The Role of Vitamin D in Retinal Diseases in Aging

维生素 D 在衰老引起的视网膜疾病中的作用

• 批准号: 8271961
• 负责人: Amy Elizabeth Millen
• 金额: $ 41.73万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8271961
• 关键词: 25-hydroxyvitamin D; Accounting; African American; Age related macular degeneration; Aging; Anti-Inflammatory Agents; Anti-inflammatory; Atherosclerosis; Automobile Driving; Biological Assay; Blindness; Blood Glucose; Blood Pressure; Blood specimen; Caucasians; Caucasoid Race; Chronic Disease; Communities; Complement Factor H; Cost Measures; Data; Development; Diabetes Mellitus; Diabetic Retinopathy; Dietary Supplementation; Dietary intake; Disease; Disease Progression; Elderly; Epidemiologic Studies; Exercise; Eye diseases; Genes; Genetic; Goals; Health; Health Care Costs; Incidence; Individual; Lead; Life; Longitudinal Studies; Minority; Participant; Persons; Physical activity; Play; Population; Population Attributable Risks; Prevalence; Prevalence Study; Prevention therapy; Property; Prospective Studies; Quality of life; Reading; Research; Retinal; Retinal Diseases; Risk; Risk Factors; Role; Sampling; Serum; Smoking; Time; United States; Vision; Visit; Vitamin D; Vitamin D Deficiency; Vitamins; Woman; Work; age related; aging population; blood glucose regulation; cohort; cost; follow-up; food preparation; high risk; men; middle age; modifiable risk; population based; prevent; prospective

DESCRIPTION (provided by applicant): The number of aging individuals with the vision threatening diseases of diabetic retinopathy (DR) and age- related macular degeneration (AMD) is projected to increase in the coming decades as the aging population of the United States grows. Identifying new modifiable factors that prevent or delay vision threatening disease is significant because it will reduce the burden of health care costs for treatment of such chronic diseases and extend the years that the elderly can be independent and participate in such vision dependent activities as driving, reading, exercise, and food preparation. Vitamin D deficiency and inadequacy is prevalent in a large portion of the aging US population, and vitamin D has been shown to have anti-inflammatory and anti- angiogenic properties, in addition to potentially modulating blood pressure and glucose control. The long-term goal of the proposed research is to better understand the role of vitamin D status in retinal diseases highly prevalent in aging individuals. Minimal research has investigated the association between vitamin D status and DR; although a strong biologic rationale supports vitamin D status as a potential modifiable risk factor for DR development and progression. At the same time, research in two large epidemiologic studies show that people with vitamin D deficiency or inadequacy (25-hydroxyvitamin D (25(OH)D)<50 nmol/L) are more likely to have prevalent AMD, but no prospective studies of AMD incidence and vitamin D status have been conducted. We hypothesize that individuals with deficient or inadequate vitamin D status, compared to individuals with adequate status, will be more likely to have AMD and DR and be more likely to develop AMD. The purpose of this proposal is to investigate associations between vitamin D status and both DR and AMD using data from the aging (45-64 years) Atherosclerosis Risk in Communities (ARIC) population-based, biracial (African American and Caucasian) cohort. We propose to use previously collected data, including graded retinal photographs for DR and AMD status, and assayed serum 25(OH)D concentrations from ARIC study participants collected from 1987-1995, as well as graded retinal photographs currently being obtained in a follow-up study (2011-2013). Specifically, we propose to investigate the association between vitamin D status, assessed at Visit 2 (1990-1992), and 1) the presence of DR assessed at Visit 3 (1993-1995) among 1,657 individuals with diabetes and 2) the presence of AMD assessed at Visit 3 (1993-1995) among 11,532 participants. Third, we also proposed to investigate, for the first time, the association between vitamin D status, assessed in 1990-1992, and the incidence or progression of AMD (from 1993-1995 to 2011-2013) in a sample of approximately 2,346 ARIC participants. This study will advance our understanding of vitamin D status in relation to common vision-threatening eye diseases in the elderly and could lead to new therapies for the prevention or reduced progression of these diseases. PUBLIC HEALTH RELEVANCE: Diabetic retinopathy (DR) and age-related macular degeneration (AMD) are common vision-threatening eye diseases among the elderly. Current work suggests that persons with adequate vitamin D status are less likely to have AMD, but little work exists on the relationship of vitamin D and DR. Using data from a population-based, longitudinal study of aging African American and Caucasian men and women, we purpose to investigate the association between vitamin D status and prevalent DR and AMD; and second, we propose to investigate, for the first time, the association between vitamin D status and incidence or progression of AMD.

描述（由申请人提供）：随着美国老龄化人口的增长，患有糖尿病视网膜病变（DR）和年龄相关性黄斑变性（AMD）等视力威胁疾病的老年人数量预计将在未来几十年增加。发现新的可改变的因素来预防或延缓威胁视力的疾病是很重要的，因为这将减少治疗这些慢性疾病的卫生保健费用负担，延长老年人能够独立并参与诸如驾驶、阅读、运动和准备食物等依赖视力的活动的时间。维生素D缺乏和不足在美国大部分老年人口中普遍存在，维生素D已被证明具有抗炎和抗血管生成特性，此外还可能调节血压和血糖控制。这项研究的长期目标是更好地了解维生素D在老年人视网膜疾病中的作用。很少有研究调查维生素D水平与糖尿病之间的关系；尽管强有力的生物学原理支持维生素D状态是DR发生和进展的潜在可改变风险因素。同时，两项大型流行病学研究表明，维生素D缺乏或不足（25-羟基维生素D (25(OH)D)<50 nmol/L）的人更容易发生AMD，但没有对AMD发病率和维生素D状况进行前瞻性研究。我们假设，与维生素D充足的个体相比，维生素D缺乏或不足的个体更容易患AMD和DR，也更容易发展为AMD。本提案的目的是研究维生素D状态与DR和AMD之间的关系，使用基于社区（ARIC）人群的老年（45-64岁）动脉粥样硬化风险的数据，双种族（非洲裔美国人和高加索人）队列。我们建议使用先前收集的数据，包括DR和AMD状态的分级视网膜照片，1987-1995年ARIC研究参与者的血清25(OH)D浓度测定，以及目前在随访研究（2011-2013）中获得的分级视网膜照片。具体来说，我们建议调查在第二次访问（1990-1992）评估的维生素D状态，1)在第3次访问（1993-1995）评估的1,657名糖尿病患者中DR的存在，以及2)在第3次访问（1993-1995）评估的11,532名参与者中AMD的存在之间的关系。第三，我们还首次提出调查1990-1992年评估的维生素D状态与AMD（1993-1995年至2011-2013年）的发病率或进展之间的关系，在大约2,346名ARIC参与者的样本中。这项研究将促进我们对维生素D状态与老年人常见视力威胁眼病的关系的理解，并可能导致预防或减少这些疾病进展的新疗法。