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Published on: May 26, 2023
MALONDIALDEHYDE LEVELS IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION: A Systematic Review and Meta-analysis
Antonio Pinna1,2, Francesco Boscia1,2, Panagiotis Paliogiannis1
1Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy.
Background/Purpose:
The role of blood malondialdehyde (MDA) in age-related macular degeneration (AMD), the leading cause of new blindness in industrialized countries, is still matter of debate. We performed a systematic review and meta-analysis of the published data on the MDA levels in AMD patients.
Methods:
PubMed, ISI Web of Sciences, and Scopus searches were performed according to MOOSE guidelines. Case-control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD, respectively. The main outcome measures were wet AMD and dry AMD. MDA level was the main exposure variable. Data were pooled using a random-effects model.
Results:
Twelve case-control studies were identified. A total of 634 AMD patients (mean age 66.7 years) and 656 controls without AMD (mean age 67.8 years) were evaluated. Extreme between-study heterogeneity was observed (I = 96.8%, P < 0.001). Pooled standardized mean difference showed that MDA values were significantly higher in patients with AMD (standardized mean difference = 1.91 µmol/L, 95% confidence interval = 1.08-2.74; P < 0.001). In a model including five studies, homogenous for age, sample matrix, and laboratory testing for MDA, heterogeneity decreased from extreme to moderate (I = 46.4%, P = 0.113), and pooled standardized mean difference, though attenuated, remained significantly higher in AMD patients (standardized mean difference = 1.07 µmol/L, 95% confidence interval = 0.82-1.31; P < 0.001).
Conclusion:
There is some evidence of higher levels of MDA in AMD patients compared with healthy controls; however, this result should be interpreted with caution because of extreme between-study heterogeneity and the possible effect of publication bias. Future studies, preferably well age-matched and of cohort design, are necessary before any firm conclusions on the putative role of elevated MDA on AMD can be drawn.
Insights
Blood malondialdehyde (MDA) levels are higher in age-related macular degeneration (AMD) patients compared to controls. However, this finding requires cautious interpretation due to significant study heterogeneity and potential publication bias.
Area of Science:
- Ophthalmology
- Biochemistry
- Medical Research
Background:
- Age-related macular degeneration (AMD) is a leading cause of blindness in industrialized nations.
- The association between blood malondialdehyde (MDA) levels and AMD remains debated.
- Oxidative stress markers, like MDA, are implicated in degenerative diseases.
Purpose of the Study:
- To systematically review and meta-analyze published data on blood malondialdehyde (MDA) levels in patients with age-related macular degeneration (AMD).
- To investigate the potential role of MDA as a biomarker for AMD.
- To synthesize evidence regarding MDA levels in AMD versus control populations.
Main Methods:
- Systematic literature search of PubMed, ISI Web of Sciences, and Scopus databases.
- Inclusion of case-control studies comparing MDA levels in AMD patients and healthy controls.
- Meta-analysis using a random-effects model to pool standardized mean differences in MDA levels.
Main Results:
- Twelve case-control studies involving 634 AMD patients and 656 controls were analyzed.
- Initial meta-analysis revealed significantly higher MDA levels in AMD patients (SMD = 1.91 µmol/L, P < 0.001) with extreme heterogeneity (I² = 96.8%).
- After adjusting for homogeneity in age, sample matrix, and laboratory methods in a subset of five studies, heterogeneity decreased (I² = 46.4%), and MDA levels remained significantly higher in AMD patients (SMD = 1.07 µmol/L, P < 0.001).
Conclusions:
- Evidence suggests elevated blood malondialdehyde (MDA) levels in age-related macular degeneration (AMD) patients compared to controls.
- The findings should be interpreted cautiously due to significant between-study heterogeneity and potential publication bias.
- Further well-designed cohort studies with age-matched participants are needed to confirm the role of MDA in AMD pathogenesis.
