The Relationship Between Plasma Concentrations of Lutein and Zeaxanthin with Self-Reported and Actual Prevalence of AMD in an Irish Population-Based Sample

Figures & data

Figure 1. The Irish Longitudinal Study on Ageing (TILDA) participants included in this investigation. Photographs were judged as ungradable based on a priori criteria of photographic quality. The phenomenon of participants without plasma concentration of lutein and zeaxanthin was attributable to one of the following: participant did not consent to give a blood sample, a failure to perform a venepuncture at the time of the health assessment, insufficient sample for carotenoid analysis or sample lost during carotenoid extraction/analysis.

Table 1. Demographics, health and lifestyle characteristics of participants in this investigation.

Variables (n = 4,423)	Mean ± SD or n (%)
Age (years)	61.36 ± 8.19
50–64	2888 (65.3%)
65–74	1174 (26.5%)
75+	361 (8.2%)
Sex (Female)	2378 (53.8%)
Education level
Primary/none	944 (21.4%)
Secondary	1861 (42.1%)
Third level	1616 (36.5%)
BMI (kg/m^Citation2)	27.13 ± 8.13
Smoking status*
Never	2036 (46.0%)
Past	1728 (39.1%)
Current	659 (14.9%)
Plasma L, µmol/L	0.2072 ± 0.128
Plasma Z, µmol/L	0.0562 ± 0.047
Family history of AMD*
Don’t know	423 (9.6%)
No	3769 (85.2%)
Yes	231 (5.2%)
Self-reported AMD*	65 (1.5%)
Grading-confirmed AMD	288 (6.5%)
Early AMD	273 (6.2%)
Late AMD	15 (0.34%)
Supplement use*	102 (2.3%)

Data displayed are mean ± standard deviation (SD) for interval data and percentages for categorical data: Variables, variables analyzed in the study; n, number of participants; Education level, highest level of education (primary/none, secondary, and third level); BMI, body mass index; Smoking status, never (non-smoker), past smoker and current smoker; Plasma lutein (L) and total zeaxanthin (Z), concentrations measured by high performance liquid chromatography; Family history of AMD, % of participants self-reporting family history of age-related macular degeneration; Self-reported AMD, % of participants that self-reported a doctor diagnosis of AMD; Grading-confirmed AMD, % of participants with grading-confirmed AMD, retinal photographs were graded by a certified grader using a modified version of the International Classification and Grading System for AMD, thereby establishing such a diagnosis; Supplement use, use of supplements containing either L and/or Z and/or MZ;* Self-reported.

Figure 2. Mean plasma concentrations of lutein and total zeaxanthin of subgroups in this investigation. Plasma lutein and zeaxanthin concentrations measured by high performance liquid chromatography. Group 1 (n = 24): grading-confirmed AMD in association with self-reported AMD; Group 2 (n = 264): grading-confirmed AMD in the absence of self-reported AMD; Group 3 (n = 41): grading-confirmed absence of AMD in association with self-reported AMD; Group 4 (n = 4094): grading-confirmed absence of AMD in association with self-reported absence of AMD. Grading-confirmed AMD, retinal photographs were graded by a certified grader using a modified version of the International Classification and Grading System for AMD; Self-reported AMD, participants were asked whether a doctor had diagnosed them with AMD.

Table 2. Summary of cross-sectional studies designed to investigate a possible relationship between age-related macular degeneration and serum concentrations of macular pigment’s constituent carotenoids.

First Author, publication year	Period of data collection	Sample size	Type of study	Correlates under investigation	Use of L and/or, Z and/or MZ containing supplements	Principal finding
EDCC Study Group, 1993^23	1986-1990	968	C-C	Serum L and Z (combined)	Data not recorded	Inverse relationship with serum L and Z
Mares-Perlman et al., 1995^33	1988-1990	334	C-C	Serum L and Z (combined)	Data not recorded	No relationship identified
Mares-Perlman et al., 2001^21	1988-1994	8,222	P-B	Serum L and Z (combined)	Data not recorded	Inverse relationship with serum L and Z**
Sanders et a., 1993^34		130	C-C	Serum L	Data not recorded	No relationship identified
Moeller et al., 2006^35	1994-98 & 2001-04*|	1,787	P-B	Serum L and Z	Data not factored	No relationship identified
Gale et al., 2003^22	1996-1997	380	P-B	Serum L and Z	Data not recorded	Inverse relationship with serum Z
Delcourt et al., 2006^20	1996-1997	640	P-B	Serum L and Z	Data not recorded	Inverse relationship with serum L and Z
Dasch et al., 2005^36	2001-2003	910	C-C	Serum L and Z	Data recorded and factored into analyses	No relationship identified
Simonelli et al., 2002^37		94	C-C	Serum L and Z (combined)	Data not recorded	No relationship identified
Michikawa et al., 2009^38	2005-2006	722	P-B	Serum L and Z (combined)	Data not recorded	No relationship identified.
Cardinault et al., 2005^39		55	C-C	Serum L and Z	Data not recorded	No relationship identified
Zhou et al., 2011^40	2007-2008	263	C-C	Serum L and Z	Data recorded and factored into analyses	Inverse relationship with serum Z

Publications organized by publication date in the absence of authors reporting period of data collection; solid line indicates the year (1999) that lutein-containing supplements were commercially available; principal finding is italicized when an inverse relationship is reported. EDCC Study Group, Eye Disease Case-Control Study Group; Type of study: C-C, case-control study; P-B, population-based study; Correlates under investigation: serum lutein (L) and total zeaxanthin (Z), concentrations measured by high performance liquid chromatography (HPLC); Use of L and/or, Z and/or MZ supplements: Data not recorded; supplement data not collected during study visit; Data not factored into analyses, supplement data was collected but not used in analysis between age-related macular degeneration subjects and control subjects; Data recorded and factored into analyses, data of supplement use was collected during study and factored into analyse, exclusion of subjects consuming supplements, or confirmation that none of the subjects consumed supplements; *Serum concentrations of L and Z were collected in 1994-1998, however data on supplement use was collected 2001–2004; **inverse relationship, though marginal.

Chew EY, Clemons TE, Agron E, Sperduto RD, Sangiovanni JP, Davis MD, Ferris FL. Ten-year follow-up of age-related macular degeneration in the age-related eye disease study: AREDS report no. 36. JAMA Ophthalmol. 2014;132(3):272–77.

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