Dietary intake of antioxidants and risk of age-related macular degeneration
Dietary intake of antioxidants and risk of age-related macular degeneration
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DOI：
10.1001/jama.294.24.3101
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发表时间：
2005-12-28
影响因子：
120.7
通讯作者：
de Jong, PTVM
中科院分区：
文献类型：
--
作者：
van Leeuwen, R;Boekhoorn, S;de Jong, PTVM
背景年龄相关性黄斑变性（AMD）是发达国家不可逆性失明的最常见原因。最近，高剂量补充 β 胡萝卜素、维生素 C 和 E 以及锌被证明可以减缓 AMD 的进展。目的 研究定期膳食摄入抗氧化剂是否与降低 AMD 发生风险相关。设计 在鹿特丹研究 (19901993) 中，使用半定量食物频率问卷对基线膳食摄入量进行评估。直到 2004 年最终随访的 AMD 事件是根据国际分类和分级系统以遮蔽方式对眼底颜色透明度进行分级来确定的。设置荷兰鹿特丹中产阶级郊区所有 55 岁或以上居民的基于人口的队列。参与者在基线时有 AMD 风险的 5836 人中，4765 人有可靠的饮食数据，4170 人参与了研究 主要结果指标 事件AMD，定义为软性明显玻璃疣伴色素改变、不明显或网状玻璃膜疣、地理萎缩或脉络膜新生血管形成。结果 平均随访8.0 年（范围0.3-13.9 年）后，560 名参与者发生AMD 事件。膳食中维生素 E 和锌的摄入量与 AMD 的发生呈负相关。维生素 E 摄入量每增加标准差的风险比 (HR) 为 0.92（95% 置信区间 [CI]，0.84-1.00），锌的风险比为 0.91（95% CI，0.83-0.98）。 β-胡萝卜素、维生素 C、维生素 E 和锌这 4 种营养素的摄入量均高于中位数，AMD 风险降低 35%（HR，0.65；95% Cl，0.46-0.92）。排除补充剂使用者并不影响结果。 结论 在这项研究中，高膳食摄入 β 胡萝卜素、维生素 C 和 E 以及锌与老年人 AMD 风险的大幅降低相关。
Context Age-related macular degeneration (AMD) is the most prevalent cause of irreversible blindness in developed countries. Recently, high-dose supplementation with beta carotene, vitamins C and E, and zinc was shown to slow the progression of AMD.Objective To investigate whether regular dietary intake of antioxidants is associated with a lower risk of incident AMD.Design Dietary intake was assessed at baseline in the Rotterdam Study (19901993) using a semiquantitative food frequency questionnaire. Incident AMD until final follow-up in 2004 was determined by grading fundus color transparencies in a masked way according to the International Classification and Grading System.Setting Population-based cohort of all inhabitants aged 55 years or older in a middle-class suburb of Rotterdam, the Netherlands.Participants Of 5836 persons at risk of AMD at baseline, 4765 had reliable dietary data and 4170 participated in the follow-up.Main Outcome Measure Incident AMD, defined as soft distinct drusen with pigment alterations, indistinct or reticular drusen, geographic atrophy, or choroidal neovascularization.Results Incident AMD occurred in 560 participants after a mean follow-up of 8.0 years (range, 0.3-13.9 years). Dietary intake of both vitamin E and zinc was inversely associated with incident AMD. The hazard ratio (H R) per standard deviation increase of intake for vitamin E was 0.92 (95% confidence interval [CI], 0.84-1.00) and for zinc was 0.91 (95% Cl, 0.83-0.98). An above-median intake of all 4 nutrients, beta carotene, vitamin C, vitamin E, and zinc, was associated with a 35% reduced risk (HR, 0.65; 95% Cl, 0.46-0.92) of AMD. Exclusion of supplement users did not affect the results.Conclusion In this study, a high dietary intake of beta carotene, vitamins C and E, and zinc was associated with a substantially reduced risk of AMD in elderly persons.