Association between Age-Related Macular Degeneration and the Risk of Diabetes Mellitus: A Nationwide Cohort Study

Abstract

Age-related macular degeneration (AMD) is a degenerative and progressive disease of the macula, the part of the retina that is responsible for central vision. AMD shares some risk factors with diabetes mellitus (DM), but little is known about the risk of DM in individuals with AMD. With the goal of establishing novel perspectives, this study aimed to investigate the association between AMD and the risk of DM using the Korean Nationwide Health Insurance Database. Individuals aged ≥ 50 years who underwent a national health screening program in 2009 were enrolled. Participants were categorized by the presence of AMD and visual disability (VD). The Cox hazard regression model was used to examine hazard ratios (HRs) of DM with adjustment for potential confounders. Stratified analyses by age, sex, and comorbidities (hypertension or dyslipidemia) were also performed. During a mean follow-up of 8.61 years, there were 403,367 (11.76%) DM incidences among the final 3,430,532 participants. The crude HR (95% confidence interval (CI)) was 1.16 (1.13–1.20) for AMD. After adjusting for potential confounders, AMD was associated with a 3% decreased risk of DM (aHR 0.97, 95% CI 0.95–1.00), but no significant association with the risk of DM was found in AMD with VD (aHR 1.03, 95% CI 0.93–1.14). In summary, we did not find an increased risk of DM in individuals with AMD. A 3% decreased risk of DM in patients with AMD is not clinically meaningful. Our study suggests that the association between AMD and the risk of DM is weak, considering the potential confounders. Further studies examining this association are needed to extend our knowledge.

Dose-response association of metformin use and risk of age-related macular degeneration among patients with type 2 diabetes mellitus: a population-based study

“…Oxidative stress and chronic inflammation may explain the correlation between DM and the risk of AMD. Oxidative stress causes outer blood–retinal barrier degeneration that contributes to AMD progression ( Jung et al, 2022 ), and oxidative stress is a risk factor for the development of insulin resistance through insulin signal disruption ( Houstis et al, 2006 ; Newsholme et al, 2019 ).…”

Efficacy of polyethylene glycol loxenatide versus insulin glargine on glycemic control in patients with type 2 diabetes: a randomized, open-label, parallel-group trial

“…Recently released data estimates that the number of individuals with T2DM worldwide will increase to 700 million by 2045 ( Sun et al, 2021 ). T2DM is considered a typical age-related disease and usually manifests after the age of 40 ( Jung et al, 2022 ). The incidence of T2DM rises with age, with pooled global estimates suggesting that it is most commonly seen around 55–59 years of age ( Tinajero and Malik, 2021 ).…”

Advanced Research in Age-Related Macular Degeneration: Special Issue

“…AMD shares some risk factors with diabetes mellitus, but little is known about the risk of DM in individuals with AMD. Jung et al [12] investigated the association between AMD and the risk of diabetes mellitus using the Korean Nationwide Health Insurance Database. A Cox hazard regression model was used to examine the hazard ratios of diabetes mellitus with adjustments for potential confounders.…”