Table2.
Hazard ratios (HR’s) of intermediate and advanced AMD according to cumulative average intake of EPA and DHA
| Quintiles | ||||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | p trend | |
| Intermediate AMD | ||||||
| EPA | ||||||
| NHS | ||||||
| Median (mg/d) | 15 | 35 | 54 | 82 | 140 | |
| Cases/person-years | 236 /300,256 | 260 /297,224 | 229 /303,226 | 254 /306,019 | 230 /302,315 | |
| Age-adjusted HR | 1 (ref) | 1.10 | 0.95 | 1.03 | 0.90 | 0.14 |
| Multivariate HR (95% CI) | 1 (ref) | 1.06 (0.89,1.27) | 0.92 (0.76,1.10) | 1.00 (0.83,1.2) | 0.88 (0.73,1.07) | 0.13 |
| HPFS | ||||||
| Median (mg/d) | 25 | 58 | 93 | 135 | 248 | |
| Cases/person-years | 80 /122,739 | 86 /123,084 | 68 /124,924 | 67 /121,765 | 79 /122,436 | |
| Age-adjusted HR | 1 (ref) | 1.02 | 0.81 | 0.8 | 0.86 | 0.21 |
| Multivariate HR (95% CI) | 1 (ref) | 1.01 (0.74,1.37) | 0.80 (0.58,1.11) | 0.84 (0.6,01.17) | 0.90 (0.65,1.25) | 0.47 |
| Pooled | 1 (ref) | 1.06 (0.91,1.23) | 0.90 (0.76,1.05) | 0.96 (0.82,1.13) | 0.89 (0.75,1.05) | 0.09 |
| DHA | ||||||
| NHS | ||||||
| Median (mg/d) | 52 | 89 | 123 | 169 | 279 | |
| Cases/person-years | 259 /302,824 | 238 /297,361 | 249 /305,730 | 253 /300,047 | 210 /303,078 | |
| Age-adjusted HR | 1 (ref) | 0.94 | 0.96 | 0.97 | 0.77 | 0.008 |
| Multivariate HR (95% CI) | 1 (ref) | 0.93 (0.78,1.11) | 0.94 (0.79,1.12) | 0.95 (0.80,1.14) | 0.76 (0.62,0.92) | 0.008 |
| HPFS | ||||||
| Median (mg/d) | 70 | 128 | 180 | 246 | 390 | |
| Cases/person-years | 84 /122,484 | 82 /124,126 | 68 /122,714 | 67 /121,959 | 79 /123,665 | |
| Age-adjusted HR | 1 (ref) | 0.93 | 0.80 | 0.77 | 0.81 | 0.14 |
| Multivariate HR (95% CI) | 1 (ref) | 0.91 (0.67,1.23) | 0.80 (0.58,1.11) | 0.80 (0.58,1.12) | 0.85 (0.61,1.18) | 0.35 |
| Pooled | 1 (ref) | 0.93 (0.80,1.08) | 0.91 (0.78,1.07) | 0.92 (0.79,1.07) | 0.78 (0.66,0.92) | 0.008 |
| EPA + DHA | ||||||
| NHS | ||||||
| Median (mg/d) | 70 | 123 | 179 | 250 | 390 | |
| Cases/person-years | 252 /301,969 | 248 /299,460 | 228 /302,148 | 262 /302,831 | 219 /302,632 | |
| Age-adjusted HR | 1 (ref) | 1 | 0.90 | 1.02 | 0.82 | 0.04 |
| Multivariate HR (95% CI) | 1 (ref) | 0.98 (0.82,1.17) | 0.88 (0.74,1.06) | 1.00 (0.84,1.19) | 0.80 (0.66,0.97) | 0.03 |
| HPFS | ||||||
| Median (mg/d) | 94 | 187 | 275 | 380 | 625 | |
| Cases/person-years | 80 /121,668 | 89 /124,756 | 71 /122,400 | 58 /122,937 | 82 /123,188 | |
