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Lutein and Zeaxanthin Status and Risk of Age-Related Macular Degeneration
Catharine R. Gale, Nigel F. Hall, David I. W. Phillips, and Christopher N. Martyn
PURPOSE. To investigate the relation between plasma concentrations of lutein and zeaxanthin and age-related macular degeneration in a group of elderly men and women. METHODS. The Wisconsin Age-Related Maculopathy Grading System was used to grade features of early and late macular degeneration in 380 men and women, aged 66 to 75 years,
from Sheffield, United Kingdom. Fasting blood samples were taken to assess plasma concentrations of lutein and zeaxanthin. RESULTS. Risk of age-related macular degeneration (early or late) was significantly higher in people with lower plasma concentrations of zeaxanthin. Compared with those whose plasma concentrations of zeaxanthin were in the highest third of the distribution, people whose plasma concentration was in the lowest third had an odds ratio for risk of age-related macular degeneration of 2.0 (95% confidence interval [CI] 1.0–4.1), after adjustment for age and other risk factors. Risk of agerelated macular degeneration was increased in people with the lowest plasma concentrations of lutein plus zeaxanthin (odds ratio [OR] 1.9, 95% CI 0.9 –3.5) and in those with the lowest concentrations of lutein (OR 1.7, 95% CI 0.9 –3.3), but neither of these relations was statistically significant. CONCLUSIONS. These findings provide support for the view that zeaxanthin may protect against age-related macular degeneration.
Invest Ophthalmol Vis Sci. 2003;44:2461–2465) DOI: 10.1167/iovs.02-0929
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Dietary Antioxidants and the Long-term Incidence of Age-Related Macular Degeneration
The Blue Mountains Eye Study
Jennifer S. L. Tan, MBBS, BE,1 Jie Jin Wang, MMed, PhD,1,2 Victoria Flood, MPH, PhD,1 Elena Rochtchina, MApplStat,1 Wayne Smith, PhD, FAFPHM,3 Paul Mitchell, MD, PhD1
Purpose: To assess the relationship between baseline dietary and supplement intakes of antioxidants and the long-term risk of incident age- related macular degeneration (AMD). Design: Australian population–based cohort study.
Participants: Of 3654 baseline (1992–1994) participants initially 49 years of older, 2454 were reexamined after 5 years, 10 years, or both.
Methods: Stereoscopic retinal photographs were graded using the Wisconsin Grading System. Data on potential risk factors were collected. Energy-adjusted intakes of beta-carotene; _-carotene; _-cryptoxanthin; lutein and zeaxanthin; lycopene; vitamins A, C, and E; and iron and zinc were the study factors. Discrete logistic models assessed AMD risk. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated after adjusting for age, gender, smoking, and other risk factors.
Results: For dietary lutein and zeaxanthin, participants in the top tertile of intake had a reduced risk of incident neovascular AMD (RR, 0.35; 95% CI, 0.13–0.92), and those with above median intakes had a reduced risk of indistinct soft or reticular drusen (RR, 0.66; 95% CI, 0.48–0.92). For total zinc intake the RR comparing the top decile intake with the remaining population was 0.56 (95% CI, 0.32–0.97) for any AMD and 0.54 (95% CI, 0.30–0.97) for early AMD. The highest compared with the lowest tertile of total beta-carotene intake predicted
incident neovascular AMD (RR, 2.68; 95% CI, 1.03–6.96; P _ 0.029, for trend). Similarly, beta-carotene intake from diet alone predicted neovascularAMD (RR comparing tertile 3 with tertile 1, 2.40; 95% CI, 0.98–5.91; P _ 0.027, for trend). This association was evident in both ever and never smokers. Higher intakes of total vitamin E predicted late AMD (RR compared with the lowest tertile, 2.83; 95% CI, 1.28–6.23; and RR, 2.55; 95% CI, 1.14–5.70 for the middle and highest tertiles, respectively; P _ 0.22, for trend).
Conclusions: In this population-based cohort study, higher dietary lutein and zeaxanthin intake reduced the risk of long-term incident AMD. This study confirmed the Age-Related Eye Disease Study finding of protective influences from zinc against AMD. Higher beta-carotene intake was associated with an increased risk of AMD.
Ophthalmology 2008;115:334–341 © 2008 by the American Academy of Ophthalmology
Plasma Lutein and Zeaxanthin and Other Carotenoids as Modifiable Risk Factors for Age-Related Maculopathy and Cataract: The POLA Study
Ce ´cile Delcourt,1 Isabelle Carrie`re,2 Martine Delage,3 Pascale Barberger-Gateau,1 Wolfgang Schalch,4 and the POLA Study Group5
PURPOSE. To assess the associations of plasma lutein and zeaxanthin and other carotenoids with the risk of age-related maculopathy (ARM) and cataract in the population-based Pathologies Oculaires Lie ´es a` l’Age (POLA) Study.
METHODS. Retinal photographs were graded according to the international classification. ARM was defined by the presence of late ARM (neovascular ARM, geographic atrophy) and/or soft indistinct drusen (125 microns) and/or soft distinct drusen (125microns) associated with pigmentary abnormalities. Cataract classification was based on a direct standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Plasma carotenoids were measured by high-performance liquid chromatography (HPLC), in 899 subjects of the
cohort. RESULTS. After multivariate adjustment, the highest quintile of plasma zeaxanthin was significantly associated with reduced risk of ARM (OR _ 0.07; 95% CI: 0.01– 0.58; P for trend _ 0.005), nuclear cataract (OR _ 0.23; 95% CI: 0.08–0.68; P for trend _ 0.003) and any cataract (OR
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