成年地中海人群膳食维生素K1摄入量与白内障手术发生率的关联：一项随机临床试验的二次分析
Association of Dietary Vitamin K1 Intake With the Incidence of Cataract Surgery in an Adult Mediterranean Population: A Secondary Analysis of a Randomized Clinical Trial.
作者信息
Camacho-Barcia María L, Bulló Mònica, Garcia-Gavilán Jesús F, Ruiz-Canela Miguel, Corella Dolores, Estruch Ramón, Fitó Montserrat, García-Layana Alfredo, Arós Fernando, Fiol Miquel, Lapetra José, Serra-Majem Lluis, Pintó Xavier, García-Arellano Ana, Vinyoles Ernest, Sorli José Vicente, Salas-Salvadó Jordi
机构信息
Human Nutrition Unit, Biochemistry and Biotechnology Department, University Hospital of Sant Joan de Reus, Reus, Spain.
Human Nutrition Unit, Biochemistry and Biotechnology Department, University Hospital of Sant Joan de Reus, Reus, Spain2Centro de Investigación Biomédica en Red Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.
出版信息
JAMA Ophthalmol. 2017 Jun 1;135(6):657-661. doi: 10.1001/jamaophthalmol.2017.1076.
IMPORTANCE
Cataract, one of the most frequent causes of blindness in developed countries, is strongly associated with aging. The exact mechanisms underlying cataract formation are still unclear, but growing evidence suggests a potential role of inflammatory and oxidative processes. Therefore, antioxidant and anti-inflammatory factors of the diet, such as vitamin K1, could play a protective role.
OBJECTIVE
To examine the association between dietary vitamin K1 intake and the risk of incident cataracts in an elderly Mediterranean population.
DESIGN, SETTING, AND PARTICIPANTS: A prospective analysis was conducted in 5860 participants from the Prevención con Dieta Mediterránea Study, a randomized clinical trial executed between 2003 and 2011. Participants were community-dwelling men (44.2%) and women (55.8%), and the mean (SD) age was 66.3 (6.1) years.
MAIN OUTCOMES AND MEASURES
Dietary vitamin K1 intake was evaluated using a validated food frequency questionnaire. The time to the cataract event was calculated as the time between recruitment and the date of the occurrence to cataract surgery, the time to the last visit of the follow-up, date of death, or the end of the study. Hazard ratios and 95% CIs for cataract incidence were estimated with a multivariable Cox proportional hazards model.
RESULTS
Participants were community-dwelling men (44.2%; n = 868) and women (55.8%; n = 1086), and the mean (SD) age was 66.3 (6.1) years. After a median of 5.6 years follow-up, we documented a total of 768 new cataracts. Participants in the highest tertile of dietary vitamin K1 intake had a lower risk of cataracts than those in the lowest tertile (hazard ratio, 0.71; 95% CI, 0.58-0.88; P = .002), after adjusting for potential confounders.
CONCLUSIONS AND RELEVANCE
High intake of dietary vitamin K1 was associated with a reduced risk of cataracts in an elderly Mediterranean population even after adjusting by other potential confounders.
TRIAL REGISTRATION
isrctn.org: ISRCTN35739639.
重要性
白内障是发达国家最常见的致盲原因之一，与衰老密切相关。白内障形成的确切机制尚不清楚，但越来越多的证据表明炎症和氧化过程可能起作用。因此，饮食中的抗氧化和抗炎因子，如维生素K1，可能起到保护作用。
目的
研究老年地中海人群饮食中维生素K1摄入量与新发白内障风险之间的关联。
设计、背景和参与者：对来自地中海饮食预防研究的5860名参与者进行前瞻性分析，该研究是一项于2003年至2011年进行的随机临床试验。参与者为社区居住男性（44.2%）和女性（55.8%），平均（标准差）年龄为66.3（6.1）岁。
主要结局和测量指标
使用经过验证的食物频率问卷评估饮食中维生素K1的摄入量。白内障事件发生时间计算为招募时间与白内障手术发生日期、随访最后一次就诊时间、死亡日期或研究结束时间之间的时间。采用多变量Cox比例风险模型估计白内障发病率的风险比和95%置信区间。
结果
参与者为社区居住男性（44.2%；n = 868）和女性（55.8%；n = 1086），平均（标准差）年龄为66.3（6.1）岁。经过中位5.6年的随访，我们共记录了768例新发白内障。在调整潜在混杂因素后，饮食中维生素K1摄入量处于最高三分位数的参与者患白内障的风险低于最低三分位数的参与者（风险比，0.71；95%置信区间，0.58 - 0.88；P = 0.002）。
结论和相关性
即使在调整其他潜在混杂因素后，老年地中海人群中高饮食维生素K1摄入量与降低的白内障风险相关。
试验注册
isrctn.org：ISRCTN35739639
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