Further evaluation of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment - Subgroup analyses
Further evaluation of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment - Subgroup analyses
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DOI：
10.1001/archopht.122.9.1306
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Schaefer, E
中科院分区：
文献类型：
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作者：
Berson, EL;Rosner, B;Schaefer, E
目的:确定二十二碳六烯酸将减缓子组的视网膜变性的视网膜色素变性患者正在接受维生素A.Design:一群208色素性视网膜炎患者,年龄在18岁到55岁,被随机分配到1200毫克的二十二碳六烯酸+ 15000 IU / d的维生素A作为视黄基棕榈酸酯(DHA +一组)或控制脂肪酸+ 15000 IU维生素A / d(控制+一组)和随访4年。每组有70%的病人服用。维生素A， 15000 IU/d。我们比较了DHA+A组与对照组+A组在进入前使用或不使用维生素A的亚组中眼功能下降的比率。我们还确定了眼功能下降是否与红细胞磷脂酰乙醇胺二十二碳六烯酸水平、饮食中omega-3脂肪酸的摄入量或使用维生素A的持续时间有关。主要观察指标为Humphrey Field Analyzer视野灵敏度、30 hz视网膜电图振幅和视力。结果：在入院前未服用维生素A的患者中，DHA+A组前2年的视场敏感度和视网膜电图幅度下降速度较对照组+A组慢（P = 0.01和P = 0.03）；这些差异在第3年和第4年的随访中没有观察到，也没有在入院前服用维生素A的患者中观察到。在整个队列中，红细胞磷脂酰乙醇胺二十二碳六烯酸水平与4年内总场敏感性下降率呈负相关(趋势检验，P =。05)。这在入组前两年未服用维生素A的人群中尤为明显（趋势检验，P = 0.003）。在整个对照组+A组中，饮食中w-3脂肪酸的摄入量与4年内总电场敏感性的丧失呈负相关(摄入量；
Objective: To determine whether docosahexaenoic acid will slow the course of retinal degeneration in subgroups of patients with retinitis pigmentosa who are receiving vitamin A.Design: A cohort of 208 patients with retinitis pigmentosa, aged 18 to 55 years, were randomly assigned to 1200 mg of docosahexaenoic acid plus 15000 IU/d of vitamin A given as retinyl palmitate (DHA+A group) or control fatty acid plus 15000 IU/d of vitamin A (control+A group) and followed up over 4 years. Seventy percent of the patients in each group were taking. vitamin A, 15000 IU/d, prior to entry. We compared rates of decline in ocular function in the DHA+A vs control+A groups among the subgroups defined by use or nonuse of vitamin A prior to entry. We also determined whether decline in ocular function was related to red blood cell phosphatidylethanolamine docosahexaenoic acid level, dietary omega-3 fatty acid intake, or duration of vitamin A use. Main outcome measures were Humphrey Field Analyzer visual field sensitivity, 30-Hz electroretinogram amplitude, and visual acuity.Results: Among patients not taking vitamin A prior to entry, those in the DHA+A group had a slower declinein field sensitivity and electroretinogram amplitude than those in the control+A group over the first 2 years (P = .01 and P = .03, respectively); these differences were not observed in years 3 and 4 of follow-up or among patients taking vitamin A prior to entry. In the entire cohort, red blood cell phosphatidylethanolamine docosahexaenoic acid level was inversely related to rate of decline in total field sensitivity over 4 years (test for trend, P =. 05). This was particularly evident over the first 2 years among those not on vitamin A prior to entry (test for trend, P = .003). In the entire control+A group, dietary w-3 fatty acid intake was inversely related to loss of total field sensitivity over 4 years (intake,