Delcourt Cécile, Carrière Isabelle, Delage Martine, Barberger-Gateau Pascale, Schalch Wolfgang
Institut National de la Santé et de la Recherche Médicale (INSERM), Research Unit U593 for Epidemiology, Public Health and Development, Université Victor Segalen Bordeaux 2, Bordeaux, France.
Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2329-35. doi: 10.1167/iovs.05-1235.
To assess the associations of plasma lutein and zeaxanthin and other carotenoids with the risk of age-related maculopathy (ARM) and cataract in the population-based Pathologies Oculaires Liées à l'Age (POLA) Study.
Retinal photographs were graded according to the international classification. ARM was defined by the presence of late ARM (neovascular ARM, geographic atrophy) and/or soft indistinct drusen (>125 microm) and/or soft distinct drusen (>125 microm) associated with pigmentary abnormalities. Cataract classification was based on a direct standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Plasma carotenoids were measured by high-performance liquid chromatography (HPLC), in 899 subjects of the cohort.
After multivariate adjustment, the highest quintile of plasma zeaxanthin was significantly associated with reduced risk of ARM (OR=0.07; 95% CI: 0.01-0.58; P for trend=0.005), nuclear cataract (OR=0.23; 95% CI: 0.08-0.68; P for trend=0.003) and any cataract (OR=0.53; 95% CI: 0.31-0.89; P for trend=0.01). ARM was significantly associated with combined plasma lutein and zeaxanthin (OR=0.21; 95% CI: 0.05-0.79; P for trend=0.01), and tended to be associated with plasma lutein (OR=0.31; 95% CI: 0.09-1.07; P for trend=0.04), whereas cataract showed no such associations. Among other carotenoids, only beta-carotene showed a significant negative association with nuclear cataract, but not ARM.
These results are strongly suggestive of a protective role of the xanthophylls, in particular zeaxanthin, for the protection against ARM and cataract.
在基于人群的年龄相关性眼病（POLA）研究中，评估血浆叶黄素、玉米黄质和其他类胡萝卜素与年龄相关性黄斑病变（ARM）及白内障风险之间的关联。
视网膜照片根据国际分类进行分级。ARM的定义为存在晚期ARM（新生血管性ARM、地图样萎缩）和/或软性边界不清的玻璃膜疣（>125微米）和/或软性边界清晰的玻璃膜疣（>125微米）并伴有色素异常。白内障分类基于裂隙灯直接标准化晶状体检查，依据晶状体混浊分类系统III。通过高效液相色谱法（HPLC）测定了队列中899名受试者的血浆类胡萝卜素。
经过多变量调整后，血浆玉米黄质最高五分位数与ARM风险降低显著相关（比值比[OR]=0.07；95%置信区间[CI]：0.01 - 0.58；趋势P值=0.005）、核性白内障（OR=0.23；95% CI：0.08 - 0.68；趋势P值=0.003）和任何类型的白内障（OR=0.53；95% CI：0.31 - 0.89；趋势P值=0.01）。ARM与血浆叶黄素和玉米黄质联合显著相关（OR=0.21；95% CI：0.05 - 0.79；趋势P值=0.01），并且倾向于与血浆叶黄素相关（OR=0.31；95% CI：0.09 - 1.07；趋势P值=0.04），而白内障未显示出此类关联。在其他类胡萝卜素中，只有β - 胡萝卜素与核性白内障呈显著负相关，但与ARM无关。
这些结果强烈提示叶黄素，尤其是玉米黄质，在预防ARM和白内障方面具有保护作用。
