Table 3.
Characteristics of included studies that investigated the associations of blood carotenoids and vitamins status and age-related macular degeneration.
| References, country | Characteristics of the study | Characteristics of the exposure | Characteristics of the participants | Adjustment for confounding factors | Study qualityc | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Design | Study name | Age range (year) | Men (%) | Assay method | Biological sample | Exposure | Control source | Ascertainment method | No. | Control (n) | Cases (n) | |||
| Merle et al. (26), France | Cohort (7.6 years follow-up) | The Alienor study | ≥73 | 36.3 | HPLC | Fasting plasma | Lutein (0.30; 0.29) mmol/L; zeaxanthin (0.07; 0.07) mmol/L; β-carotene (0.75; 0.70) mmol/L; ß-cryptoxanthin (0.30; 0.29) mmol/L; lycopene (0.46; 0.41) mmol/L (mean)b | PBS | International classification system | 609 | – | 54 late AMD | Sex, smoking, alcohol marital status, AMD grade at baseline, BMI, supplement use, blood draw season, diabetes, blood cholesterol, triglycerides, physical activity, AMD genetic risk score | High |
| EDCC Group (19), USA | Case control | EDDC | 55–80 | 43.8 | Reverse-phase HPLC | Fasting plasma | Lutein/zeaxanthin (0.25; 0.67) μmol/L; β-carotene (0.21; 0.74) μmol/L; ß-cryptoxanthin (0.09; 0.33) μmol/L; lycopene (0.19; 0.61) μmol/L; α-tocopherol (24.50; 43.39) μmol/L (median)b | HBS | NR | – | 615 | 421 late AMD | Age, sex, clinic, smoking, blood cholesterol, horizontal cup-disc ratio | High |
| Mares-Perlman et al. (20), USA | Nested case-control | BDEM | ≥43 | 50.0 | HPLC | Non-fasting serum | Lutein/zeaxanthin (0.29; 0.29) μmol/L; β-carotene (0.38; 0.39) μmol/L; ß-cryptoxanthin (0.18; 0.19) nmol/L; lycopene (0.51; 0.51) μmol/L; α-tocopherol (33.9; 32.3) μmol/L (mean)a | PBS | WARMGS | – | 167 | 167 early and late AMD | Age, blood cholesterol, beer drinking, vitamin C, vitamin E, and zinc use | High |
| Moeller et al. (27), USA | Case-control | CAREDS | 50–79 | NR | Reverse-phase HPLC | Fasting plasma | Lutein/zeaxanthin (0.15; 0.50) μmol/L (median)b | PBS | WARMGS | – | 1.787 | 331 early AMD | Age, smoking, family history of AMD, diabetes and CVD, hormone replacement therapy use | High |
| Present study, 2021, China | Matched case-control | Xi'an Eye Study | ≥45 | 48.6 | Reverse-phase HPLC | Fasting plasma | Lutein/zeaxanthin (0.32; 0.97) μmol/L; β-carotene (0.16; 0.28) μmol/L; ß-cryptoxanthin (0.04; 0.40) nmol/L; lycopene (0.03; 0.51) μmol/L; retinol (3.46; 6.27) μmol/L; α-tocopherol (32.7; 71.68) μmol/L (median)b | PBS | WARMGS | – | 296 | 164 early and late AMD | Age, sex, smoking, alcohol, education, physical activity, BMI, history of diabetes, blood cholesterol | High |
| Delcourt et al. (21), France | Cross-sectional | POLA | ≥60 | 43.7 | HPLC | Fasting plasma | Retinol (1.85; 2.80) μmol/L; α-tocopherol (27.2; 40.6) (median)b | PBS | International classification system | 2,157 | – | 41 early and late AMD | Age, sex, smoking, education, BMI, history of hypertension, diabetes, CHD, stroke, and angioplasty | Moderate |
| Mares-Perlman et al. (28), USA | Cross-sectional | NHANES III | ≥40 | NR | Reverse-phase HPLC | Fasting plasma | Lutein/zeaxanthin (2.08; 2.15) μmol/L (mean)b | PBS | WARMGS | 8,222 | – | 907 early and late AMD | Age, sex, smoking, alcohol, BMI, history of hypertension | High |
| Gale et al. (29), UK | Cross-sectional | the Jessop Hospital for Women | 66–75 | 54.0 | HPLC | Fasting plasma | Lutein/zeaxanthin (0.17; 0.25) μmol/L (median)b | HBS | WARMGS | 380 | – | 78 early and late AMD | Age, smoking, alcohol, blood cholesterol, hypermetropic refractive error, angioplasty or coronary artery bypass | High |
| Delcourt et al. (30), France | Cross-sectional | POLA | ≥60 | NR | HPLC | Fasting plasma | Lutein/zeaxanthin (0.25; 0.56) μmol/L; β-carotene (0.27; 0.97) μmol/L; ß-cryptoxanthin (0.13; 0.47) μmol/L; lycopene (0.22; 0.71) μmol/L (median)b | PBS | International classification system | 899 | – | 41 early and late AMD | Age, sex, smoking, BMI, lipid-standardized α-tocopherol, blood cholesterol | High |
| Michikawa et al. (31), Japan | Cross-sectional | Residents in Takasaki City | ≥65 | 41.1 | HPLC | Non-fasting serum | Lutein/zeaxanthin (0.48; 0.36) μmol/L; β-carotene (0.77; 0.41) μmol/L; ß-cryptoxanthin (0.19; 0.08) μmol/L; lycopene (0.20; 0.15) μmol/L; retinol (2.08; 2.15) μmol/L; α-tocopherol (26.00; 19.60) μmol/L (geometric mean)a | PBS | AREDS classification system | 722 | – | 40 early and late AMD | Age, sex, smoking, alcohol, education, outdoor activity, BMI, history of hypertension and cataract surgery, blood cholesterol, hemoglobin A1c | High |
AREDS, The Age-Related Eye Disease Study; AMD, age-related macular degeneration; BDEM, the Beaver Dam Eye study; BMI, body mass index; CAREDS, the Carotenoids in Age-Related Eye Disease study; EDDC, the Eye Disease Case-Control study; HBS, hospital-based study; HPLC, High Performance Liquid Chromatography; PBS, population-based study; POLA, Pathologies Oculaires Liées à l'Age study; NHANES III, the Third National Health and Nutrition Examination study; NR, not reported; WARMGS, Wisconsin Age-Related Maculopathy Grading System.
a
Exposure in controls vs. cases.
b
Lowest vs. highest categories in all subjects.
c
Study quality was assessed with the Newcastle-Ottawa Scale (for cohort and case-control study) or the Agency for Healthcare Research and Quality (for cross-sectional study).
CI, confidence interval.