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Benedicte MJ Merle, Audrey Cougnard-Gregoire, Jean-Francois Korobelnik, Wolfgang Schalch, Stéphane Eteve, Catherine Féart, Cécilia Samieri, Marie-Noelle Delyfer, Cecile DelCourt; Plasma carotenoids a biomarker of AMD risk: the Alienor Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4804.
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Carotenoids may protect against age-related macular degeneration (AMD) possibly through blue light absorption and protection against oxidation. Epidemiological studies have shown that high dietary carotenoids intake may reduce the risk of AMD. Biomarkers of carotenoids represent a more objective assessment of nutritional status and no prospective study has assessed the association between plasma carotenoids and the incidence of AMD. We report the association of plasma carotenoids with the 8-year incidence of advanced AMD in French elderly subjects.
The Alienor study is a population-based cohort study of 963 residents of Bordeaux (France), aged 73 years or more at baseline (2006). Participants were followed-up every 2 years. AMD was graded on the basis of retinal fundus photographs and spectral domain optical coherence tomography. Plasma carotenoids were determined from fasting blood samples using high performance liquid chromatography. Survival analysis using individual eye as the unit of analysis was used to assess associations between plasma carotenoids and incident AMD.
Among 603 participants at risk for incident AMD with plasma carotenoids status, 54 (9%) developed advanced AMD. After adjustment for age, sex, AMD grade at baseline, smoking, alcohol consumption, dietary carotene and lutein intake, Mediterranean diet score, total energy intake, season of blood draw, body mass index, diabetes, total cholesterol (TC), triglycerides (TG), marital status, physical activity, AMD supplement use and AMD genetic risk score, higher plasma lutein level was significantly associated with a lower risk for incident advanced AMD (Hazard Ratio (HR) for 1-standard-deviation, 0.60 (95% CI: 0.39-0.92), p=0.02). We also assessed the association of carotenoids/(TG+TC) ratio with incident advanced AMD. Higher lutein/(TG+TC) and zeaxanthin/(TG+TC) ratios were significantly associated with a lower risk for incident advanced AMD (HR, 0.58 (95% CI: 0.37-0.91), p=0.02; HR, 0.71 (95% CI: 0.52-0.98), p=0.04, respectively) after adjustment. Other carotenoids and ratios were not associated with incidence of advanced AMD.
Higher plasma level of lutein, lutein/(TG+TC) and zeaxanthin/(TG+TC) ratios were associated with reduced risk of developing advanced AMD. Biomarkers, such as plasma lutein, have the advantage of taking into account bioavailability and may be a useful tool for AMD prevention.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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