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Protective Effects of Bone Mineral Density on Age-Related Macular Degeneration: A Mendelian Randomization Study
Yuxin Sun1,2, Junfei Huang1, Ziran Zhang1
1The Second Clinical Medicine School, Southern Medical University, Guangzhou, China, fimmu.com.
Introduction:
Observational studies have established the connection between a decrease in bone mineral density (BMD) and an increased susceptibility to age-related macular degeneration (AMD). However, the cause-and-effect link of this correlation remains uncertain. This study employed Mendelian randomization (MR) methods to examine the causality between BMDs and AMD.
Materials And Methods:
The GEnetic Factors for OSteoporosis (GEFOS) Consortium, UK Biobank, and FinnGen Biobank offered summary statistics for BMD and AMD. We adopted an array of quality control procedures to screen for eligible instrumental single nucleotide polymorphisms (SNPs). The inverse variance weighting (IVW) algorithm was the most trustworthy approach in MR analyses. Furthermore, we employed additional analytical methods such as MR-Egger and weighted median (WM) for confirming the soundness of the present MR outcomes.
Results:
The findings indicated that genetically predicted total body BMD (TB-BMD, IVW: OR = 0.772, 95% CI = 0.642-0.928, p = 0.006), lumbar spine BMD (LS-BMD, IVW: OR = 0.739, 95% CI = 0.583-0.937, p = 0.013), femoral neck (FN-BMD, WM: OR = 0.626, 95% CI = 0.432-0.906, p = 0.013), and TB-BMD (age over 60, MR-Egger, OR = 0.383, 95% CI = 0.163-0.902, p = 0.041) were associated with lower odds of wet AMD. No significant causal relationship can be found between other BMDs and Wet-AMD, or between BMDs and Dry-AMD.
Conclusion:
Our MR analysis supported the causal correlation between genetically predicted BMD and Wet-AMD. As to Dry-AMD, it was not causally related to BMD. Our study complemented the evidence from previous observational surveys and emphasized the extraordinary importance of monitoring BMD for preventing and treating AMD.
Insights
Lower bone mineral density (BMD) is causally linked to an increased risk of wet age-related macular degeneration (AMD). This genetic study confirms a link between BMD and wet AMD, but not dry AMD.
Area of Science:
- Ophthalmology
- Genetics
- Bone Metabolism
Background:
- Observational studies suggest a link between decreased bone mineral density (BMD) and increased risk of age-related macular degeneration (AMD).
- The causal relationship between BMD and AMD remains uncertain.
- Mendelian randomization (MR) is a robust method for inferring causality from observational data.
Purpose of the Study:
- To investigate the causal relationship between genetically predicted bone mineral density (BMD) and age-related macular degeneration (AMD) using Mendelian randomization.
- To differentiate the causal effects of BMD on wet AMD versus dry AMD subtypes.
Main Methods:
- Utilized summary statistics from large-scale genetic consortia (GEFOS, UK Biobank, FinnGen) for BMD and AMD.
- Applied rigorous quality control to select instrumental single nucleotide polymorphisms (SNPs).
- Employed inverse variance weighting (IVW), MR-Egger, and weighted median (WM) methods for robust causal inference.
Main Results:
- Genetically predicted total body BMD (TB-BMD), lumbar spine BMD (LS-BMD), and femoral neck BMD (FN-BMD) were associated with significantly lower odds of developing wet AMD.
- A specific analysis of TB-BMD in individuals over 60 also showed a reduced odds of wet AMD.
- No significant causal associations were found between BMD and dry AMD, or other BMD measures and wet AMD.
Conclusions:
- Mendelian randomization analysis supports a causal link between genetically predicted BMD and an increased risk of wet AMD.
- BMD is not found to be causally associated with dry AMD.
- Findings underscore the importance of monitoring BMD for the prevention and management of wet AMD.
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