The Role of Vitamin D in Retinal Diseases in Aging

维生素 D 在衰老引起的视网膜疾病中的作用

• 批准号: 8271961
• 负责人: Amy Elizabeth Millen
• 金额: $ 41.73万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8271961
• 关键词: 25-hydroxyvitamin D; Accounting; African American; Age related macular degeneration; Aging; Anti-Inflammatory Agents; Anti-inflammatory; Atherosclerosis; Automobile Driving; Biological Assay; Blindness; Blood Glucose; Blood Pressure; Blood specimen; Caucasians; Caucasoid Race; Chronic Disease; Communities; Complement Factor H; Cost Measures; Data; Development; Diabetes Mellitus; Diabetic Retinopathy; Dietary Supplementation; Dietary intake; Disease; Disease Progression; Elderly; Epidemiologic Studies; Exercise; Eye diseases; Genes; Genetic; Goals; Health; Health Care Costs; Incidence; Individual; Lead; Life; Longitudinal Studies; Minority; Participant; Persons; Physical activity; Play; Population; Population Attributable Risks; Prevalence; Prevalence Study; Prevention therapy; Property; Prospective Studies; Quality of life; Reading; Research; Retinal; Retinal Diseases; Risk; Risk Factors; Role; Sampling; Serum; Smoking; Time; United States; Vision; Visit; Vitamin D; Vitamin D Deficiency; Vitamins; Woman; Work; age related; aging population; blood glucose regulation; cohort; cost; follow-up; food preparation; high risk; men; middle age; modifiable risk; population based; prevent; prospective

DESCRIPTION (provided by applicant): The number of aging individuals with the vision threatening diseases of diabetic retinopathy (DR) and age- related macular degeneration (AMD) is projected to increase in the coming decades as the aging population of the United States grows. Identifying new modifiable factors that prevent or delay vision threatening disease is significant because it will reduce the burden of health care costs for treatment of such chronic diseases and extend the years that the elderly can be independent and participate in such vision dependent activities as driving, reading, exercise, and food preparation. Vitamin D deficiency and inadequacy is prevalent in a large portion of the aging US population, and vitamin D has been shown to have anti-inflammatory and anti- angiogenic properties, in addition to potentially modulating blood pressure and glucose control. The long-term goal of the proposed research is to better understand the role of vitamin D status in retinal diseases highly prevalent in aging individuals. Minimal research has investigated the association between vitamin D status and DR; although a strong biologic rationale supports vitamin D status as a potential modifiable risk factor for DR development and progression. At the same time, research in two large epidemiologic studies show that people with vitamin D deficiency or inadequacy (25-hydroxyvitamin D (25(OH)D)<50 nmol/L) are more likely to have prevalent AMD, but no prospective studies of AMD incidence and vitamin D status have been conducted. We hypothesize that individuals with deficient or inadequate vitamin D status, compared to individuals with adequate status, will be more likely to have AMD and DR and be more likely to develop AMD. The purpose of this proposal is to investigate associations between vitamin D status and both DR and AMD using data from the aging (45-64 years) Atherosclerosis Risk in Communities (ARIC) population-based, biracial (African American and Caucasian) cohort. We propose to use previously collected data, including graded retinal photographs for DR and AMD status, and assayed serum 25(OH)D concentrations from ARIC study participants collected from 1987-1995, as well as graded retinal photographs currently being obtained in a follow-up study (2011-2013). Specifically, we propose to investigate the association between vitamin D status, assessed at Visit 2 (1990-1992), and 1) the presence of DR assessed at Visit 3 (1993-1995) among 1,657 individuals with diabetes and 2) the presence of AMD assessed at Visit 3 (1993-1995) among 11,532 participants. Third, we also proposed to investigate, for the first time, the association between vitamin D status, assessed in 1990-1992, and the incidence or progression of AMD (from 1993-1995 to 2011-2013) in a sample of approximately 2,346 ARIC participants. This study will advance our understanding of vitamin D status in relation to common vision-threatening eye diseases in the elderly and could lead to new therapies for the prevention or reduced progression of these diseases. PUBLIC HEALTH RELEVANCE: Diabetic retinopathy (DR) and age-related macular degeneration (AMD) are common vision-threatening eye diseases among the elderly. Current work suggests that persons with adequate vitamin D status are less likely to have AMD, but little work exists on the relationship of vitamin D and DR. Using data from a population-based, longitudinal study of aging African American and Caucasian men and women, we purpose to investigate the association between vitamin D status and prevalent DR and AMD; and second, we propose to investigate, for the first time, the association between vitamin D status and incidence or progression of AMD.

