Özet:
Background Age-related maculopathy (ARM)
or degeneration (ARMD) is the leading cause
of irreversible blindness in developed
countries. Despite several studies on the
morphology of ARMD, the aetiology is
unknown and factor(s) contributing to the
pathogenesis remain to be characterised. More
recent studies have demonstrated that
cholesterol esters and lipids are present within
Bruch’s membrane deposits and drusen, and
dietary fat intake is associated with ARMD.
The product of Ob gene, leptin, is a recently
discovered peptide participating in human
metabolism. There is a direct relationship
between serum leptin and diet, and
lipoprotein metabolism, but the role of leptin
in the course of ARMD has not previously
been investigated.
Purpose This cross-sectional case–control
study investigated whether serum leptin level
was associated with ARMD as a new possible
risk factor and to assess its relationship with
disease severity.
Methods A total of 32 patients with ARM or
ARMD (17 men, 15 women) and 20 age- and
sex-matched healthy control subjects without
ARMD (11 men, nine women) from a similar
ethnic background were enrolled in this
multicentre study. Body mass index (BMI)
(weight (kg)/height (m2
)) was calculated for
each group. The presence of maculopathy was
assessed on the basis of colour fundus
photographs using an international
classification system. Patients were classified
as early-ARM (n ¼ 16) or late-ARMD (n ¼ 16)
using clinical examination and grading of
photographs. Serum leptin levels were
measured by an enzyme-linked
immunosorbent assay kit. The Mann–Whitney
U test or w2 test was used for statistics as
indicated, and Po0.05 was considered to be
significant.
Results The age, sex ratio, and BMI between
groups were comparable. Patients with
maculopathy had significantly (Po0.001)
lower leptin levels (mean7SD, 6.0172.55 ng/
ml) than control subjects (13.2172.27 ng/ml).
In addition, late-ARMD patients had
significantly lower leptin levels (3.8170.58 ng/
ml) than early-ARM patients (8.2171.68 ng/ml,
Po0.001) or control subjects (Po0.001).
Conclusion Leptin seems to be a possible
newly associated factor in the course of ARM
and may be involved in the lipid composition
of the macular lesions, especially in
late-ARMD.
