remain significant even after adjusting for hypertension and other covariates. In summary, we provide evidence demonstrating that genetic factors independent of hypertension affect retinal vessel diameters.

Adult↗

PubMed2006

Apolipoprotein E gene and early age-related maculopathy: the Atherosclerosis Risk in Communities Study.

OBJECTIVE: To examine the association between the apolipoprotein E (APOE) gene and early age-related maculopathy (ARM) in middle-aged persons. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Participants from the Atherosclerosis Risk in Communities Study (n = 10139; age range, 49-73 years). METHODS: Retinal photography was performed on 1 randomly selected eye, and grading for presence of ARM was carried out using a modification of the Wisconsin ARM Grading System. Early ARM was defined as the presence of either soft drusen alone, retinal pigment epithelial depigmentation alone, or a combination of soft drusen with increased retinal pigment and/or depigmentation. DNA extracted from blood samples of participants were analyzed for common allelic variants of the APOE gene (epsilon2, epsilon3, and epsilon4). MAIN OUTCOME MEASURES: Presence of early ARM on retinal photographs. RESULTS: The prevalence of early ARM was similar in participants with different APOE genotypes: epsilon2/epsilon2 (5.9%), epsilon2/epsilon3 (5.2%), epsilon2/epsilon4 (3.2%), epsilon3/epsilon3 (5.2%), epsilon3/epsilon4 (4.9%), and epsilon4/epsilon4 (4.1%). After controlling for age, gender, race, cigarette smoking, and other factors, early ARM was not associated with APOE genotypes, with an odds ratio (OR) of 1.35 (95% confidence interval [CI], 0.54-3.38) for epsilon2/epsilon2 genotype, an OR of 1.06 (95% CI, 0.80-1.40) for epsilon2/epsilon3 genotype, an OR of 0.63 (95% CI, 0.32-1.24) for epsilon2/epsilon4 genotype, an OR of 0.99 (95% CI, 0.80-1.24) for epsilon3/epsilon4 genotype, and an OR of 0.88 (95% CI, 0.47-1.63) for epsilon4/epsilon4 genotype, as compared with epsilon3/epsilon3 genotype (reference). No associations were found for specific early ARM signs or in analyses stratified by age, gender, race, or cigarette smoking status. CONCLUSIONS: These data provide no evidence of a strong association between the APOE gene and early ARM in middle-aged persons. This suggests that APOE is not likely a major determinant of the early stages of ARM in younger people. However, our study does not exclude the possibility of a weaker association or that APOE may influence only the development of late ARM in older populations, as reported in other studies.

Aged↗

PubMed2006

Are inflammatory factors related to retinal vessel caliber? The Beaver Dam Eye Study.

OBJECTIVE: To examine the relationship of systemic markers of inflammation, endothelial dysfunction, and serum folate level to retinal vessel diameter. METHODS: Cross-sectional analyses were completed for data from a random sample of 396 persons aged 50 to 86 years who underwent a baseline examination from 1988 to 1990. Standardized protocols for blood collection and measurement of markers were used. Diameters of arterioles and venules were measured from digitized photographs. Standard univariate and multivariate analyses were performed. RESULTS: While controlling for age, smoking status, diabetes status, serum high-density lipoprotein cholesterol, and hematocrit, wider retinal venular diameters were associated with higher serum high-sensitivity C-reactive protein, interleukin 6, and amyloid A levels. While controlling for age, systolic and diastolic blood pressure, smoking, serum high-density lipoprotein cholesterol level, and gout, smaller arteriolar diameters were associated with higher serum amyloid A and lower serum albumin and folate levels but not high-sensitivity C-reactive protein or interleukin 6 levels. Levels of serum soluble intercellular adhesion molecule-1 and serum soluble E-selectin, markers of endothelial dysfunction, were not associated with retinal arteriolar or venular diameters. CONCLUSIONS: These data show an association of inflammatory markers with larger retinal venular diameter, suggesting that retinal venular caliber may be a marker of systemic inflammation.

Aged↗

PubMed2006

Age-related eye disease, visual impairment, and survival: the Beaver Dam Eye Study.

