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Retinal Physician

Article

High and Low HDL Levels Associated With AMD Risk

Researchers also identified associated genes and hypothesized a mechanism of drusenogenesis with Lp(a).

By: Sarah Fackler, managing editor, Optometric Management
Retinal Physician June 24, 2025

Clinical Scorecard: High and Low HDL Levels Associated With AMD Risk

At a Glance

CategoryDetail
ConditionAge-Related Macular Degeneration (AMD)
Key MechanismsU-shaped association between serum HDL levels and AMD risk; involvement of specific genetic variants and lipoprotein(a) in disease susceptibility.
Target PopulationPatients with AMD and age-, sex-, and race-matched healthy controls.
Care SettingClinical research utilizing data from the National Institutes of Health’s All of Us Research Program.

Key Highlights

  • Significant U-shaped association between HDL levels and AMD risk.
  • Lowest AMD risk observed at HDL levels between 40 and 60 mg/dL.
  • Genetic variants CFH (rs1061170) and ARMS2 (rs10490924) significantly associated with AMD.
  • Both low and high HDL levels linked to increased AMD risk (P<.001).
  • Lipoprotein(a) (Lp[a]) identified as a novel SNP associated with AMD risk.

Guideline-Based Recommendations

Diagnosis

  • Utilize multivariable logistic regression models to assess associations between HDL metrics and AMD status.

Management

  • Monitor HDL levels in patients at risk for AMD, aiming for levels between 40 and 60 mg/dL.

Monitoring & Follow-up

  • Regular assessment of HDL and associated genetic variants in AMD patients.

Risks

  • Increased AMD risk associated with both low and high HDL levels.

Patient & Prescribing Data

2,328 patients with AMD and 5,028 healthy controls.

Consider genetic testing for SNPs related to HDL metabolism and AMD risk.

Clinical Best Practices

  • Incorporate genetic data into AMD risk assessments.
  • Educate patients on the implications of HDL levels on AMD risk.
  • Further research into the mechanisms linking HDL and AMD is warranted.

References