Serum Lipid Biomarkers as Predictors for Age-Related Macular Degeneration Risk: A Cross-Sectional Analysis from the Beichen Eye Study

Abstract Background: This population-based study aimed to investigate the associations between serum lipid biomarkers and the prevalence of age-related macular degeneration (AMD). Methods: This cross-sectional study analyzed data from 4748 subjects over 50 years old who were enrolled in the Beichen Eye Study. 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)were assessed. Additionally, basic information, BMI, history of disease related to lipid metabolism, living habits and history of statin use were collected. Results: This study included 4748 participants, and 1245 of whom were diagnosed with AMD. The overall prevalence of AMD was 26.22%. The prevalence of AMD increased significantly with age (Z=-6.58, P<0.001). TG/HDL-c and HDL-c/LDL-c were significantly associated with the incidence of AMD (Z=-2.71, P=0.007; Z=-1.98, P=0.047, respectively). Multivariate logistic regression revealed that a high TG/HDL-c ratio (OR=0.80, P<0.05) and high NHR (OR=0.83, P<0.05) were both inversely associated with AMD risk, indicating protective effects. Elevated TG levels were also found to be protective against AMD (OR=0.80, P<0.05). Elevated HDL-c was associated with a paradoxical increase in AMD risk, especially in the second tertile (OR=1.04, 95% CI=0.89–1.22; P<0.05). Conclusions: This study suggested that an elevated TG/HDL-c ratio and NHR serve as protective biomarkers for AMD, with higher TG levels showing a protective effect. Conversely, HDL-c levelsdemonstrated a paradoxical association with AMD risk.These findings provide insights into the complex role of lipid metabolism in AMD pathogenesis and suggest potential biomarkers for AMD risk prediction.