Millen Amy E, Voland Rick, Sondel Sherie A, Parekh Niyati, Horst Ronald L, Wallace Robert B, Hageman Gregory S, Chappell Rick, Blodi Barbara A, Klein Michael L, Gehrs Karen M, Sarto Gloria E, Mares Julie A
Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY 14214, USA.
Arch Ophthalmol. 2011 Apr;129(4):481-9. doi: 10.1001/archophthalmol.2011.48.
The relationship between serum 25-hydroxyvitamin D (25[OH]D) concentrations (nmol/L) and the prevalence of early age-related macular degeneration (AMD) was investigated in participants of the Carotenoids in Age-Related Eye Disease Study.
Stereoscopic fundus photographs, taken from 2001 to 2004, assessed AMD status. Baseline (1994-1998) serum samples were available for 25(OH)D assays in 1313 women with complete ocular and risk factor data. Odds ratios (ORs) and 95% confidence intervals (CIs) for early AMD (n = 241) of 1287 without advanced disease were estimated with logistic regression and adjusted for age, smoking, iris pigmentation, family history of AMD, cardiovascular disease, diabetes, and hormone therapy use.
In multivariate models, no significant relationship was observed between early AMD and 25(OH)D (OR for quintile 5 vs 1, 0.79; 95% CI, 0.50-1.24; P for trend = .47). A significant age interaction (P = .002) suggested selective mortality bias in women aged 75 years and older: serum 25(OH)D was associated with decreased odds of early AMD in women younger than 75 years (n = 968) and increased odds in women aged 75 years or older (n = 319) (OR for quintile 5 vs 1, 0.52; 95% CI, 0.29-0.91; P for trend = .02 and OR, 1.76; 95% CI, 0.77-4.13; P for trend = .05, respectively). Further adjustment for body mass index and recreational physical activity, predictors of 25(OH)D, attenuated the observed association in women younger than 75 years. Additionally, among women younger than 75 years, intake of vitamin D from foods and supplements was related to decreased odds of early AMD in multivariate models; no relationship was observed with self-reported time spent in direct sunlight.
High serum 25(OH)D concentrations may protect against early AMD in women younger than 75 years.
在年龄相关性眼病研究中的类胡萝卜素参与者中，研究血清25-羟基维生素D（25[OH]D）浓度（nmol/L）与早期年龄相关性黄斑变性（AMD）患病率之间的关系。
2001年至2004年拍摄的立体眼底照片用于评估AMD状态。1313名具有完整眼部和危险因素数据的女性有1994年至1998年的基线血清样本可用于25(OH)D检测。对1287名无晚期疾病的早期AMD患者（n = 241）的优势比（OR）和95%置信区间（CI）进行逻辑回归估计，并对年龄、吸烟、虹膜色素沉着、AMD家族史、心血管疾病、糖尿病和激素治疗使用情况进行调整。
在多变量模型中，未观察到早期AMD与25(OH)D之间存在显著关系（第5分位数与第1分位数的OR为0.79；95%CI，0.50 - 1.24；趋势P = 0.47）。显著的年龄交互作用（P = 0.002）表明75岁及以上女性存在选择性死亡偏倚：血清25(OH)D与75岁以下女性（n = 968）早期AMD的较低优势比相关，而与75岁及以上女性（n = 319）的较高优势比相关（第5分位数与第1分位数的OR分别为0.52；95%CI，0.29 - 0.91；趋势P = 0.02和OR，1.76；95%CI，0.77 - 4.13；趋势P = 0.05）。对25(OH)D的预测因素体重指数和休闲体育活动进行进一步调整后，减弱了75岁以下女性中观察到的关联。此外，在75岁以下女性中，在多变量模型中，从食物和补充剂中摄入维生素D与早期AMD的较低优势比相关；未观察到与自我报告的直接日晒时间有任何关系。
高血清25(OH)D浓度可能对75岁以下女性预防早期AMD有保护作用。
