{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T17:36:13Z","timestamp":1768584973460,"version":"3.49.0"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107-2314-B-016 -031-MY3"],"award-info":[{"award-number":["MOST 107-2314-B-016 -031-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-110112"],"award-info":[{"award-number":["TSGH-D-110112"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-110109"],"award-info":[{"award-number":["TSGH-D-110109"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-B-110012"],"award-info":[{"award-number":["TSGH-B-110012"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003559","name":"Ministry of National Defense","doi-asserted-by":"crossref","award":["MND-MAB-110-084"],"award-info":[{"award-number":["MND-MAB-110-084"]}],"id":[{"id":"10.13039\/501100003559","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003559","name":"Ministry of National Defense","doi-asserted-by":"crossref","award":["MAB-E-110001"],"award-info":[{"award-number":["MAB-E-110001"]}],"id":[{"id":"10.13039\/501100003559","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To analyze the association between glucosamine (GlcN) use and the risk of age-related macular degeneration (AMD) using claims data from the National Health Insurance Research Database (NHIRD).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective, population-based study was conducted with NHIRD data from a 14-year period (2000\u20132013). Chi-squared and Student\u2019s t-tests were used to evaluate differences between the study and comparison cohorts for categorical and continuous variables, respectively. Risk factors for disease development were examined by the adjusted hazard ratio (aHR) with 95% confidence interval. Kaplan-Meier analysis was performed to compare the cumulative risk of AMD between the two cohorts.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In total, 1,344 patients with GlcN treatment were enrolled in the study cohort and 5,376 patients without GlcN use were enrolled in the comparison cohort. The incidence rate of AMD was lower with GlcN use (3.65%) than without GlcN use (5.26%) (P = 0.014). GlcN use was associated with a lower risk of developing AMD among patients with hyperlipidemia, coronary artery disease, chronic obstructive pulmonary disease, stroke, other neurological disorders, or degenerative arthritis. Although the incidence of wet type AMD did not significantly differ (P = 0.91), the incidence of dry type AMD was lower in patients with GlcN use (2.9%) than those without GlcN use (4.84%) (P = 0.003). Kaplan-Meier analysis similarly revealed a lower rate of dry type AMD in patients with GlcN use compared to those without GlcN use (log-rank P = 0.004).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>GlcN treatment can decrease the risk of developing dry type AMD. Further prospective controlled studies are needed to determine the effectiveness of GlcN treatment in patients with AMD and the associated mechanism.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251925","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T17:43:31Z","timestamp":1621446211000},"page":"e0251925","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of glucosamine on age-related macular degeneration in patients: A nationwide, population-based cohort study"],"prefix":"10.1371","volume":"16","author":[{"given":"Kathy Ming","family":"Feng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu-Chien","family":"Chien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiann-Torng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Hao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Hsiang","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-An","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-7753","authenticated-orcid":true,"given":"Ching-Long","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"issue":"24","key":"pone.0251925.ref001","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1056\/NEJMra0801537","article-title":"Age-related macular degeneration","volume":"358","author":"RD Jager","year":"2008","journal-title":"The New England journal of medicine"},{"issue":"2","key":"pone.0251925.ref002","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1016\/S2214-109X(13)70145-1","article-title":"Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis","volume":"2","author":"WL Wong","year":"2014","journal-title":"The Lancet Global health"},{"issue":"4","key":"pone.0251925.ref003","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.ajo.2015.06.023","article-title":"Disease Burden in the Treatment of Age-Related Macular Degeneration: Findings From a Time-and-Motion Study","volume":"160","author":"JL Prenner","year":"2015","journal-title":"American journal of ophthalmology"},{"issue":"7","key":"pone.0251925.ref004","doi-asserted-by":"crossref","first-page":"3126","DOI":"10.1167\/iovs.08-1803","article-title":"Prevalence and