The heritability of macular response to supplemental lutein and zeaxanthin: a classic twin study.
OBJECTIVE
Antioxidant supplements may reduce age-related macular degeneration (AMD) progression. The macular carotenoids are of particular interest because of their biochemical, optical, and anatomic properties. This classic twin study was designed to determine the heritability of macular pigment (MP) augmentation in response to supplemental lutein (L) and zeaxanthin (Z).


METHODS
A total of 322 healthy female twin volunteers, aged 16-50 years (mean 40 ± 8.7) was enrolled in a prospective, nonrandomized supplement study. Macular pigment optical density (MPOD) measurements using two techniques (2-wavelength fundus autofluorescence [AF] and heterochromatic flicker photometry [HFP]), and serum concentrations of L and Z, were recorded at baseline, and at 3 and 6 months following daily supplementation with 18 mg L and 2.4 mg Z for a study period of 6 months.


RESULTS
At baseline, mean MPOD was 0.44 density units (SD 0.21, range 0.04-1.25) using HFP, and 0.41 density units (SD 0.15) using AF. Serum L and Z levels were raised significantly from baseline following 3 months' supplementation (mean increase 223% and 633%, respectively, P < 0.0001 for both), with no MPOD increase. After 6 months' supplementation, a small increase in MPOD was seen (mean increase 0.025 ± 0.16, P = 0.02, using HFP). Subdivision of baseline MPOD into quartiles revealed that baseline levels made no difference to the treatment effect. Genetic factors explained 27% (95% confidence interval [CI] 7-45) of the variation in MPOD response. Distribution profiles of macular pigment did not change in response to supplementation.


CONCLUSIONS
MPOD response to supplemental L and Z for a period of 6 months was small (an increase over baseline of 5.7% and 3.7%, measured using HFP and AF, respectively), and was moderately heritable. Further study is indicated to investigate the functional and clinical impact of supplementation with the macular carotenoids.
Department of Twin Research and Genetic Epidemiology, King's College London, St. Thomas' Hospital campus, London, United Kingdom. chris.hammond@kcl.ac.uk
Christopher J
CJ
Hammond
S H Melissa
SH
Liew
Frederik J
FJ
Van Kuijk
Stephen
S
Beatty
John M
JM
Nolan
Tim D
TD
Spector
Clare E
CE
Gilbert
D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D014975:Lutein / Q000008:administration & dosage* / Q000097:blood; D008268:Macular Degeneration / Q000097:blood / Q000235:genetics / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D012168:Retinal Pigments / Q000032:analysis* / Q000235:genetics; D024341:Xanthophylls / Q000008:administration & dosage* / Q000097:blood; D055815:Young Adult; D065146:Zeaxanthins
D000975:Antioxidants; D012168:Retinal Pigments; D024341:Xanthophylls; D065146:Zeaxanthins; D014975:Lutein