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E.Y. Chew, T. Clemens, S. Bressler, M. Klein, A. Ruby, J. Seddon, AREDS Research Group; Serum Nutrient Levels as Risk Factors for Neovascular AMD . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3303.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the association of nutrients measured in serum samples in patients enrolled in the Age–Related Eye Disease Study (AREDS) with prevalent and incident neovascular (NV) age–related macular degeneration (AMD). Methods: Serum was examined for 13 analytes in participants at 4 of the 11 AREDS clinics at baseline, and at 3 of the 4 clinics during follow–up. . Participants were randomized into 4 treatment groups: high doses of selected antioxidant vitamins, zinc, vitamins plus zinc, or placebo. The risk of NV AMD comparing top vs bottom quintiles of serum level was modeled by multivariable logistic and repeated measures logistic regressions, with previously identified covariates. Results: NV AMD at baseline was less common among participants with highest serum lutein/zeaxanthin levels compared with lowest (OR 0.52, 95% CI 0.30–0.90). Among the 557 participants with a fellow eye with advanced AMD or with large drusen incident AMD was also less common for those in the highest quintile of lutein/zeaxanthin (OR 0.72, 95% CI 0.53–0.97). The risk of prevalent NV AMD was similarly reduced at baseline for those in the highest serum beta–cryptoxanthin group (OR 0.44, 95% CI 0.26–0.74), with a non–significant trend for incident AMD (OR 0.74, 95% CI 0.52–1.06). The risk of both prevalent and incident AMD was also less for highest serum beta–carotene levels: (OR 0.82, 95% CI 0.47–1.41) and (OR 0.63, 95% CI 0.42–0.94) respectively. A similar pattern was seen for the highest quintile of HDL–cholesterol for risk of both prevalent and incident AMD: (OR 0.71, 95% CI 0.38–1.31) and (OR 0.58, 95% CI 0.38–0.88) respectively. Suggestive results for other serum levels were also found. Conclusions: Elevated serum levels of lutein/zeaxanthin, beta–cryptoxanthin, beta–carotene, and HDL–cholesterol were found to be associated with a lower risk of prevalent and incident NV AMD in AREDS. The findings for the carotenoids are consistent with the dietary data and with the favorable treatment effect that was found in the major outcomes for AREDS.
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