OBJECTIVE: To investigate the relationship of age-related maculopathy, cataract, glaucoma, visual impairment, and diabetic retinopathy to survival during a 14-year period. METHODS: Persons ranging in age from 43 to 84 years in the period from September 15, 1987, to May 4, 1988, participated in the baseline examination of the population-based Beaver Dam Eye Study (n = 4926). Standardized protocols, including photography, were used to determine the presence of ocular disease. Survival was followed using standardized protocols. RESULTS: As of December 31, 2002, 32% of the baseline population had died (median follow-up, 13.2 years). After adjusting for age, sex, and systemic and lifestyle factors, poorer survival was associated with cortical cataract (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.06-1.37), any cataract (HR, 1.16; 95% CI, 1.03-1.32), diabetic retinopathy (HR per 1-step increase in 4-level severity, 1.36; 95% CI, 1.14-1.63), and visual impairment (HR, 1.24; 95% CI, 1.04-1.48) and marginally associated with increasing severity of nuclear sclerosis (HR, 1.07; 95% CI, 0.99-1.16). Age-related maculopathy and glaucoma were not associated with poorer survival. Associations tended to be slightly stronger in men than women. CONCLUSIONS: Cataract, diabetic retinopathy, and visual impairment were associated with poorer survival and not explained by traditional risk factors for mortality. These ocular conditions may serve as markers for mortality in the general population.

Adult↗

PubMed2006

Markers of inflammation, vascular endothelial dysfunction, and age-related cataract.

PURPOSE: To examine the associations of systemic markers of inflammatory disease and vascular endothelial dysfunction with three types of age-related cataract. DESIGN: Cross-sectional analyses of data from a population-based sample of adults. METHODS: Standardized protocols for blood collection, measurement of markers, administration of a questionnaire, and grading of lens photographs to determine cataract were used. Univariable and multivariable analyses were performed. SETTINGS: Cohort in Beaver Dam, Wisconsin. STUDY POPULATION: A random sample of 396 persons who were > or =50 years of age. MAIN OUTCOME MEASURE: Prevalent age-related nuclear, cortical, and posterior subcapsular cataract. RESULTS: Interleukin-6 and intracellular adhesion molecule-1 were associated significantly with prevalent nuclear cataract (odds ratio for each quartile, 1.45 and 2.17, respectively). Many of the associations of markers with cataract types were not linear. There were no significant associations between the markers and cortical or posterior subcapsular cataract. CONCLUSION: Two serum markers of systemic inflammation and vascular endothelial dysfunction were associated with nuclear cataract.

Adult↗

PubMed2006

Diabetic retinopathy in a multi-ethnic cohort in the United States.

PURPOSE: To describe the prevalence and risk factors of diabetic retinopathy in a multi-ethnic US population of whites, blacks, hispanics, and chinese. DESIGN: Cross-sectional study of 778 individuals from ages 45 to 85 years with diabetes, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Retinal photographs were obtained with a 45 degrees nonmydriatic digital fundus camera. Presence and severity of diabetic retinopathy were graded at a central reading center on the basis of a modification of the Airlie House classification system. All participants underwent a standardized interview, examination, and laboratory investigations. RESULTS: In this population with diabetes, the prevalence of any retinopathy was 33.2% and macular edema 9.0%. The prevalence of any diabetic retinopathy and macular edema was significantly higher in blacks (36.7% and 11.1%) and hispanics (37.4% and 10.7%) than in whites (24.8% and 2.7%) and chinese (25.7% and 8.9%) (P = .01 and P = .007, comparing racial/ethnic differences for retinopathy and macular edema, respectively). Significant independent predictors of any retinopathy were longer duration of diabetes, higher fasting serum glucose, use of diabetic oral medication or insulin, and greater waist-hip ratio. Race was not an independent predictor of any retinopathy. CONCLUSIONS: This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.

Aged↗

PubMed2006

Age-related macular degeneration and optic disk cupping: the Beaver Dam Eye Study.

PURPOSE: To examine the association between presence, severity, and extent of lesions of age-related macular degeneration (AMD) and optic disk and cup diameters in a general population. DESIGN: Cross-sectional study. METHODS: setting: Population-based. study population: Adults aged 43 to 86 years participating in the Beaver Dam Eye Study. observation procedures: Fundus photographs were graded for lesions of AMD using standard protocols. The photographs were obtained during the baseline examination of the Beaver Dam Eye Study. main outcome measure: Optic disk cupping as related to presence, severity, and extent of lesions of AMD. RESULTS: There were no significant differences in the vertical optic disk and cup measurements or in the vertical cup to disk ratios by severity of lesions of AMD (P values all greater than .10). In those eyes with late lesions of AMD, there was no association of the size of the lesions or their distribution in the fundus and the extent of cupping. CONCLUSIONS: From a population perspective, there is no relationship of the presence or severity of AMD and optic disk cupping.

Adult↗