Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study.
OBJECTIVE
To assess the associations of plasma lutein and zeaxanthin and other carotenoids with the risk of age-related maculopathy (ARM) and cataract in the population-based Pathologies Oculaires Liées à l'Age (POLA) Study.


METHODS
Retinal photographs were graded according to the international classification. ARM was defined by the presence of late ARM (neovascular ARM, geographic atrophy) and/or soft indistinct drusen (>125 microm) and/or soft distinct drusen (>125 microm) associated with pigmentary abnormalities. Cataract classification was based on a direct standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Plasma carotenoids were measured by high-performance liquid chromatography (HPLC), in 899 subjects of the cohort.


RESULTS
After multivariate adjustment, the highest quintile of plasma zeaxanthin was significantly associated with reduced risk of ARM (OR=0.07; 95% CI: 0.01-0.58; P for trend=0.005), nuclear cataract (OR=0.23; 95% CI: 0.08-0.68; P for trend=0.003) and any cataract (OR=0.53; 95% CI: 0.31-0.89; P for trend=0.01). ARM was significantly associated with combined plasma lutein and zeaxanthin (OR=0.21; 95% CI: 0.05-0.79; P for trend=0.01), and tended to be associated with plasma lutein (OR=0.31; 95% CI: 0.09-1.07; P for trend=0.04), whereas cataract showed no such associations. Among other carotenoids, only beta-carotene showed a significant negative association with nuclear cataract, but not ARM.


CONCLUSIONS
These results are strongly suggestive of a protective role of the xanthophylls, in particular zeaxanthin, for the protection against ARM and cataract.
Delcourt
Cécile
C
Institut National de la Santé et de la Recherche Médicale (INSERM), Research Unit U593 for Epidemiology, Public Health and Development, Université Victor Segalen Bordeaux 2, Bordeaux, France. cecile.delcourt@isped.u-bordeaux2.fr
Carrière
Isabelle
I
Delage
Martine
M
Barberger-Gateau
Pascale
P
Schalch
Wolfgang
W
D002386:Cataract / Q000097:blood* / Q000453:epidemiology; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D014975:Lutein / Q000097:blood*; D008268:Macular Degeneration / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D024341:Xanthophylls / Q000097:blood*; D065146:Zeaxanthins; D019207:beta Carotene / Q000097:blood*
D024341:Xanthophylls; D065146:Zeaxanthins; D019207:beta Carotene; D014975:Lutein