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生活方式的改变、营养和维生素补充剂与年龄相关性黄斑变性。

Lifestyle modification, nutritional and vitamins supplements for age-related macular degeneration.

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Acta Ophthalmol. 2013 Feb;91(1):6-11. doi: 10.1111/j.1755-3768.2011.02357.x. Epub 2012 Jan 23.

Abstract

PURPOSE

To provide a systematic review of the published studies pertaining to the lifestyle modification, dietary, nutritional and vitamins supplements for preventing occurrence or halting deterioration of age-related macular degeneration (AMD).

METHODS

The literature searches from 1990 to December 2010 with following keywords, 'age related macular degeneration', 'nutrition', 'antioxidant', 'diet' and 'vitamins supplements' using search engines Pubmed, Google Scholar, Medline and the Cochrane Library. Meta-analyses, population-based cohort studies and case-controlled trials were reviewed, whereas small cases series, case reports, commentaries, abstracts in proceedings or personal observations were excluded.

RESULTS

Smoking and obesity are identified risk factors for AMD. High dietary intakes of omega-3 fatty acids, and macular xanthophylls lutein and zeaxanthin have been associated with a lower risk of prevalence and incidence in AMD. Vitamin B and extracts from wolfberry, Gingko biloba and berry anthocyanins were also subjects of intense research interests, but there has been no concluding scientific evidence yet. The Age-Related Eye Disease study (AREDS) is the only large-scale randomized controlled clinical trial to show beneficial effect of AREDS formulation of vitamins C, E, beta-carotene and zinc with copper in reducing the risk progression to advanced AMD in patients with intermediate AMD or with advanced AMD in one eye.

CONCLUSION

Quit smoking is an important advice to patients to prevent or slow the progress of AMD. There is no recommendation for routine nutritional or vitamins supplementation for primary prevention. However, patients with documented intermediate risk of AMD or advanced AMD in one eye are recommended to take AREDS-type vitamin supplements.

摘要

目的

对已发表的有关生活方式改变、饮食、营养和维生素补充剂用于预防或阻止年龄相关性黄斑变性(AMD)发生或恶化的研究进行系统评价。

方法

使用搜索引擎 Pubmed、Google Scholar、Medline 和 Cochrane Library,以“age related macular degeneration”、“nutrition”、“antioxidant”、“diet”和“vitamins supplements”为关键词,对 1990 年至 2010 年 12 月的文献进行检索。综述了荟萃分析、基于人群的队列研究和病例对照研究,而排除了小病例系列、病例报告、评论、会议论文摘要或个人观察。

结果

吸烟和肥胖被认为是 AMD 的危险因素。大量摄入 ω-3 脂肪酸以及黄斑叶黄素和玉米黄质与 AMD 的患病率和发病率降低相关。维生素 B 和枸杞、银杏叶和浆果花青素提取物也是研究热点,但尚未有结论性的科学证据。年龄相关性眼病研究(AREDS)是唯一一项大型随机对照临床试验,表明 AREDS 配方的维生素 C、E、β-胡萝卜素和锌与铜对患有中间型 AMD 或一眼患有晚期 AMD 的患者,可降低进展为晚期 AMD 的风险。

结论

戒烟是预防或减缓 AMD 进展的重要建议。对于初级预防,不建议常规补充营养或维生素。然而,对于有中间型 AMD 或一眼患有晚期 AMD 的患者,建议服用 AREDS 型维生素补充剂。

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