Serum Lipid Biomarkers and Their Associations with Age-Related Macular Degeneration: A Cross-Sectional Analysis from the Beichen Eye Study

Abstract Background This population-based study examined the cross-sectional associations between serum lipid biomarkers and the prevalence of age-related macular degeneration (AMD). Methods This cross-sectional study analyzed data from 4748 subjects aged over 50 years who were enrolled in the Beichen Eye Study. We assessed TG/HDL-c, HDL-c/LDL-c, the neutrophil/HDL-c ratio (NHR), the lymphocyte/HDL-c ratio (LHR), the monocyte/HDL-c ratio (MHR), the platelet/HDL-c ratio (PHR), the platelet/lymphocyte ratio (PLR), and the neutrophil/lymphocyte ratio (NLR). Additionally, demographic characteristics, BMI, medical history, and statin use history were collected. Logistic regression models were adjusted for age, sex, BMI, fasting glucose, diabetes, hypertension, smoking, alcohol consumption, coronary heart disease, and statin use. Results Among 4,748 participants, 1,245 had AMD (overall prevalence: 26.22%). Age distribution differed between AMD and non-AMD groups (Z = − 6.58, P < 0.001). In univariate analysis, TG/HDL-c (Z = − 2.71, P = 0.007) and HDL-c/LDL-c (Z = − 1.98, P = 0.047) differed significantly between groups. In multivariable logistic regression, the highest tertile of TG/HDL-c, compared with the lowest tertile, was associated with lower odds of AMD (OR = 0.80, 95% CI: 0.69–0.95). The highest tertile of NHR showed an inverse association (OR = 0.83, 95% CI: 0.69–0.98; P for trend = 0.032). Relative to the highest TG category, participants in the middle TG category had higher odds of AMD (OR = 1.17, 95% CI: 1.01–1.34, P for trend = 0.039). HDL-c alone showed no linear association with AMD risk (P for trend = 0.269). Conclusions In this cross-sectional study, higher TG/HDL-c ratio was associated with lower AMD prevalence. Lower TG levels were associated with higher AMD prevalence. The NHR association was nominally significant but did not survive Bonferroni correction for multiple comparisons. HDL-c alone was not independently associated with AMD in this cohort. These cross-sectional associations are exploratory and require prospective validation before any clinical application.