维生素补充剂的使用与白内障：蓝山眼研究

Use of vitamin supplements and cataract: the Blue Mountains Eye Study.

作者信息

Kuzniarz M, Mitchell P, Cumming R G, Flood V M

机构信息

Departments of Ophthalmology and Public Health & Community Medicine, the University of Sydney, Sydney, Australia.

出版信息

Am J Ophthalmol. 2001 Jul;132(1):19-26. doi: 10.1016/s0002-9394(01)00922-9.

DOI:10.1016/s0002-9394(01)00922-9

PMID:11438049

Abstract

PURPOSE

To investigate relationships between use of vitamin supplements and the three principal cataract types in a population-based sample.

METHODS

We studied 2873 of the 3654 participants (79%) aged 49 to 97 years attending the cross-sectional Blue Mountains Eye Study who completed a detailed food frequency questionnaire, which included type, dose, and duration of vitamin supplement use. Masked grading of nuclear, cortical, and posterior subcapsular opacities from lens photographs was performed, using the Wisconsin method.

RESULTS

Use of multivitamin supplements was associated with reduced prevalence of nuclear cataract, odds ratio 0.6, 95% confidence interval 0.4 to 1.0, P =.05. For both nuclear and cortical cataract, longer duration of multivitamin use was associated with reduced cataract prevalence (nuclear cataract, trend P =.02; cortical cataract, trend P =.03). Use of thiamin supplements was associated with reduced prevalence of nuclear (odds ratio 0.6, confidence interval 0.4 to 1.0, P =.03, dose trend P =.03) and cortical cataract (odds ratio 0.7, confidence interval 0.5 to 0.9, P =.01, dose trend P =.02). Riboflavin (odds ratio 0.8, confidence interval 0.6 to 1.0, P =.05) and niacin (odds ratio 0.7, confidence interval 0.6 to 1.0, P =.04) supplements exerted a weaker protective influence on cortical cataract. Vitamin A supplements were protective against nuclear cataract (odds ratio 0.4, confidence interval 0.2 to 0.8, P =.01, dose trend P =.01). Folate (odds ratio 0.4, confidence interval 0.2 to 0.9, P =.03) appeared protective for nuclear cataract, whereas both folate (odds ratio 0.6, confidence interval 0.3 to 0.9, P =.01, dose trend P =.04) and vitamin B12 supplements (odds ratio 0.7, confidence interval 0.5 to 1.0, P =.03, dose trend P =.02) were strongly protective against cortical cataract.

CONCLUSIONS

Long-term use of multivitamins, B group and vitamin A supplements was associated with reduced prevalence of either nuclear or cortical cataract. A strong protective influence on cortical cataract, from use of folate or vitamin B12 supplements, is a new finding.

摘要

目的

在一个基于人群的样本中研究维生素补充剂的使用与三种主要白内障类型之间的关系。

方法

我们对参加蓝山眼科横断面研究的3654名年龄在49至97岁的参与者中的2873人（79%）进行了研究，这些参与者完成了一份详细的食物频率问卷，其中包括维生素补充剂的类型、剂量和使用持续时间。使用威斯康星方法对晶状体照片中的核性、皮质性和后囊下混浊进行盲法分级。

结果

使用多种维生素补充剂与核性白内障患病率降低相关，比值比为0.6，95%置信区间为0.4至1.0，P = 0.05。对于核性和皮质性白内障，多种维生素使用时间越长，白内障患病率越低（核性白内障，趋势P = 0.02；皮质性白内障，趋势P = 0.03）。使用硫胺素补充剂与核性（比值比0.6，置信区间0.4至1.0，P = 0.03，剂量趋势P = 0.03）和皮质性白内障患病率降低相关（比值比0.7，置信区间0.5至0.9，P = 0.01，剂量趋势P = 0.02）。核黄素（比值比0.8，置信区间0.6至1.0，P = 0.05）和烟酸（比值比0.7，置信区间0.6至1.0，P = 0.04）补充剂对皮质性白内障的保护作用较弱。维生素A补充剂可预防核性白内障（比值比0.4，置信区间0.2至0.8，P = 0.01，剂量趋势P = 0.01）。叶酸（比值比0.4，置信区间0.2至0.9，P = 0.03）似乎对核性白内障有保护作用，而叶酸（比值比0.6，置信区间0.3至0.9，P = 0.01，剂量趋势P = 0.04）和维生素B12补充剂（比值比0.7，置信区间0.5至1.0，P = 0.03，剂量趋势P = 0.02）对皮质性白内障均有较强的保护作用。