Relationship of Supplement Use to Age–Related Maculopathy in the Carotenoids and Age–Related Eye Disease Study (CAREDS), an ancillary study to the Women's Health Initiative (WHI)

Abstract

Abstract: : Purpose: To examine the relationship of supplement use to the occurrence of age–related maculopathy (ARM). Methods: The prevalence of ARM was determined from fundus photographs taken at CAREDS study visits between 2001–2003 in a preliminary sample of 1512 women (50+ years of age) from the Observational Study Cohort of the WHI in Portland, OR, Iowa City, IA, and Madison, WI, selected based on high and low dietary intake of lutein+zeaxanthin at WHI baseline visits from 1994–1997. Supplement types included multivitamins, high dose antioxidants (at least 2 of the following: ≥10,000 IU/day of beta–carotene, ≥120 mg/day of vitamin C, or ≥60 IU/day of vitamin E from supplements), and high dose zinc (>15 mg/day from supplements). Odds ratios (OR) for ARM were computed from logistic regression after adjusting for age and other potential confounders (various physical, lifestyle, and medical factors) determined at WHI enrollment, when they influenced odds ratios > 10%. Results: Most women (88%) reported using supplements at the time of CAREDS, with 604 using multivitamins (not high dose antioxidant or high dose zinc supplement users), 486 using high dose antioxidants, and 237 using high dose zinc supplements. Duration of use varied among these women. Odds Ratios for early ARM were significantly lower in women using high dose antioxidants for > 10 years compared to non–supplement users (OR=0.45 (95% Confidence Interval=(0.2–0.9)), p–trend over duration=0.03). No significant confounders were found for this model. OR for pigmentary abnormalities and soft drusen were in a similar direction, but not statistically significant. Use of multivitamins or high dose zinc supplements were unrelated to any ARM lesion. Results of final analyses in approximately 2000 women will be reported. Conclusions: Use of high dose antioxidant supplements for long durations (> 10 years) was associated with lower risk for early stages of ARM. Use of multivitamins or high dose zinc supplements were unrelated to ARM.

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