Center for Community Outreach and Policy, Stein Eye Institute, David Geffen School of Medicine, UCLA (University of California Los Angeles).
Department of Biostatistics, Fielding School of Public Health, UCLA.
JAMA Ophthalmol. 2018 Feb 1;136(2):141-147. doi: 10.1001/jamaophthalmol.2017.5702.
Identifying whether an association exists between daily dietary polyunsaturated fatty acid (PUFA) consumption and the prevalence of glaucoma in the United States may provide modifiable dietary risk factors for the development of glaucoma.
To analyze the association between glaucoma and daily dietary intake of PUFAs, including ω-3 fatty acids, in the US population.
DESIGN, SETTING, AND PARTICIPANTS: Data from 3865 participants in the National Health and Nutrition Examination Survey (NHANES) 2005-2008 database who were 40 years or older, had participated in the vision health and dietary intake questionnaires, and had available results from laboratory tests and eye examinations that included frequency-doubling technology visual field loss detection tests and optic disc photographs were included. Data collection was performed by NHANES from 2005 to 2006. Data for the present study were downloaded from their database May 1 to 30, 2017. Data analyses were performed from June 1 to October 1, 2017.
Daily dietary intake of PUFAs, including ω-3 fatty acids.
Prevalence of glaucoma in the United States as defined using the Rotterdam criteria, which included a combination of optic cupping or asymmetry and visual field defect results.
Of the 83 643 392 weighted survey participants included in this cross-sectional study, 43 660 327 (52.2%) were women and 3 076 410 (3.7%) met our criteria for having glaucoma. Compared with participants without glaucoma, those with glaucoma were older (mean [SE] age, 61.4 [0.8] vs 53.7 [0.4] years; P < .001). Increased levels of daily dietary intake of eicosapentaenoic acid (odds ratio [OR], 0.06; 95% CI, 0.00-0.73) and docosahexaenoic acid (OR, 0.06; 95% CI, 0.01-0.87) were associated with significantly lower odds of having glaucoma. However, participants with daily total dietary PUFA intake levels in the second (OR, 2.84; 95% CI, 1.39-5.79) and third (OR, 2.97; 95% CI, 1.08-8.15) quartiles showed significantly increased odds of meeting our criteria for a diagnosis of glaucoma.
Increased daily dietary consumption levels of eicosapentaenoic acid and docosahexaenoic acid were associated with lower likelihood of glaucomatous optic neuropathy. However, consumption levels of total PUFAs in the higher quartiles were associated with a higher risk of glaucoma, which may have resulted from the relative intakes of ω-6 and ω-3 fatty acids and other confounding comorbidities. This study also hypothesizes that increasing the proportion of dietary ω-3 consumption levels while controlling overall daily PUFA intake may be protective against glaucoma. However, longitudinal studies or randomized clinical trials are needed to assess these hypotheses.
确定美国日常饮食多不饱和脂肪酸（PUFA）消耗与青光眼患病率之间是否存在关联，可能为青光眼的发展提供可改变的饮食风险因素。
分析美国人群中青光眼与每日饮食中多不饱和脂肪酸（包括 ω-3 脂肪酸）摄入的关系。
设计、地点和参与者：纳入了 2005-2008 年美国国家健康和营养检查调查（NHANES）数据库中 3865 名年龄在 40 岁或以上的参与者的数据，这些参与者参与了视力健康和饮食摄入问卷调查，并且有实验室检查和眼部检查的结果，包括频域技术视野损失检测试验和视盘照片。数据由 NHANES 于 2005 年至 2006 年收集。本研究的数据于 2017 年 5 月 1 日至 30 日从其数据库中下载。数据分析于 2017 年 6 月 1 日至 10 月 1 日进行。
多不饱和脂肪酸（包括 ω-3 脂肪酸）的日常饮食摄入量。
使用包括视盘凹陷或不对称和视野缺损结果的鹿特丹标准定义的美国青光眼患病率。
在这项横断面研究中，共纳入 8364392 名加权调查参与者，其中 43660327 名（52.2%）为女性，3076410 名（3.7%）符合我们的青光眼标准。与没有青光眼的参与者相比，患有青光眼的参与者年龄更大（平均[SE]年龄，61.4[0.8] vs 53.7[0.4]岁；P<0.001）。每日饮食中摄入的二十碳五烯酸（EPA，OR，0.06；95%CI，0.00-0.73）和二十二碳六烯酸（DHA，OR，0.06；95%CI，0.01-0.87）水平增加与青光眼的发病风险显著降低相关。然而，每日总饮食多不饱和脂肪酸摄入水平处于第二（OR，2.84；95%CI，1.39-5.79）和第三（OR，2.97；95%CI，1.08-8.15）四分位数的参与者患青光眼的几率显著增加。
EPA 和 DHA 的每日饮食摄入量增加与青光眼性视神经病变的可能性降低相关。然而，较高四分位数的总多不饱和脂肪酸的消耗水平与更高的青光眼风险相关，这可能是由于 ω-6 和 ω-3 脂肪酸的相对摄入量以及其他混杂的合并症所致。本研究还假设，在控制每日多不饱和脂肪酸总摄入量的同时增加饮食中 ω-3 脂肪酸的比例可能有助于预防青光眼。然而，需要进行纵向研究或随机临床试验来评估这些假设。
