Diet and Lifestyle Factors Reducing Risk for Age-Related Eye Disease

摘要 这项应用是为了继续我们对饮食和生活方式因素降低年龄相关眼睛风险的研究 并阐述了国家眼科研究所研究的优先事项，以“描绘出 环境和遗传学是视网膜疾病的危险因素。这些研究的独特之处在于对 维生素D状态、类胡萝卜素状态和广泛健康饮食模式得分的重要性。这是 世界范围内最大的样本，包括记录年龄相关阶段的两张眼睛照片 黄斑变性和眼睛黄斑中类胡萝卜素密度的测量，其中 情况就会发展。之前的资金已经允许收集最全面的一套营养 可用于评估的数据作为年龄相关性黄斑变性(AMD)较低患病率的预测因素，以及 来自美国三个州的50-79岁女性的平均六年后类胡萝卜素的年龄- 相关眼病研究(N=1,787)。因为眼睛照片可以识别早期的变化，在大多数女性 意识到他们的存在，我们能够研究一段时间内可改变的饮食和生活方式习惯 当它们可能影响早期阶段时。我们最近报告了支持保护性作用的证据 维生素D，黄斑类胡萝卜素，叶黄素和玉米黄质，健康的饮食模式和体力活动 AMD早期/中期的发展。有强有力的证据表明，这些早期的变化 对发展到高级阶段有高度的预测性。然而，这些先前的估计是 患有AMD的遗传倾向不同的人之间的关联强度。这个项目，它 是妇女健康倡议的附属机构，可以从储存的血液样本中获取DNA，我们将使用 确定女性患AMD的高危基因的特征，这些高危基因对AMD的风险有强烈的预测作用。 研究并确定维生素D和视网膜类胡萝卜素状况良好的女性的特征。我们将使用这些 计算遗传风险等级分数的数据反映了AMD的总体遗传易感性水平。到时候我们会的 评估健康饮食和生活方式与AMD之间关系的优势是否存在于那些 遗传风险等级得分，与得分较低的女性相比。这些关于以下范围的见解 基于遗传易感性的营养因素的重要性将有助于确定医生和 公共卫生官员可以用来告诉人们饮食可能会降低AMD的发展和恶化的风险， 以受益最大的人群为目标，并激励人们采取预防策略。增加了 最近与类胡萝卜素和维生素D状态相关的候选基因的基因分型 也可能提示AMD的新的遗传预测因子，并提供关于叶黄素和 玉米黄质和维生素D可以预防AMD。

ABSTRACT This application is to continue our studies of "Diet and Lifestyle Factors Reducing Risk for Age-Related Eye Disease" and addresses the National Eye Institute's priority for research to "Delineate the interacting roles of the environment and genetics as risk factors for retinal disease." Unique to these studies is the assessment of the importance of vitamin D status, carotenoid status and scores on broad healthy diet patterns. This is the largest sample, world-wide, that incorporates both eye photographs which document stages of age-related macular degeneration and measurements of the density of the carotenoids in the macula of the eye, where this condition develops. Previous funding has permitted the collection of the most comprehensive set of nutritional data available to evaluate as predictors of lower prevalence of age-related macular degeneration (AMD), an average of six-years later in women 50-79 years of age from three US states in the Carotenoids in Age- Related Eye Disease Study (N=1,787). Because eye photographs identify early changes, before most women are aware of their presence, we were able to study modifiable dietary and lifestyle habits during periods of time when they are likely to influence early stages. We recently reported evidence to support protective roles of vitamin D, the macular carotenoids, lutein and zeaxanthin, healthy diet patterns and physical activity against the development of early/intermediate stages of AMD. There is strong evidence that these early changes are highly predictive of developing advanced stages. However, these previous estimates are "averages" of the strength of associations across people who differ in genetic propensity for developing AMD. This project, which is ancillary to the Women's Health Initiative, has access to DNA from stored blood samples which we will use to characterize women for high risk genotypes which have strongly predicted risk for AMD in recent large studies and to characterize women with good status of vitamin D and retinal carotenoids. We will use these data to calculate genetic risk rank scores reflect level of overall genetic susceptibility to AMD. We will then evaluate whether the strengths of associations of healthy diets and lifestyles to AMD in people who have high, genetic risk rank scores, compared with women who have low scores. These insights about the range of importance of nutritional factors based on genetic susceptibility will help identify strategies that physicians and public health officials can use to inform people of diets that may lower risk for developing and worsening AMD, to target people who will benefit most, and to motivate people to adopt preventive strategies. The addition of genotyping for candidate genes which have recently been related to the status of carotenoids and vitamin D may also suggest new genetic predictors of AMD and provide insights about mechanisms by which lutein and zeaxanthin, and vitamin D, protect against AMD.