associated risk factors of age-related macular degeneration in an elderly Chinese population in Taiwan: the Shihpai Eye Study","volume":"49","author":"SJ Chen","year":"2008","journal-title":"Investigative ophthalmology & visual science"},{"issue":"5","key":"pone.0251925.ref005","first-page":"367","article-title":"An international classification and grading system for age-related maculopathy and age-related macular degeneration","volume":"39","author":"AC Bird","year":"1995","journal-title":"The International ARM Epidemiological Study Group. Survey of ophthalmology"},{"issue":"3","key":"pone.0251925.ref006","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/IAE.0000000000000036","article-title":"Current knowledge and trends in age-related macular degeneration: genetics, epidemiology, and prevention","volume":"34","author":"R Velez-Montoya","year":"2014","journal-title":"Retina (Philadelphia, Pa)"},{"issue":"11","key":"pone.0251925.ref007","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1001\/archopht.1984.01040031330019","article-title":"Age-related macular degeneration and blindness due to neovascular maculopathy","volume":"102","author":"FL Ferris","year":"1984","journal-title":"Archives of ophthalmology"},{"issue":"2","key":"pone.0251925.ref008","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.fct.2004.11.006","article-title":"Glucosamine effects in humans: a review of effects on glucose metabolism, side effects, safety considerations and efficacy","volume":"43","author":"JW Anderson","year":"2005","journal-title":"Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association"},{"issue":"3","key":"pone.0251925.ref009","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S0014-5793(01)03255-0","article-title":"Glucosamine modulates IL-1-induced activation of rat chondrocytes at a receptor level, and by inhibiting the NF-\u03baB pathway","volume":"510","author":"JN Gouze","year":"2002","journal-title":"FEBS Letters"},{"issue":"9252","key":"pone.0251925.ref010","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0140-6736(00)03610-2","article-title":"Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial","volume":"357","author":"JY Reginster","year":"2001","journal-title":"The Lancet"},{"issue":"2","key":"pone.0251925.ref011","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1167\/iovs.05-1008","article-title":"Glucosamine Sulfate Inhibits TNF-\u03b1 and IFN-\u03b3-Induced Production of ICAM-1 in Human Retinal Pigment Epithelial Cells In Vitro","volume":"47","author":"J-T Chen","year":"2006","journal-title":"Investigative ophthalmology & visual science"},{"issue":"4","key":"pone.0251925.ref012","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1167\/iovs.11-9291","article-title":"Glucosamine Modulates TNF-\u03b1\u2013Induced ICAM-1 Expression and Function Through O-Linked and N-Linked Glycosylation in Human Retinal Pigment Epithelial Cells","volume":"53","author":"C-L Chen","year":"2012","journal-title":"Investigative ophthalmology & visual science"},{"issue":"12","key":"pone.0251925.ref013","doi-asserted-by":"crossref","first-page":"5441","DOI":"10.1167\/iovs.08-1784","article-title":"Inhibitory Effects of Glucosamine on Endotoxin-Induced Uveitis in Lewis Rats","volume":"49","author":"Y-H Chang","year":"2008","journal-title":"Investigative ophthalmology & visual science"},{"issue":"1","key":"pone.0251925.ref014","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4103\/jmedsci.jmedsci_138_17","article-title":"Glucosamine attenuates hydrogen peroxide-induced premature senescence in human retinal pigment epithelial cells in vitro","volume":"38","author":"C-L Chen","year":"2018","journal-title":"Journal of Medical Sciences"},{"issue":"5","key":"pone.0251925.ref015","article-title":"Glucosamine-Induced Autophagy through AMPK(-)mTOR Pathway Attenuates Lipofuscin-Like Autofluorescence in Human Retinal Pigment Epithelial Cells In Vitro","volume":"19","author":"CL Chen","year":"2018","journal-title":"International journal of molecular sciences"},{"issue":"9","key":"pone.0251925.ref016","doi-asserted-by":"crossref","first-page":"e25416","DOI":"10.1371\/journal.pone.0025416","article-title":"Inducing autophagy by rapamycin before, but not after, the formation of plaques and tangles ameliorates cognitive deficits","volume":"6","author":"S Majumder","year":"2011","journal-title":"PLoS One"},{"key":"pone.0251925.ref017","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.preteyeres.2017.03.002","article-title":"The impact of oxidative stress and inflammation on RPE degeneration in non-neovascular AMD","volume":"60","author":"S Datta","year":"2017","journal-title":"Prog Retin Eye Res"},{"issue":"4","key":"pone.0251925.ref018","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S0161-6420(00)00580-7","article-title":"Risk factors for age-related macular degeneration: Pooled findings from three continents","volume":"108","author":"W