It may be the “good” cholesterol but elevated levels of high-density lipoprotein (HDL) could be a risk factor in age-related macular degeneration (AMD) pathogenesis. A recent study noted that an increase in HDL from the 25th percentile to the 75th percentile coincides with an AMD risk increase of about 20%.

Based on health data of 30,953 participants from Western Europe, researchers have shown that high circulating HDL cholesterol levels and low triglyceride levels are significantly associated with AMD. Extra-large HDL sub-fractions appear to be drivers of this association. On the other hand, low-density lipoprotein (LDL)-cholesterol only reached statistical significance in the association with early AMD.

The study found that the high HDL and low triglyceride level measurements showed the strongest association with drusen and early stage AMD. This suggests that lipids play an important role in the disease’s beginning phase. Researchers believe intervention at this phase would be most promising in preventing blindness. They do believe that further research should address whether systemic lipids directly influence AMD or represent lipid metabolism in the retina. 

Colijn JM, den Hollander AI, Demirkan A, et al. Increased high density lipoprotein-levels associated with age-related macular degeneration. Evidence from the EYE-RISK and E3 consortia. Ophthalmology. October 10, 2018. [Epub ahead of print].