Measures of Body Shape and Adiposity as Related to Incidence of Age-Related Eye Diseases: Observations From the Beaver Dam Eye Study

PURPOSE: To examine the effect of obesity on the incidence of age-related eye disease. METHODS: Participants of the Beaver Dam Eye Study were examined every 5 years over a 20-year period (1988-1990 through 2008-2010). Lens and fundus photographs were used to evaluate presence and severity of cataract and macular degeneration. Height and weight were measured at all examinations. Waist and hip circumference were measured at all examinations beginning at the first follow-up (1993-1995). Models of ocular outcomes over 15 years were stratified by sex and smoking status. RESULTS: Overall, 2641 participants contributed 5567 person-visits to 15-year incidence analysis. Female nonsmokers had increased risk of late AMD associated with higher body mass index (BMI; hazard ratio [HR] per 2.5 kg/m(2) 1.31, 95% confidence interval [CI] 1.15-1.50, P < 0.001), waist to hip ratio (HR per 0.1 cm/cm 1.95, 95% CI 1.33-2.86, P < 0.001), waist circumference (HR per 5 cm 1.21, 95% CI 1.10-1.34, P < 0.001), and waist to height ratio (HR per 0.1 cm/cm 1.74, 95% CI 1.31-2.31, P < 0.001). Increased BMI was also associated with early AMD in female nonsmokers (HR 1.10, 95% CI 1.02-1.19, P = 0.02). CONCLUSIONS: Female nonsmokers had risk of late AMD associated with increasing measures of greater obesity and increased risk of early AMD associated with greater BMI.