Abstract
PurposeTo analyze the association between glucosamine (GlcN) use and the risk of age-related macular degeneration (AMD) using claims data from the National Health Insurance Research Database (NHIRD).MethodsA retrospective, population-based study was conducted with NHIRD data from a 14-year period (2000–2013). Chi-squared and Student’s t-tests were used to evaluate differences between the study and comparison cohorts for categorical and continuous variables, respectively. Risk factors for disease development were examined by the adjusted hazard ratio (aHR) with 95% confidence interval. Kaplan-Meier analysis was performed to compare the cumulative risk of AMD between the two cohorts.ResultsIn total, 1,344 patients with GlcN treatment were enrolled in the study cohort and 5,376 patients without GlcN use were enrolled in the comparison cohort. The incidence rate of AMD was lower with GlcN use (3.65%) than without GlcN use (5.26%) (P = 0.014). GlcN use was associated with a lower risk of developing AMD among patients with hyperlipidemia, coronary artery disease, chronic obstructive pulmonary disease, stroke, other neurological disorders, or degenerative arthritis. Although the incidence of wet type AMD did not significantly differ (P = 0.91), the incidence of dry type AMD was lower in patients with GlcN use (2.9%) than those without GlcN use (4.84%) (P = 0.003). Kaplan-Meier analysis similarly revealed a lower rate of dry type AMD in patients with GlcN use compared to those without GlcN use (log-rank P = 0.004).ConclusionsGlcN treatment can decrease the risk of developing dry type AMD. Further prospective controlled studies are needed to determine the effectiveness of GlcN treatment in patients with AMD and the associated mechanism.
Highlights
Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in the developed world, especially among those older than 50 years [1]
1,344 patients with GlcN treatment were enrolled in the study cohort and 5,376 patients without GlcN use were enrolled in the comparison cohort
GlcN use was associated with a lower risk of developing AMD among patients with hyperlipidemia, coronary artery disease, chronic obstructive pulmonary disease, stroke, other neurological disorders, or degenerative arthritis
Summary
Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in the developed world, especially among those older than 50 years [1]. AMD places a heavy burden on patients, caregivers, and physicians [3]. AMD is classified into two types: dry (non-neovascular) and wet (neovascular). The dry type is predominant, accounting for 85–90% of all patients with AMD. The early stage of dry AMD causes mild vision loss, and drusen may appear in the macula under fundus examination [5]. It may progress to geographic atrophy (GA), causing irreversible visual impairment [6]. The wet type affects approximately 10–15% of all patients with AMD, but accounts for 90% of cases of vision loss among patients with AMD [7]
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