描述（由申请人提供）：随着美国人口老龄化的增长，预计未来几十年患有糖尿病性视网膜病（DR）和年龄相关性黄斑变性（AMD）等威胁视力疾病的老年人数量将会增加。确定预防或延缓威胁视力疾病的新的可改变因素具有重要意义，因为它将减轻治疗此类慢性疾病的医疗费用负担，并延长老年人独立并参与驾驶、阅读等视力依赖活动的年限。 、锻炼和食物准备。维生素 D 缺乏和不足在美国大部分老龄人口中普遍存在，维生素 D 除了可能调节血压和血糖控制外，还被证明具有抗炎和抗血管生成特性。拟议研究的长期目标是更好地了解维生素 D 状态在老年人中高度流行的视网膜疾病中的作用。初步研究调查了维生素 D 状态与 DR 之间的关联；尽管强有力的生物学原理支持维生素 D 状态作为 DR 发生和进展的潜在可改变危险因素。同时，两项大型流行病学研究表明，维生素D缺乏或不足（25-羟基维生素D（25(OH)D）<50 nmol/L）的人更有可能患有AMD，但尚无前瞻性研究对 AMD 发病率和维生素 D 状况进行了评估。我们假设，与维生素 D 充足的个体相比，维生素 D 缺乏或不足的个体更有可能患有 AMD 和 DR，并且更有可能发展为 AMD。本提案的目的是利用基于老龄化（45-64 岁）社区动脉粥样硬化风险 (ARIC) 人群的混血儿（非裔美国人和白种人）队列的数据，调查维生素 D 状态与 DR 和 AMD 之间的关联。我们建议使用以前收集的数据，包括 DR 和 AMD 状态的分级视网膜照片，以及 1987-1995 年收集的 ARIC 研究参与者的血清 25(OH)D 浓度分析，以及目前在后续研究中获得的分级视网膜照片。学习（2011-2013）。具体来说，我们建议调查 1,657 名糖尿病患者中第 2 次访视（1990-1992 年）评估的维生素 D 状态与 1）第 3 次访视（1993-1995 年）评估的 DR 的存在和 2）存在 DR 之间的关联。 AMD 在第 3 次访问（1993-1995）中对 11,532 名参与者进行了评估。第三，我们还提议首次调查 1990-1992 年评估的维生素 D 状态与 AMD 的发病率或进展（从 1993-1995 年到 2011-2013 年）之间的关联，样本中约有 2,346 名 ARIC参与者。这项研究将增进我们对维生素 D 状况与老年人常见的威胁视力的眼病相关的了解，并可能带来预防这些疾病或减缓这些疾病进展的新疗法。 公共卫生相关性：糖尿病视网膜病变 (DR) 和年龄相关性黄斑变性 (AMD) 是老年人中常见的威胁视力的眼部疾病。目前的研究表明，维生素 D 水平充足的人患 AMD 的可能性较小，但关于维生素 D 和 DR 之间关系的研究很少。我们利用一项针对老年非裔美国人和白人男性和女性的基于人群的纵向研究数据，旨在调查维生素 D 状况与流行的 DR 和 AMD 之间的关联；其次，我们建议首次研究维生素 D 状态与 AMD 发病或进展之间的关联。