Department of Ophthalmology, University of California, San Francisco.
Department of Ophthalmology, Stanford University, Stanford, California.
JAMA Ophthalmol. 2015 Jul;133(7):746-54. doi: 10.1001/jamaophthalmol.2015.0514.
Despite widespread use of calcium supplementation among elderly people, little is known about the association between such consumption and the prevalence of age-related macular degeneration (AMD) in the United States.
To investigate the association between self-reported supplementary calcium consumption and the prevalence of AMD in a representative US sample.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included 3191 participants 40 years and older in the 2007-2008 National Health and Nutrition Examination Survey (NHANES) who were evaluated for the presence or absence of AMD by fundus photography. Participants were interviewed regarding use of dietary supplements and antacids during the 30-day period preceding enrollment. Self-reported supplementary intake of calcium was aggregated and divided into quintiles. Fundus photographs were graded for the presence or absence of AMD. Information regarding demographics, comorbidities, and health-related behaviors was obtained via interview. Multivariable logistic regression models were created to determine the odds of an AMD diagnosis among participants in each quintile of self-reported calcium vs participants not self-reporting supplementary calcium consumption after adjusting for confounders.
Self-reported use of calcium supplements.
Presence or absence of AMD by fundus photography.
A total of 248 participants (7.8%) were diagnosed with AMD. Mean ages were 67.2 years for those with AMD and 55.8 for those without AMD. After adjustment for potential confounding variables, study participants who self-reported consumption of more than 800 mg/d of supplementary calcium were found to have higher odds of an AMD diagnosis based on fundus photography evaluation compared with those not self-reporting supplementary calcium consumption (odds ratio, 1.85; 95% CI, 1.25-2.75). The association between self-reported supplementary calcium intake and AMD was stronger in older than younger individuals (odds ratio, 2.63; 95% CI, 1.52-4.54). A clear dose-response association between the quintiles of self-reported supplementary calcium intake and AMD was not established.
Self-reported supplementary calcium consumption is associated with increased prevalence of AMD, with the findings suggesting a threshold rather than a dose-response relationship. The stronger association in older individuals may be due to relatively longer duration of calcium supplementation in older individuals.
尽管老年人广泛使用钙补充剂，但对于这种消费与美国年龄相关性黄斑变性（AMD）患病率之间的关系知之甚少。
在具有代表性的美国样本中调查自我报告的补充钙消耗与 AMD 患病率之间的关系。
设计、设置和参与者：这项横断面研究包括 2007-2008 年全国健康和营养检查调查（NHANES）中 3191 名年龄在 40 岁及以上的参与者，他们通过眼底摄影评估 AMD 的存在或不存在。在入组前的 30 天内，对参与者进行了关于膳食补充剂和抗酸剂使用情况的访谈。汇总并将自我报告的补充钙摄入量分为五分位数。通过眼底照相评估是否存在 AMD。通过访谈获得有关人口统计学、合并症和与健康相关行为的信息。创建多变量逻辑回归模型，以确定在调整混杂因素后，自我报告的钙摄入量处于每个五分位的参与者与未报告补充钙消耗的参与者之间 AMD 诊断的可能性。
自我报告使用钙补充剂。
通过眼底照相评估 AMD 的存在或不存在。
共有 248 名参与者（7.8%）被诊断为 AMD。AMD 患者的平均年龄为 67.2 岁，无 AMD 患者的平均年龄为 55.8 岁。在调整潜在混杂变量后，与未报告补充钙消耗的参与者相比，自我报告每天摄入超过 800mg 补充钙的参与者基于眼底照相评估，他们更有可能被诊断为 AMD（优势比，1.85；95%CI，1.25-2.75）。与较年轻的个体相比，在年龄较大的个体中，自我报告的补充钙摄入量与 AMD 之间的关联更强（优势比，2.63；95%CI，1.52-4.54）。自我报告的补充钙摄入量五分位数与 AMD 之间并未建立明确的剂量反应关系。
自我报告的补充钙消耗与 AMD 患病率增加相关，研究结果表明存在阈值而不是剂量反应关系。在年龄较大的个体中，这种关联更强可能是由于年龄较大的个体补充钙的时间相对较长。
