Abstract
Lutein and zeaxanthin may lower the risk of age-related macular degeneration (AMD). We evaluated the associations of plasma lutein and zeaxanthin with the incidence of advanced AMD in the Alienor study (Antioxydants Lipides Essentiels Nutrition et Maladies Oculaires). Alienor study is a prospective population-based cohort of 963 residents of Bordeaux, France, who were 73 years or older at baseline (2006–2008). The present study included 609 participants with complete ophthalmologic and plasma carotenoids data. Examinations were performed every two years over an eight-year period (2006 to 2017). Plasma lutein and zeaxanthin were determined at baseline from fasting blood samples using high-performance liquid chromatography. Cox proportional hazard models were used to assess associations between plasma lutein, zeaxanthin, and their (total cholesterol (TC) + triglycerides (TG)) ratios with AMD. Among the 609 included participants, 54 developed advanced incident AMD during a median follow-up time of 7.6 years (range 0.7 to 10.4). Participants with higher plasma lutein had a reduced risk for incident advanced AMD in the fully adjusted model (HR = 0.63 per 1-SD increase (95% CI, 0.41–0.97), p = 0.03). A similar association was observed using the lutein/(TC + TG) ratio (HR = 0.59 (95% CI, 0.39–0.90), p = 0.01). No associations were evidenced for other carotenoids. Higher plasma lutein was associated with a 37% reduced risk of incident advanced AMD.
Highlights
Age-related macular degeneration (AMD) is the leading cause of central vision loss in industrialized countries [1]
After adjustment for sex and AMD grade at Alienor baseline (Model 1), higher lutein and zeaxanthin were associated with a lower risk of developing advanced AMD, with an Hazard ratios (HRs) of 0.71 (95% confidence interval (CI), 0.52–0.98), and 0.69, respectively
HR for 1-standard deviation (SD) increase. b Model 2, HR was estimated using Cox proportional model adjusted for sex, AMD grade at baseline, smoking status, alcohol consumption, season of blood draw, body mass index, diabetes, total cholesterol, triglycerides, marital status, physical activity, use of AMD supplement and genetic risk score
Summary
Age-related macular degeneration (AMD) is the leading cause of central vision loss in industrialized countries [1]. This degenerative disease affects the central part of the retina, which is crucial for daily living tasks such as reading, driving, and recognition of faces. Epidemiological studies have observed a reduced risk of AMD associated with high dietary consumption of carotenoids, including lutein and zeaxanthin [5,6,7,8,9,21,22,23,24,25,26]. We investigated the associations between plasma lutein and zeaxanthin, a biomarker of nutritional carotenoids status, and the 8-year of incidence of advanced AMD in a population-based prospective study of French elderly subjects
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