DIETARY CAROTENOIDS, VITAMIN-A, VITAMIN-C, AND VITAMIN-E, AND ADVANCED AGE-RELATED MACULAR DEGENERATION
DIETARY CAROTENOIDS, VITAMIN-A, VITAMIN-C, AND VITAMIN-E, AND ADVANCED AGE-RELATED MACULAR DEGENERATION
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DOI：
10.1001/jama.272.18.1413
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发表时间：
1994-11-09
影响因子：
120.7
通讯作者：
WILLETT, W
中科院分区：
文献类型：
--
作者：
SEDDON, JM;AJANI, UA;WILLETT, W
目的.-评估膳食中类胡萝卜素和维生素 A、C 和 E 的摄入量与新生血管性年龄相关性黄斑变性 (AMD) 风险之间的关系，新生血管性年龄相关性黄斑变性是成人不可逆性失明的主要原因。设计.-多中心眼病病例对照研究。设置.-美国五个眼科中心。患者.-总共 356 例受试者，他们在入组前 1 年内被诊断为晚期 AMD，年龄55 至 80 岁，居住在参与临床中心附近。 520 名对照受试者与病例受试者来自同一地理区域，患有其他眼部疾病，并根据年龄和性别与病例进行频率匹配。主要结果指标：- 通过使用多重逻辑回归分析，根据抗氧化状态的饮食指标、控制吸烟和其他危险因素来估计 AMD 的相对风险。结果：- 膳食中类胡萝卜素的摄入量较高与 AMD 的风险较低相关。调整 AMD 的其他风险因素后，我们发现类胡萝卜素摄入量最高五分之一的人患 AMD 的风险比最低五分之一的人低 43%（比值比，0.57；95% 置信区间，0.35 至 0.92；趋势 P=0.02）。在特定的类胡萝卜素中，叶黄素和玉米黄质主要从深绿色叶类蔬菜中获得，与降低 AMD 风险的相关性最强（趋势 P=0.001）。一些富含类胡萝卜素的食物与 AMD 呈负相关。特别是，较高频率地摄入菠菜或羽衣甘蓝与显着降低 AMD 风险相关（P 为趋势
Objective.-To evaluate the relationships between dietary intake of carotenoids and vitamins A, C, and E and the risk of neovascular age-related macular degeneration (AMD), the leading cause of irreversible blindness among adults.Design.-The multicenter Eye Disease Case-Control Study.Setting.-Five ophthalmology centers in the United States.Patients.-A total of 356 case subjects who were diagnosed with the advanced stage of AMD within 1 year prior to their enrollment, aged 55 to 80 years, and residing near a participating clinical center. The 520 control subjects were from the same geographic areas as case subjects, had other ocular diseases, and were frequency-matched to cases according to age and sex.Main Outcome Measures.-The relative risk for AMD was estimated according to dietary indicators of antioxidant status, controlling for smoking and other risk factors, by using multiple logistic-regression analyses.Results.-A higher dietary intake of carotenoids was associated with a lower risk for AMD. Adjusting for other risk factors for AMD, we found that those in the highest quintile of carotenoid intake had a 43% lower risk for AMD compared with those in the lowest quintile (odds ratio, 0.57; 95% confidence interval, 0.35 to 0.92; P for trend=.02). Among the specific carotenoids, lutein and zeaxanthin, which are primarily obtained from dark green, leafy vegetables, were most strongly associated with a reduced risk for AMD (P for trend=.001). Several food items rich in carotenoids were inversely associated with AMD. In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD (P for trend