ω-3减缓视网膜色素变性进展

2012-02-24 MedSci MedSci原创

一篇发表在JAMA/Archives期刊之一Archives of Ophthalmology上的报道,揭示患视网膜色素变性成年人服用VitA补充剂4至6年后,距离和视网膜视力年下降率缓慢,因服用富ω- 3脂肪酸的饮食。 视网膜色素变性是一种视网膜受损伤的眼疾。全世界大约2百万人(约1/4000)受这种典型的引起夜盲的疾病影响。症状通常首次出在儿童时期,但是诸如视野变小、管视和失明一样的严重

一篇发表在JAMA/Archives期刊之一Archives of Ophthalmology上的报道,揭示患视网膜色素变性成年人服用VitA补充剂4至6年后,距离和视网膜视力年下降率缓慢,因服用富ω- 3脂肪酸的饮食。

视网膜色素变性是一种视网膜受损伤的眼疾。全世界大约2百万人(约1/4000)受这种典型的引起夜盲的疾病影响。症状通常首次出在儿童时期,但是诸如视野变小、管视和失明一样的严重视力问题通常直到成年早期到晚期才出现。

1984到1991年、1996到2001年和2003到2008年开展的3个涉及典型视网膜色素变性病例的人类临床试验的视力数据被哈佛医学院和波士顿马萨诸塞州眼耳医院的Eliot L. Berson博士和他的研究小组检查。在当前的研究中,研究小组登记了357个都服用维生素A棕梠酸酯(15,000 IU/d)的病人。

这项研究的结果揭示,消费高ω- 3脂肪酸膳食的参与者(≥0.20 g/d)的距离视力平均年下降率相对于消费低ω- 3脂肪酸膳食的参与者较低。

在以前的一项研究中,研究小组揭示ω- 3脂肪酸摄入膳食对防止中心视野敏感性有影响。他们发现,接受每天至少0.20gω- 3脂肪酸摄入膳食联合每天维生素A棕梠酸酯1500IU的病人的中心视野敏感性下降率比接受更低ω- 3脂肪酸摄入膳食和相同剂量VitA的病人慢50%。

因此,VitA与高ω- 3脂肪酸摄入膳食结合的治疗服法使许多视网膜色素病人为他们的大部分生活维持视力与中心视野成为可能。

在早期治疗糖尿病视网膜病变研究(ETDRS)距离视力测试的每年简讯中的下降率评论,研究人员解释说,在4至6年时间内,每年简讯中的接受高ω- 3脂肪酸摄入膳食联合VitA的个人的平均下降率是0.59点,而接受低ω- 3脂肪酸摄入膳食结合VitA的个人的是1点。

一个代表性病人,他开始接受VitA直到35岁并吃富ω- 3脂肪酸摄入膳食(例如,每周服1/3到2/3盎司的鱼油)具有50点的ETDRS视力(相当于斯内伦视力表的20/ 30),平均而言,期望他们79岁时下降到24点的ETDRS视力(相当于斯内伦视力表的20/ 100),而接受维生素和低ω- 3脂肪酸摄入膳食(例如,每周服不到1/3盎司的鱼油)的病人在61岁时将下降到这一水平。

ω-3 Intake and Visual Acuity in Patients With Retinitis Pigmentosa Receiving Vitamin A

Eliot L. Berson, Bernard Rosner, Michael A. Sandberg, Carol Weigel-DiFranco, Walter C. Willett

ABSTRACT Objective :To evaluate whether a diet high in long-chain -3 fatty acids can slow the rate of visual acuity loss among patients with retinitis pigmentosareceiving vitamin A palmitate. Methods:We calculated dietary intake from questionnaires completed annually by 357 adult patients from 3 randomized trials who were all receiving vitamin A, 15 000 IU/d, for 4 to 6 years. Rates of visual acuity decline were compared between those with high ( 0.20 g/d) vs low (<0.20 g/d) -3 intake. Analyses took age into account. Results :Mean rates of decline of acuity were slower among those with high -3 intake: Early Treatment Diabetic Retinopathy Study distance acuity: high intake = 0.59 letter per year, low intake = 1.00 letter per year, P = .001; Snellen retinal acuity: high intake = 1.5% per year, low intake = 2.8% per year, P = .03. Conclusions: We conclude that mean annual rates of decline in distance and retinal visual acuities in adults with retinitis pigmentosa receiving vitamin A, 15 000 IU/d, are slower over 4 to 6 years among those consuming a diet rich in -3 fatty acids. To our knowledge, this is the first report that nutritional intake can modify the rate of decline of visual acuity in retinitis pigmentosa.

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    2012-08-15 sunylz
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    2012-02-26 zutt
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    2012-02-26 huangdf