Joint Associations of Diet, Lifestyle, and Genes with Age-Related Macular Degeneration.
Joint Associations of Diet, Lifestyle, and Genes with Age-Related Macular Degeneration.
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DOI：
10.1016/j.ophtha.2015.07.029
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发表时间：
2015-11
期刊：
影响因子：
13.7
通讯作者：
Mares JA
中科院分区：
文献类型：
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作者：
Meyers KJ;Liu Z;Millen AE;Iyengar SK;Blodi BA;Johnson E;Snodderly DM;Klein ML;Gehrs KM;Tinker L;Sarto GE;Robinson J;Wallace RB;Mares JA
健康的饮食和生活方式被认为可以预防年龄相关性黄斑变性（AMD），但这些益处是否因高风险AMD基因型而异尚不清楚。目的是研究健康饮食和生活方式与遗传风险对AMD发病率的联合影响。研究了健康生活方式评分及其与AMD风险基因型的相互作用与六年后评估的AMD患病率的关系。在类胡萝卜素相关眼病研究（CAREDS）中的50-79岁女性，暴露和AMD数据可用（N= 1，663）。健康生活方式评分（0-6分）是根据1994-1998年期间评估的健康饮食指数评分、体力活动（MetHrs/周）和吸烟包年数分配的。遗传风险基于补体因子H（CFH）中的Y 402 H和年龄相关性黄斑病变易感基因座2（ARMS 2）中的A69 S。健康生活方式评分和基因型之间的相互作用与AMD的几率进行了评估。在暴露评估后6年（2001-2004年）拍摄立体眼底照片并对AMD进行分级。共有308名女性患有早期AMD，29名患有晚期AMD。与具有低遗传风险（TT）和健康生活方式评分为4-6的女性相比，具有低健康生活方式评分（0-2）和高风险CFH基因型（CC）的女性患AMD的几率高3.3倍（95%CI：1.8-6.1）。在整个样本中，没有显著的相加（SI=1.08，95%CI：0.70-1.67）或相乘（P相互作用=0.94）相互作用。将样本限制为AMD评估前饮食稳定的患者（n=728）加强了联合效应（OR=4.6，95%CI：1.85-11.6），并表明高风险基因型和低生活方式评分相结合的关联性比简单地将两种效应相加所预期的更强（SI=1.34，95%CI：1.05-1.70）。调整膳食叶黄素和玉米黄质衰减，因此部分解释了联合协会。没有显著的证据表明ARMS 2和生活方式评分存在相加或相乘的相互作用。在大多数AMD病例为早期的样本中，这些结果表明高风险Y 402 H基因型和不良饮食和生活方式的影响至少以相加的方式结合联合收割机以影响AMD的几率，但可能联合收割机超过其单独影响的总和。
Healthy diets and lifestyles are thought to protect against age-related macular degeneration (AMD), but whether the benefits vary across high risk AMD genotypes is unknown. The objective is to investigate the joint effects of healthy diet and lifestyle with genetic risk on the odds for AMD. Healthy lifestyles scores and their interactions with AMD risk genotypes were studied in relation to the prevalence of AMD, assessed six years later. Women 50–79 years of age in the Carotenoids in Age-Related Eye Disease Study (CAREDS) with exposure and AMD data available (N=1,663). Healthy lifestyle scores (0–6 points) were assigned based on Healthy Eating Index scores, physical activity (MetHrs/week), and pack years of smoking assessed between 1994–1998. Genetic risk was based on Y402H in complement factor H (CFH) and A69S in age-related maculopathy susceptibility locus 2 (ARMS2). Interactions between healthy lifestyle score and genotype in relation to the odds of AMD were assessed. Stereoscopic fundus photographs were taken and graded for AMD six years after exposure assessment (2001–2004). A total of 308 women had early AMD and 29 had late AMD). The odds of AMD were 3.3 times greater in women with both low healthy lifestyle score (0–2) and high risk CFH genotype (CC), relative to those who had low genetic risk (TT) and healthy lifestyle scores of 4–6 (95% CI:1.8–6.1). There were no significant additive (SI=1.08, 95% CI: 0.70–1.67) or multiplicative (Pinteraction=0.94) interactions in the full sample. Limiting the sample to those with stable diets prior to AMD assessment (n=728) strengthened the joint effects (OR=4.6, 95% CI: 1.85–11.6) and suggested high risk genotype and low lifestyle score combined had a stronger association than expected by simply adding the two effects (SI=1.34, 95% CI: 1.05–1.70). Adjusting for dietary lutein and zeaxanthin attenuated, and therefore partially explained the joint association. There was no significant evidence of additive or multiplicative interactions for ARMS2 and lifestyle score. These results, in a sample in which the majority of AMD cases were early, suggest the effects of high risk Y402H genotype and poor diets and lifestyles combine in at least an additive manner to influence odds for AMD, but may combine to be more than the sum of their individual effects.