Plasma Lutein And Zeaxanthin And The Risk For Age-related Maculopathy: The Alienor Study

Abstract

 

Purpose:

 

Lutein and zeaxanthin may protect against age-related maculopathy (ARM) possibly through blue light absorption and protection against oxidation. Results of epidemiological studies are inconsistent in this field. We report the associations of ARM with plasma carotenoids, measured 7 years before eye examination, in French elderly subjects

 

Methods:

 

The Alienor Study is a population-based study on nutrition and age-related eye diseases. 963 subjects had an eye examination from September 2006 to May 2008 in Bordeaux (France). ARM was classified from colour photographs in five exclusive stages: late neovascular ARM; late atrophic ARM (geographic atrophy); early ARM2 (large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities); early ARM1 (large soft distinct drusen alone or pigment abnormalities alone); no ARM. Plasma carotenoids were determined from the blood samples collected at baseline examination of the 3C Study (1999-2001) and kept frozen at -80°C for about 10 years. Associations were estimated using logistic Generalized Estimating Equations (GEE) models, subjects without ARM being the reference. Analyses were adjusted for age, gender, educational level, monthly income, smoking, HDL-Cholesterol, triglycerides, body mass index, cataract extraction, and gene polymorphisms ApoE4, ApoE2, CFH Y402H and LOC387715

 

Results:

 

Of 963 subjects, 662 had complete data, representing 1281 gradable eyes. After multivariate adjustment, subjects with high plasma concentration of lutein and of combined lutein and zeaxanthin were at higher risk of early ARM2 (OR=1.32, 95% confidence interval (CI): 1.04-1.66, p=0.02 and OR=1.32, CI: 1.05-1.65, p=0.02, respectively). Association with zeaxanthin was in the same direction, but did not reach statistical significance (OR=1.16, CI: 0.98-1.36, p=0.08). The other stages of ARM were not significantly associated with lutein or zeaxanthin

 

Conclusions:

 

The results of the present study are not in favour of a reduced risk for ARM with high plasma levels of lutein and zeaxanthin. They might be explained by residual confounding, in particular by sunlight exposure, which will soon be estimated in our study

 

Keywords: age-related macular degeneration • macular pigment • clinical (human) or epidemiologic studies: risk factor assessment