Flood Victoria, Smith Wayne, Wang Jie Jin, Manzi Fiona, Webb Karen, Mitchell Paul
Department of Public Health and Community Medicine, Westmead Hospital, University of Sydney, Sydney, Australia.
Ophthalmology. 2002 Dec;109(12):2272-8. doi: 10.1016/s0161-6420(02)01263-0.
To investigate associations between dietary intake, including modest supplement intake, of antioxidant vitamins and zinc at baseline and the 5-year incidence of early age-related maculopathy (ARM).
Population-based cohort study.
From 1992 through 1994, 3654 persons aged 49 years or more (82% of those eligible) living in two postcode areas west of Sydney, Australia, were examined for the Blue Mountains Eye Study baseline. Five years later, 2335 persons (75% of known survivors) were reexamined.
A 145-item Food Frequency Questionnaire (FFQ) was used to assess nutrient intakes. Of the 2335 people who attended a follow-up visit, 1989 (85%) had completed a FFQ at baseline. The nutrients examined in this study included: alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, lycopene, retinol, vitamin A, vitamin C, and zinc.
Early ARM was assessed by masked grading of stereo retinal photographs. Definitions for incidence closely followed those used in the Beaver Dam Eye Study.
Early ARM developed in 192 persons (8.7% 5-year incidence) who did not have either late or early ARM at baseline. Of these, 159 persons completed the FFQ at baseline. After adjusting for age, gender, family history of ARM, and smoking status at baseline, no associations, or any trends suggesting possible association, were found between baseline intake of the nutrients examined, apart from vitamin C, and the 5-year incidence of early ARM. Compared with the lowest quintile, increasing baseline intakes of vitamin C, from diet and supplements, was associated with an increased risk of incident early ARM (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.0-3.0; and OR, 2.3; 95% CI, 1.3-4.0 for the fourth and fifth quintiles, respectively).
Our cohort study of an older population could not find evidence of protection associated with usual dietary antioxidant or zinc intakes (including use of supplements) on the 5-year incidence of early ARM.
研究基线时抗氧化维生素和锌的膳食摄入量（包括适量补充剂摄入量）与早期年龄相关性黄斑病变（ARM）5年发病率之间的关联。
基于人群的队列研究。
1992年至1994年期间，对居住在澳大利亚悉尼以西两个邮政编码区域的3654名49岁及以上的人（占符合条件者的82%）进行了蓝山眼研究基线检查。五年后，对2335人（占已知幸存者的75%）进行了复查。
使用一份包含145个条目的食物频率问卷（FFQ）来评估营养素摄入量。在参加随访的2335人中，1989人（85%）在基线时完成了FFQ。本研究中检测的营养素包括：α-胡萝卜素、β-胡萝卜素、β-隐黄质、叶黄素和玉米黄质、番茄红素、视黄醇、维生素A、维生素C和锌。
通过对立体视网膜照片进行盲法分级来评估早期ARM。发病率的定义严格遵循比弗迪姆眼研究中使用的定义。
192人（5年发病率为8.7%）在基线时既没有晚期也没有早期ARM，但后来出现了早期ARM。其中，159人在基线时完成了FFQ。在对年龄、性别、ARM家族史和基线吸烟状况进行调整后，除维生素C外，所检测营养素的基线摄入量与早期ARM的5年发病率之间未发现关联，也没有任何表明可能存在关联的趋势。与最低五分位数相比，从饮食和补充剂中增加维生素C的基线摄入量与早期ARM发病风险增加相关（第四和第五五分位数的优势比[OR]分别为1.7；95%置信区间[CI]，1.0 - 3.0；以及OR，2.3；95% CI，1.3 - 4.0）。
我们对老年人群的队列研究未能发现常规膳食抗氧化剂或锌摄入量（包括使用补充剂）与早期ARM 5年发病率之间存在保护关联的证据。
