国际眼科纵览 ›› 2026, Vol. 50 ›› Issue (1): 54-60.doi: 10.3760/cma.i.cn115500-20251016-26108

• 综述 • 上一篇    下一篇

脂代谢在年龄相关性黄斑变性发生发展中的作用机制

高钰敏   刘东成   秦波  刘静雯 卢怡洁   

  1. 1 暨南大学第二临床医学院,深圳 518000;2 暨南大学附属爱尔眼科医院(深圳),深圳 518032;3 深圳市爱尔眼科技术研究所,深圳 518000
  • 收稿日期:2025-10-16 出版日期:2026-02-22 发布日期:2026-02-22
  • 通讯作者: 秦波,Email:qinbozf @126.com
  • 基金资助:
    爱尔眼科医院集团科研基金项目(AGF2301D29, AGF2301D33, AGF2301D34)

Mechanism of lipid metabolism in the development of age-related macular degeneration

Gao Yumin, Liu Dongcheng, Qin Bo, Liu Jingwen, Lu Yijie   

  1. 1 The Second Clinical Medical College, Jinan University, Shenzhen 518000, China; 2 Aier Eye Hospital Affiliated to Jinan University (Shenzhen), Shenzhen 518032, China; 3 Shenzhen Aier Eye Technology Institute, Shenzhen 518000, China
  • Received:2025-10-16 Online:2026-02-22 Published:2026-02-22
  • Contact: Qin Bo, Email: qinbozf @126.com
  • Supported by:
     Aier Eye Hospital Group Research Fund Project (AGF2301D29, AGF2301D33, AGF2301D34)

摘要: 年龄相关性黄斑变性(age-related macular degeneration,AMD)是全球失明的主要原因。大量证据提示,脂质稳态改变可能导致AMD。脂代谢为视网膜提供能量、构成细胞结构、维持细胞稳态。循环脂蛋白的不平衡导致AMD的发生,脂代谢通过脂褐素的积累、线粒体功能障碍、新生血管的形成三种机制导致AMD;脂代谢基因中,ATP结合盒转运蛋白A1的保护性等位基因能增强胆固醇外排功能,减少脂质沉积,而风险性变异则会削弱该功能;载脂蛋白E的ε4等位基因是AMD重要的保护因素,与促进脂质清除有关,而ε2等位基因则通常与风险增加相关;胆固醇酯转移蛋白和肝脂肪酶C基因也都存在作用相反的位点。了解脂质在AMD的发展和维持中的作用,可开发针对脂代谢相关的AMD治疗方法,从为脂代谢相关的AMD治疗提供新的方案。

关键词: 年龄相关性黄斑变性, 脂质代谢, 视网膜

Abstract: Age-related macular degeneration (AMD) is a leading cause of global blindness and currently remains incurable. Accumulating evidence suggests that alterations in lipid homeostasis may contribute to the pathogenesis of AMD. Lipid metabolism supplies energy to the retina, contributes to cellular structure, and maintains cellular homeostasis. Specifically, imbalances in circulating lipoproteins have been implicated in the onset of AMD. Lipid metabolism influences AMD progression through mechanisms such as lipofuscin accumulation, mitochondrial dysfunction, and neovascularization.Among lipid metabolism genes,the protective allele of the ATP-binding cassette transporter A1 can enhance cholesterol excretion and reduce lipid deposition, while the risk variant weakens this function. The ε4 allele of apolipoprotein E is an important protective factor for AMD and may be related to the promotion of lipid clearance. The ε2 allele is usually associated with an increased risk. There are also opposite-effect loci for the cholesterol ester transfer protein and liver lipase C genes. By understanding the role of lipids in the development and maintenance of AMD, developing treatment methods targeting lipid metabolism-related AMD can provide new solutions for the treatment of AMD related to lipid metabolism.

Key words: Age-related macular degeneration, Lipid metabolism, Retina