Smith","year":"2001","journal-title":"Ophthalmology"},{"key":"pone.0251925.ref019","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/1471-2415-10-31","article-title":"Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis","volume":"10","author":"U Chakravarthy","year":"2010","journal-title":"BMC ophthalmology"},{"issue":"10153","key":"pone.0251925.ref020","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/S0140-6736(18)31550-2","article-title":"Age-related macular degeneration","volume":"392","author":"P Mitchell","year":"2018","journal-title":"Lancet"},{"issue":"4","key":"pone.0251925.ref021","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1001\/archophthalmol.2011.376","article-title":"Prevalence of and risk factors for age-related macular degeneration in a multiethnic Asian cohort","volume":"130","author":"CM Cheung","year":"2012","journal-title":"Archives of ophthalmology"},{"issue":"6","key":"pone.0251925.ref022","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1001\/archophthalmol.2010.92","article-title":"The prevalence of age-related macular degeneration and associated risk factors","volume":"128","author":"R Klein","year":"2010","journal-title":"Archives of ophthalmology"},{"issue":"9","key":"pone.0251925.ref023","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1038\/sj.eye.6701978","article-title":"Smoking and age-related macular degeneration: a review of association","volume":"19","author":"J Thornton","year":"2005","journal-title":"Eye (Lond)"},{"key":"pone.0251925.ref024","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.2147\/CIA.S143508","article-title":"Recent developments in age-related macular degeneration: a review","volume":"12","author":"WM Al-Zamil","year":"2017","journal-title":"Clin Interv Aging"},{"issue":"6","key":"pone.0251925.ref025","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/archopht.126.6.840","article-title":"Pulmonary disease and age-related macular degeneration: the Beaver Dam Eye Study","volume":"126","author":"R Klein","year":"2008","journal-title":"Archives of ophthalmology"},{"issue":"12","key":"pone.0251925.ref026","first-page":"1777","article-title":"Comorbidity of dementia and age-related macular degeneration calls for clinical awareness: a meta-analysis","volume":"103","author":"SS Rong","year":"2019","journal-title":"Br J Ophthalmol"},{"issue":"9","key":"pone.0251925.ref027","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00018-016-2147-8","article-title":"Inflammation and its role in age-related macular degeneration","volume":"73","author":"A Kauppinen","year":"2016","journal-title":"Cell Mol Life Sci"},{"issue":"13","key":"pone.0251925.ref028","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1042\/CS20160487","article-title":"Cellular and molecular mechanisms of asthma and COPD","volume":"131","author":"PJ Barnes","year":"2017","journal-title":"Clin Sci (Lond)"},{"key":"pone.0251925.ref029","doi-asserted-by":"crossref","first-page":"l1628","DOI":"10.1136\/bmj.l1628","article-title":"Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank","volume":"365","author":"H Ma","year":"2019","journal-title":"BMJ"},{"issue":"6","key":"pone.0251925.ref030","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1136\/annrheumdis-2020-217176","article-title":"Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study","volume":"79","author":"ZH Li","year":"2020","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"pone.0251925.ref031","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1167\/iovs.09-4207","article-title":"Soluble and mature amyloid fibrils in drusen deposits","volume":"51","author":"JM Isas","year":"2010","journal-title":"Investigative ophthalmology & visual science"},{"issue":"11","key":"pone.0251925.ref032","doi-asserted-by":"crossref","first-page":"e012177","DOI":"10.1136\/bmjopen-2016-012177","article-title":"Commonly prescribed drugs associate with cognitive function: a cross-sectional study in UK Biobank","volume":"6","author":"AJ Nevado-Holgado","year":"2016","journal-title":"BMJ Open"},{"issue":"16","key":"pone.0251925.ref033","article-title":"Glucosamine Enhancement of BDNF Expression and Animal Cognitive Function","volume":"25","author":"LY Chou","year":"2020","journal-title":"Molecules"},{"issue":"10","key":"pone.0251925.ref034","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1007\/s00296-012-2416-2","article-title":"Role of glucosamine in the treatment for osteoarthritis","volume":"32","author":"JY Reginster","year":"2012","journal-title":"Rheumatol Int"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T17:43:55Z","timestamp":1621446235000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251925"}},"subtitle":[],"editor":[{"given":"Der-Chong","family":"Tsai","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,19]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0251925","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,19]]}}}