| Age-adjusted HR | 1 (ref) | 1.05 | 0.86 | 0.69 | 0.87 | 0.15 |
| Multivariate HR (95% CI) | 1 (ref) | 1.03 (0.76,1.40) | 0.86 (0.62,1.19) | 0.73 (0.52,1.03) | 0.92 (0.66,1.27) | 0.38 |
| Pooled | 1 (ref) | 1.00 (0.86,1.17) | 0.88 (0.75,1.04) | 0.94 (0.80,1.10) | 0.83 (0.71,0.98) | 0.03 |
| EPA + DHA (supplement users excluded) | ||||||
| NHS | ||||||
| Median (mg/d) | 66 | 118 | 170 | 233 | 355 | |
| Cases/person-years | 237 /286,521 | 234 /281,743 | 213 /281,446 | 232 /280,475 | 207 /275,902 | |
| Age-adjusted HR | 1 (ref) | 1.01 | 0.91 | 0.98 | 0.86 | 0.09 |
| Multivariate HR (95% CI) | 1 (ref) | 0.99 (0.82,1.19) | 0.89 (0.74,1.08) | 0.96 (0.80,1.16) | 0.84 (0.69,1.03) | 0.09 |
| HPFS | ||||||
| Median (mg/d) | 90 | 180 | 260 | 358 | 564 | |
| Cases/person-years | 76 /114,609 | 83 /114,692 | 61 /111,874 | 55 /111,261 | 69 /109,760 | |
| Age-adjusted HR | 1 (ref) | 1.04 | 0.81 | 0.71 | 0.81 | 0.07 |
| Multivariate HR (95% CI) | 1 (ref) | 1.03 (0.75,1.41) | 0.80 (0.57,1.13) | 0.76 (0.53,1.08) | 0.88 (0.63,1.25) | 0.29 |
| Pooled | 1 (ref) | 1.01 (0.86,1.18) | 0.88 (0.75,1.04) | 0.92 (0.78,1.08) | 0.86 (0.72,1.02) | 0.04 |
| Advanced AMD | ||||||
| EPA | ||||||
| NHS | ||||||
| Cases/person-years | 182 /300,294 | 201 /297,277 | 198 /303,243 | 225 /306,041 | 204 /302,325 | |
| Age-adjusted HR | 1 (ref) | 1.11 | 1.07 | 1.20 | 1.06 | 0.60 |
| Multivariate HR (95% CI) | 1 (ref) | 1.07 (0.88,1.31) | 1.05 (0.86,1.29) | 1.21 (0.99,1.48) | 1.11 (0.89,1.36) | 0.29 |
| HPFS | ||||||
| Cases/person-years | 80 /122,749 | 66 /123,111 | 64 /124,929 | 62 /121,771 | 74 /122,437 | |
| Age-adjusted HR | 1 (ref) | 0.81 | 0.77 | 0.77 | 0.82 | 0.37 |
| Multivariate HR (95% CI) | 1 (ref) | 0.84 (0.60,1.16) | 0.82 (0.59,1.14) | 0.88 (0.62,1.23) | 0.99 (0.71,1.38) | 0.70 |
| Pooled | 1 (ref) | 1.00 (0.84,1.19) | 0.98 (0.83,1.17) | 1.11 (0.94,1.32) | 1.07 (0.89,1.28) | 0.37 |
| DHA | ||||||
| NHS | ||||||
| Cases/person-years | 185 /302,871 | 216 /297,373 | 205 /305,774 | 210 /300,073 | 194 /303,089 | |
| Age-adjusted HR | 1 (ref) | 1.21 | 1.12 | 1.15 | 1.02 | 0.66 |
| Multivariate HR (95% CI) | 1 (ref) | 1.20 (0.98,1.46) | 1.12 (0.92,1.37) | 1.17 (0.96,1.44) | 1.06 (0.86,1.32) | 0.90 |
| HPFS | ||||||
| Cases/person-years | 84 /122,496 | 65 /124,148 | 71 /122,708 | 54 /121,976 | 72 /123,669 | |
| Age-adjusted HR | 1 (ref) | 0.75 | 0.82 | 0.62 | 0.75 | 0.10 |
