Association between Dietary Xanthophyll (Lutein and Zeaxanthin) Intake and Early Age-Related Macular Degeneration: The Atherosclerosis Risk in Communities Study

<p><i><b>Purpose</b></i>: To examine the association between xanthophyll intake and prevalent early age-related macular degeneration (AMD) using data from the Atherosclerosis Risk in Communities Study (<i>n</i> = 10,295). Potential effect modification by genetic polymorphisms and biomarkers of high-density lipoprotein (HDL) metabolism was explored.</p> <p><i><b>Methods</b></i>: Xanthophyll intake was assessed at visit 1 (1987–1989) using food frequency questionnaires. Prevalent early AMD was assessed at visit 3 (1993–1995) via retinal photographs. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for AMD by quintiles of xanthophyll intake, adjusted for age, sex, race, field center, and pack-years of smoking. To evaluate effect modification, the association between tertiles (T) of xanthophyll intake and AMD was stratified by complement factor H (<i>CFH</i>) rs1061170 and age-related maculopathy susceptibility 2 (<i>ARMS2</i>) rs10490924 genotypes, as well as by median cutpoints of HDL biomarkers.</p> <p><i><b>Results</b></i>: Xanthophyll intake was not associated with AMD in the overall sample, Caucasians (<i>n</i> = 8257), or African-Americans (<i>n</i> = 2038). Exploratory analyses observed that the association between xanthophyll intake and AMD varied statistically significantly by <i>CFH</i> rs1061170 genotype among Caucasians (<i>p</i> for interaction = 0.045) but not African Americans. No interactions were observed between xanthophyll intake and <i>ARMS2</i> rs10490924. Moreover, higher xanthophyll intake was associated with decreased odds of AMD among participants with lower HDL (OR = 0.79, 95% CI 0.57–1.09) but not higher HDL (<i>p</i> for interaction = 0.048).</p> <p><i><b>Conclusion</b></i>: Xanthophyll intake was not associated with early AMD. Further studies to investigate this association by genetic susceptibility or variations in HDL metabolism are needed.</p>