Association between dietary glycernic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study
Association between dietary glycernic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study
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DOI：
10.1093/ajcn/86.1.180
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发表时间：
2007-07-01
影响因子：
7.1
通讯作者：
Taylor, Allen
中科院分区：
文献类型：
--
作者：
Chiu, Chung-Jung;Milton, Roy C.;Taylor, Allen
背景：老年性黄斑变性(AMD)是导致不可逆性失明的主要原因。AMD似乎与包括视网膜病变和心血管疾病(CVD)在内的糖尿病相关疾病具有几个与碳水化合物相关的机制和危险因素；然而，到目前为止，只有一项小型研究解决了这个问题。目的：目的：验证饮食血糖指数(DGI)与非糖尿病老年人群中AMD的风险和严重程度相关的假设。设计：来自年龄相关眼病研究(AREDS)的4099名年龄在55-80岁(56%的女性)的参与者的饮食信息。根据玻璃体大小和范围、地理萎缩的存在和新生血管的变化，将基线的8125只合格眼分为5组AMD中的1组。结果：与DGI的前五分位眼相比，DGI的第四和第五分位数眼发生大面积玻璃体萎缩、地理萎缩和新生血管的风险显著或暗示地更高。最高五分位数的多变量调整优势比(95%CI)分别为1.42(1.09，1.84)、1.78(0.81，3.90)和1.41(0.95，2.08)，其中只有大玻璃体的优势比显著。DGI与AMD的严重程度也有显著的正相关关系(P为Trend<；0.001)。DGI高于性别中位数(女性：77.9；男性：79.3)的人患晚期AMD(地理萎缩和新生血管)的风险增加了49%。这一结果表明，如果AREDS参与者食用DGI低于中位数的饮食，20%的AMD流行病例将被消除。结论：基线AREDS横断面分析得出的DGI与AMD之间的关联表明，DGI的降低可能为降低AMD的风险提供了一种手段。
Background: Age-related macular degeneration (AMD) is the major cause of irreversible blindness. AMD appears to share several carbohydrate-related mechanisms and risk factors with diabetes-related diseases, including retinopathy and cardiovascular disease (CVD); however, to date, only one small study has addressed this issue.Objective: The objective was to test the hypothesis that dietary glycemic index (dGI), which has been related to the risk of diabetes and CVD, is associated with the risk and severity of AMD in nondiabetic elderly populations.Design: Dietary information was obtained from 4099 participants aged 55-80 y (56% women) in the Age-Related Eye Disease Study (AREDS). A total of 8125 eligible eyes at baseline were classified into 1 of 5 AMD groups according to the size and extent of drusen, the presence of geographic atrophy, and neovascular changes. We used a generalized estimating approach to evaluate the relations between dGI and risk and severity of AMD with eyes as the unit of analysis.Results: Compared with eyes in the first quintile of dGI, eyes in the fourth and fifth quintiles had a significantly or suggestively higher risk of large drusen, geographic atrophy, and neovascularization. The multivariate-adjusted odds ratios (95% CIs) for the highest quintile were 1.42 (1.09, 1.84), 1.78 (0.81, 3.90), and 1.41 (0.95, 2.08), respectively, of which only the odds ratio for large drusen was significant. A significant positive relation between dGI and severity of AMD was also noted (P for trend < 0.001). There was a 49% increase in the risk of advanced AMD (geographic atrophy plus neovascularization) for persons with a dGI higher than the sex median (women: >= 77.9; men: >= 79.3). This result indicated that 20% of prevalent cases of AMD would have been eliminated if the AREDS participants consumed diets with a dGI below the median.Conclusion: The association between dGI and AMD from the AREDS cross-sectional analysis at baseline suggests that a reduction in the dGI, a modifiable risk factor, may provide a means of diminishing the risk of AMD.