| Multivariate HR (95% CI) | 1 (ref) | 0.76 (0.55,1.05) | 0.87 (0.63,1.21) | 0.71 (0.50,1.01) | 0.89 (0.64,1.24) | 0.67 |
| Pooled | 1 (ref) | 1.06 (0.90,1.26) | 1.04 (0.88,1.24) | 1.03 (0.86,1.23) | 1.01 (0.84,1.21) | 0.75 |
| EPA + DHA | ||||||
| NHS | ||||||
| Cases/person-years | 177 /302,026 | 216 /299,479 | 205 /302,179 | 211 /302,856 | 201 /302,639 | |
| Age-adjusted HR | 1 (ref) | 1.25 | 1.17 | 1.20 | 1.09 | 0.93 |
| Multivariate HR (95% CI) | 1 (ref) | 1.23 (1.01,1.50) | 1.17 (0.96,1.44) | 1.22 (0.99,1.5) | 1.15 (0.93,1.42) | 0.49 |
| HPFS | ||||||
| Cases/person-years | 78 /121,683 | 74 /124,775 | 62 /122,405 | 62 /122,938 | 70 /123,196 | |
| Age-adjusted HR | 1 (ref) | 0.91 | 0.76 | 0.77 | 0.78 | 0.13 |
| Multivariate HR (95% CI) | 1 (ref) | 0.93 (0.68,1.28) | 0.82 (0.58,1.15) | 0.88 (0.62,1.24) | 0.93 (0.66,1.31) | 0.77 |
| Pooled | 1 (ref) | 1.14 (0.96,1.35) | 1.06 (0.89,1.27) | 1.11 (0.93,1.33) | 1.08 (0.90,1.29) | 0.86 |
| EPA + DHA (supplement users excluded) | ||||||
| NHS | ||||||
| Cases/person-years | 170 /286,565 | 189 /281,778 | 187 /281,460 | 195 /280,510 | 178 /275,921 | |
| Age-adjusted HR | 1 (ref) | 1.15 | 1.14 | 1.17 | 1.06 | 0.82 |
| Multivariate HR (95% CI) | 1 (ref) | 1.12 (0.91,1.38) | 1.13 (0.91,1.39) | 1.18 (0.95,1.45) | 1.08 (0.87,1.35) | 0.57 |
| HPFS | ||||||
| Cases/person-years | 77 /114,618 | 64 /114,715 | 63 /111,870 | 52 /111,272 | 47 /109,775 | |
| Age-adjusted HR | 1 (ref) | 0.81 | 0.81 | 0.68 | 0.56 | 0.002 |
| Multivariate HR (95% CI) | 1 (ref) | 0.82 (0.59,1.15) | 0.85 (0.61,1.20) | 0.77 (0.53,1.10) | 0.68 (0.46,0.99) | 0.05 |
| Pooled | 1 (ref) | 1.03 (0.86,1.23) | 1.04 (0.87,1.24) | 1.05 (0.88,1.26) | 0.96 (0.79,1.16) | 0.29 |
Multivariate models were adjusted for: age (continuous), race (Caucasians or not), BMI (<18.5, 18.5–23, 23–25, 25–30, 30–35, ≥ 35 kg/m2), pack-years of smoking (never, 1–9, 10–24, 25–44, 45–64, ≥65y), physical activity (<3, 3–8.9, 9–17.9, 18–26.9, ≥27 MET-h/wk), current aspirin use (≥1 tablets/wk or none), history of hypertension and hypercholesterolemia, dietary variables including aHEI (excluding EPA and DHA), ALA, total energy intake (all in quintiles). In NHS, models were additionally adjusted for postmenopausal status and menopausal hormone use (never, current and past).
DHA and EPA included intake from diet and supplements unless otherwise specified.