Tan Jennifer S L, Wang Jie Jin, Flood Victoria, Rochtchina Elena, Smith Wayne, Mitchell Paul
Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, Westmead Hospital, University of Sydney, Sydney, Australia.
Ophthalmology. 2008 Feb;115(2):334-41. doi: 10.1016/j.ophtha.2007.03.083. Epub 2007 Jul 30.
To assess the relationship between baseline dietary and supplement intakes of antioxidants and the long-term risk of incident age-related macular degeneration (AMD).
Australian population-based cohort study.
Of 3654 baseline (1992-1994) participants initially 49 years of older, 2454 were reexamined after 5 years, 10 years, or both.
Stereoscopic retinal photographs were graded using the Wisconsin Grading System. Data on potential risk factors were collected. Energy-adjusted intakes of alpha-carotene; beta-carotene; beta-cryptoxanthin; lutein and zeaxanthin; lycopene; vitamins A, C, and E; and iron and zinc were the study factors. Discrete logistic models assessed AMD risk. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, smoking, and other risk factors.
Incident early, late, and any AMD.
For dietary lutein and zeaxanthin, participants in the top tertile of intake had a reduced risk of incident neovascular AMD (RR, 0.35; 95% CI, 0.13-0.92), and those with above median intakes had a reduced risk of indistinct soft or reticular drusen (RR, 0.66; 95% CI, 0.48-0.92). For total zinc intake the RR comparing the top decile intake with the remaining population was 0.56 (95% CI, 0.32-0.97) for any AMD and 0.54 (95% CI, 0.30-0.97) for early AMD. The highest compared with the lowest tertile of total beta-carotene intake predicted incident neovascular AMD (RR, 2.68; 95% CI, 1.03-6.96; P = 0.029, for trend). Similarly, beta-carotene intake from diet alone predicted neovascular AMD (RR comparing tertile 3 with tertile 1, 2.40; 95% CI, 0.98-5.91; P = 0.027, for trend). This association was evident in both ever and never smokers. Higher intakes of total vitamin E predicted late AMD (RR compared with the lowest tertile, 2.83; 95% CI, 1.28-6.23; and RR, 2.55; 95% CI, 1.14-5.70 for the middle and highest tertiles, respectively; P = 0.22, for trend).
In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD. Higher beta-carotene intake was associated with an increased risk of AMD.
评估抗氧化剂的基线饮食和补充剂摄入量与年龄相关性黄斑变性（AMD）发病的长期风险之间的关系。
基于澳大利亚人群的队列研究。
在3654名最初年龄在49岁及以上的基线（1992 - 1994年）参与者中，2454人在5年、10年或两者之后接受了重新检查。
使用威斯康星分级系统对立体视网膜照片进行分级。收集潜在风险因素的数据。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、维生素A、C和E以及铁和锌的能量调整摄入量是研究因素。离散逻辑模型评估AMD风险。在调整年龄、性别、吸烟和其他风险因素后计算风险比（RRs）和95%置信区间（CIs）。
早期、晚期和任何类型AMD的发病情况。
对于饮食中的叶黄素和玉米黄质，摄入量处于最高三分位数的参与者发生新生血管性AMD的风险降低（RR，0.35；95%CI，0.13 - 0.92），摄入量高于中位数的参与者出现不清晰的软性或网状玻璃膜疣的风险降低（RR，0.66；95%CI，0.48 - 0.92）。对于总锌摄入量，与其余人群相比，最高十分位数摄入量者发生任何类型AMD的RR为0.56（95%CI，0.32 - 0.97），发生早期AMD的RR为0.54（95%CI，0.30 - 0.97）。总β - 胡萝卜素摄入量最高三分位数与最低三分位数相比，预测新生血管性AMD的发病（RR，2.68；95%CI，1.03 - 6.96；趋势P = 0.029）。同样，仅饮食中的β - 胡萝卜素摄入量预测新生血管性AMD（三分位数3与三分位数1相比的RR，2.40；95%CI，0.98 - 5.91；趋势P = 0.027）。这种关联在曾经吸烟者和从不吸烟者中均明显。总维生素E摄入量较高预测晚期AMD（与最低三分位数相比的RR，2.83；95%CI，1.28 - 6.23；中间和最高三分位数的RR分别为2.55；95%CI，1.14 - 5.70；趋势P = 0.22）。
在这项基于人群的队列研究中，较高的饮食中叶黄素和玉米黄质摄入量降低了长期发生AMD的风险。本研究证实了年龄相关性眼病研究中关于锌对AMD有保护作用的发现。较高的β - 胡萝卜素摄入量与AMD风险增加有关。
