Dietary Habits, Fatty Acids and Carotenoid Levels Are Associated with Neovascular Age-Related Macular Degeneration in Chinese

Abstract

The role of diet and circulatory carotenoids and docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are implicated in age-related macular degeneration (AMD) but not well studied in Chinese. However, other fatty acids were not comprehensively evaluated if it had additional consequence on AMD. This study investigated the relationship among dietary habits, fatty acids levels, carotenoids and AMD in Hong Kong Chinese adults. In this cross-sectional case-controlled study, plasma fatty acids including, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA), and carotenoids levels were quantified between patients with neovascular AMD (n = 99) and age-gender-matched controls (n = 198). A food frequency questionnaire was also conducted. Low blood carotenoid levels and omega-3 PUFAs namely DHA, EPA and -linolenic acid increased the odds ratio of developing neovascular AMD. High blood omega-6 PUFAs specifically arachidonic acid and eicosadienoic acid, oleic acid (a MUFA) and SFA levels increased the odds ratio of having neovascular AMD. Neovascular AMD group had significantly less omega-3 PUFA rich food (vegetables, nuts, seafood) intake and higher SFA (meat) intake than controls. In short, neovascular AMD was associated with lower circulatory levels of carotenoids and omega-3 PUFAs, and higher level of omega-6 PUFAs, oleic acid and SFAs in the Hong Kong Chinese population. These findings enhance the understandings of dietary impacts on neovascular AMD and provide a context for future nutritional intervention studies.

Comparative efficacy and safety of anti-vascular endothelial growth factor regimens for neovascular age-related macular degeneration: systematic review and Bayesian network meta-analysis

“… 1 With a global prevalence of 8.7%, projected cases of any AMD are 196 million globally in 2020, 2 with an expected increase to 288 million in 2040, with most cases occurring in Asia (113 million in 2040). 3 At the early stages of AMD, drusen can be observed in the macular region, and advanced stages of AMD may manifest as non-neovascular or neovascular. Neovascular age-related macular degeneration (nAMD), characterized by choroidal neovascularization, accounts for only 4–7% of the overall prevalence of AMD, 2 but is responsible for more than 90% of severe visual loss or legal blindness caused by AMD.…”

Increase in omega-6 and decrease in omega-3 polyunsaturated fatty acid oxidation elevates the risk of exudative AMD development in adults with Chinese diet

“…Furthermore, oxidative stress status of the patients depended on lipid peroxidation products related to ARA only and not EPA, DHA or other PUFA, that are suggested to have pivotal roles in disease development. We hypothesize that the poor DHA and antioxidant carotenoid diet as reported in our previous study [19] increased the risk of AMD development in adults in part, attributed by certain oxidized products derived from PUFA. In support, we determined (1) the antioxidant status (antioxidant enzymes, carotenoid levels), (2) plasma omega-6 PUFA to omega-3 PUFA ratio status and (3) plasma and urine lipid oxidation products (isoprostanes, HETE, HDHA, specialized pro-resolving mediators, aldehydes) and 8-hydroxy-2'deoxyguanosisne (a DNA adduct of oxidative damage) of AMD patients compared to healthy age-matched controls in adults with Chinese diet.…”

“…Detailed recruitment criteria and baseline characteristics of the subjects are described in previous study [19]. Plasma fatty acids and carotenoid levels were measured [19] and reported as total carotenoids and omega-6/omega-3 PUFA ratios in this study. These values were not calculated previously [19].…”

Altersbedingte Makuladegeneration und Omega-3

“…In derselben Studienpopulation wurden die Spiegel der einzelnen Fettsäuren von Gesunden und AMD-Patienten miteinander verglichen [6] Antioxidanzien aus der AREDS-Studie plus Lutein/Zeaxanthin aus der AREDS2-Studie. Obwohl AREDS2 bezüglich Omega-3 negativ verlaufen war, empfahl ich Frau B. wegen der positiven epidemiologischen Studien und der methodischen Mängel der AREDS2-Studie bezüglich Omega-3 ein Omega-3-Präparat.…”

“…Carotinoidspiegel und Omega-6/3-Quotient bei Gesunden und AMD-Patienten. Verschiedene Nährstoffe und ihre Differenz bei AMD und Gesunden sowie die Odds Ratio für AMD bei einem niedrigen Spiegel[6]. EPA und DHA bedeutet ein 3-bis knapp 8-fach erhöhtes Risiko, dass eine AMD auftritt, wobei der Effekt für die pflanzliche ALA am schwächsten und für die maritimen EPA und DHA am stärksten ist.…”