长期营养摄入与早期年龄相关性晶状体核混浊

Long-term nutrient intake and early age-related nuclear lens opacities.

作者信息

Jacques P F, Chylack L T, Hankinson S E, Khu P M, Rogers G, Friend J, Tung W, Wolfe J K, Padhye N, Willett W C, Taylor A

机构信息

Laboratory for Nutrition and Vision, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA 02111, USA.

出版信息

Arch Ophthalmol. 2001 Jul;119(7):1009-19. doi: 10.1001/archopht.119.7.1009.

DOI:10.1001/archopht.119.7.1009

PMID:11448323

Abstract

OBJECTIVE

To assess the relation between usual nutrient intake and subsequently diagnosed age-related nuclear lens opacities.

SUBJECTS

Four hundred seventy-eight nondiabetic women aged 53 to 73 years from the Boston, Mass, area without previously diagnosed cataracts sampled from the Nurses' Health Study cohort.

METHODS

Usual nutrient intake was calculated as the average intake from 5 food frequency questionnaires that were collected during a 13- to 15-year period before the evaluation of lens opacities. The duration of vitamin supplement use was determined from 7 questionnaires collected during this same period. We defined nuclear opacities as a nuclear opalescence grade of 2.5 or higher using the Lens Opacification Classification System III.

RESULTS

The prevalence of nuclear opacification was significantly lower in the highest nutrient intake quintile category relative to the lowest quintile category for vitamin C (P<.001), vitamin E (P =.02), riboflavin (P =.005), folate (P =.009), beta-carotene (P =.04), and lutein/zeaxanthin (P =.03). After adjustment for other nutrients, only vitamin C intake remained significantly associated (P =.003 for trend) with the prevalence of nuclear opacities. The prevalence of nuclear opacities was significantly lower (P<.001) in the highest vitamin C intake quintile category relative to the lowest quintile category (odds ratio, 0.31; 95% confidence interval, 0.16-0.58). There were also statistically significant trends of decreasing prevalence of nuclear opacities with increasing duration of use of vitamin C (P =.004 for trend), vitamin E (P =.03 for trend), and multivitamin (P =.04 for trend) supplements, but only duration of vitamin C supplement use remained significantly associated with nuclear opacities after mutual adjustment for use of vitamin E (P =.05 for trend) or multivitamin (P =.02 for trend) supplements. The prevalence of nuclear opacities was significantly lower (P =.004) for women who used a vitamin C supplement for 10 or more years relative to women who never used vitamin C supplements (odds ratio, 0.36; 95% confidence interval, 0.18-0.72). Plasma measures of vitamins C and E taken at the eye examination were also inversely associated with the prevalence of nuclear opacities.

CONCLUSION

These results provide additional evidence that antioxidant nutrients play a role in the prevention of age-related nuclear lens opacities.

摘要

目的

评估日常营养摄入量与随后诊断出的年龄相关性核性晶状体混浊之间的关系。

研究对象

从护士健康研究队列中抽取的478名年龄在53至73岁之间、来自马萨诸塞州波士顿地区且此前未被诊断出患有白内障的非糖尿病女性。

方法

日常营养摄入量通过在评估晶状体混浊前13至15年期间收集的5份食物频率问卷的平均摄入量来计算。维生素补充剂的使用时长根据同一时期收集的7份问卷来确定。我们使用晶状体混浊分级系统III将核性混浊定义为核透明度等级为2.5或更高。

结果

相对于维生素C（P<0.001）、维生素E（P = 0.02）、核黄素（P = 0.005）、叶酸（P = 0.009）、β-胡萝卜素（P = 0.04）和叶黄素/玉米黄质（P = 0.03）摄入量最低的五分位数类别，最高营养摄入量五分位数类别中的核性混浊患病率显著更低。在对其他营养素进行调整后，只有维生素C摄入量与核性混浊患病率仍显著相关（趋势P = 0.003）。相对于最低五分位数类别，最高维生素C摄入量五分位数类别中的核性混浊患病率显著更低（P<0.001）（比值比，0.31；95%置信区间，0.16 - 0.58）。随着维生素C（趋势P = 0.004）、维生素E（趋势P = 0.03）和多种维生素（趋势P = 0.04）补充剂使用时长的增加，核性混浊患病率也存在统计学上的显著下降趋势，但在对维生素E（趋势P = 0.05）或多种维生素（趋势P = 0.02）补充剂的使用进行相互调整后，只有维生素C补充剂的使用时长仍与核性混浊显著相关。相对于从未使用过维生素C补充剂的女性，使用维生素C补充剂达10年或更长时间的女性的核性混浊患病率显著更低（P = 0.004）（比值比，0.36；95%置信区间，0.18 - 0.72）。在眼部检查时测得的血浆维生素C和维生素E水平也与核性混浊患病率呈负相关。