Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111, USA.
Invest Ophthalmol Vis Sci. 2010 Jun;51(6):2897-905. doi: 10.1167/iovs.08-2824. Epub 2010 Feb 24.
In vitro and in vivo animal studies suggest that dietary carbohydrates play a role in cataractogenesis. Few epidemiologic studies have been conducted to evaluate this association. The objective of this study was to examine the cross-sectional associations between total carbohydrate intake, dietary glycemic index (dGI), and the risk of cortical and nuclear cataracts.
After excluding 864 persons from 2473 eligible participants, 1609 eligible nondiabetic participants (mean age, 57.6 years, 55.9% female) in the Melbourne Visual Impairment Project (VIP) were enrolled. Dietary information derived from a semiquantitative food-frequency questionnaire and cataract status graded by the Wilmer protocol (cortical cataract: opacity >or=4/16; nuclear cataract grade >or=2) were collected. With the use of the generalized estimating approach to logistic regression to account for the lack of independence between the eyes of an individual, the associations between dietary carbohydrates and risk of cataract in eyes with no or a single type (pure) of cataract were examined.
Multivariate adjustment showed that pure cortical cataract (197 eyes) was significantly associated with total carbohydrate intake (odds ratio [OR] comparing the highest quartile with the lowest quartile = 3.19, 95% confidence interval [CI] = 1.10-9.27; P(trend) = 0.017). The OR for nuclear cataract (366 eyes) comparing the third quartile of dGI with the first quartile (OR = 1.64, 95% CI = 1.02-2.65) was significant, but there was not a consistent dose-response association (P(trend) = 0.75).
Carbohydrate intake may be optimized to prolong eye lens function. Because of the high proportion of subjects with missing covariates, these results warrant further study.
体外和动物体内研究表明，膳食碳水化合物在白内障的形成中起作用。很少有流行病学研究来评估这种关联。本研究的目的是检验总碳水化合物摄入量、饮食血糖生成指数（dGI）与皮质性白内障和核性白内障风险之间的横断面关联。
在排除了 2473 名合格参与者中的 864 人后，1609 名合格的非糖尿病参与者（平均年龄 57.6 岁，55.9%为女性）被纳入墨尔本视觉障碍项目（VIP）。膳食信息来自半定量食物频率问卷，白内障状况按照威尔默方案（皮质性白内障：混浊度≥4/16；核性白内障等级≥2）分级。使用广义估计方程的逻辑回归来解释个体双眼之间缺乏独立性，研究了膳食碳水化合物与无或单一类型（单纯型）白内障眼白内障风险之间的关系。
多变量调整显示，单纯皮质性白内障（197 只眼）与总碳水化合物摄入量显著相关（最高四分位组与最低四分位组的比值比[OR]为 3.19，95%置信区间[CI]为 1.10-9.27；P（趋势）=0.017）。dGI 第三四分位数与第一四分位数相比，核性白内障（366 只眼）的 OR 为 1.64，95%CI 为 1.02-2.65，差异有统计学意义，但没有一致的剂量-反应关系（P（趋势）=0.75）。
优化碳水化合物的摄入可能有助于延长晶状体的功能。由于有大量缺失协变量的受试者，这些结果需要进一步研究。
