Age-related Macular Degeneration and Antioxidant Status in the POLA Study

Abstract

To give the levels of antioxidant nutrients in relation to age-related macular degeneration (AMD). Methods: Pathologies Oculaires Liées à l'Age is a population-based study on cataract and AMD and their risk factors, carried out on 2584 inhabitants of Sète, France. Age-related macular degeneration was defined by findings from fundus photographs according to an international classification. Biological measurements were taken from fasting blood samples. Results: After multivariate adjustment, plasma ␣-tocopherol levels showed a weak negative association with late AMD (P = .07). Lipid-standardized plasma ␣-tocopherol levels showed a significant negative association with EPIDEMIOLOGY AND BIOSTATISTICS

Effect of the main dietary antioxidants (carotenoids, γ-tocopherol, polyphenols, and vitamin C) on α-tocopherol absorption

“…Lutein was chosen as the antioxidant to compete with a-tocopherol for absorption because both vitamin E and lutein supplements are becoming increasingly popular owing to their potential ability to prevent agerelated macular degeneration (Belda et al, 1999;Delcourt et al, 1999;Mares-Perlman et al, 2001;Olmedilla et al, 2003;Richer et al, 2004). Data from the clinical study suggest that increasing dietary lutein from 18 to 36 mg reduces a-tocopherol absorption (area under the curve (AUC) down by 38%).…”

Application of Nutrigenomics in Eye Health

“…Initial epidemiological observations, showing that high vitamin E plasma levels may protect against AMD [4], have been confirmed by a large randomised clinical trial performed in the United States. In this study, performed on nearly 5,000 subjects, supplementation for 6 years with high doses of antioxidants (vitamin E, C and beta-carotene) and zinc significantly reduced by 34 % the risk of developing advanced AMD in subjects with early AMD [5].…”

Review of nutrient actions on age-related macular degeneration

“…Data from the National Health and Nutrition Examination Survey, reported by Goldberg et al, showed a negative association between the frequency of fruit and vegetables rich in vitamin A consumed and the prevalence of AMD [16]. However, several subsequent studies and a large metaanalysis failed to confirm this association [20,22,39,40], and unexpectedly, one report even suggested an increased risk in the development of late AMD in participants who took vitamin A [41]. With these conflicting results, more research is needed regarding the association between vitamin A and AMD.…”

“…Although there was no association found between vitamin E and AMD in the Eye Disease Case-Control Study [17], in the POLA (Pathologies Oculaires Liées à l'Age) study by Delcourt et al, a reduction in the risk of late AMD in individuals with enhanced plasma levels of alpha-tocopherol was demonstrated [39]. Several studies report a weak or non-existent association between alpha-tocopherol levels/vitamin E supplements and the risk of AMD [33,45].…”

“…However, no significant association between vitamin C intake and AMD was observed in the Eye Disease Case-Control Study Group or in the POLA study [17,39]. The lack of effect that vitamin C had on primary prevention of AMD was further supported by a Cochrane analysis conducted by Evans and Lawrenson [35].…”