Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2024-04-04 DOI:10.1016/j.advnut.2024.100216

Weili Hu, Vernice Seah, Vanessa Huang, Jung Eun Kim

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引用次数: 0

Abstract

Antioxidants are bioactive molecules that function to scavenge free radicals and balance oxidative stress. Although all antioxidants can act as reactive oxygen species scavengers, their efficacy on eye health may vary. Moreover, the comparative effectiveness and potential additive effect between groups of antioxidants, hitherto, have not been systematically studied. A systematic review and network meta-analysis were conducted to investigate the comparative or additive effect of dietary antioxidant supplements on eye health. Four databases (PubMed, Embase, CINAHL, and Cochrane) were searched, and relevant randomized controlled trials were identified. Out of 60 articles selected for systematic review, 38 were included in the network meta-analysis, categorized into 8 distinct antioxidant-supplemented groups and placebo. All groups significantly increased macular pigment optical density and contrast sensitivity at low spatial frequency, whereas only the antioxidant mixture + lutein (L) + fatty acid combination exhibited significant improvements in visual acuity (hazard ratio = –0.15; 95% confidence interval: –0.28, –0.02) and L + zeaxanthin combination for photostress recovery time (hazard ratio = –5.75; 95% confidence interval: –8.80, –1.70). Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at low spatial frequency (67.7%). However, these findings should be interpreted with caution due to low quality of evidence, primarily influenced by indirectness and potential publication bias. Overall, antioxidant supplementation was estimated to improve eye health parameters, whereas different combinations of antioxidants may also have varying effects on improving visual health from multiple perspectives.

This study was registered at PROSPERO as CRD42022369250.

查看原文本刊更多论文

补充抗氧化剂对黄斑色素光学密度和视觉功能的影响：随机对照试验的系统回顾和网络元分析

抗氧化剂是一种生物活性分子，具有清除自由基和平衡氧化应激的功能。虽然所有抗氧化剂都可以作为活性氧清除剂，但它们对眼睛健康的功效可能各不相同。此外，迄今为止，还没有系统地研究过各组抗氧化剂之间的比较效果和潜在的叠加效应。为了研究膳食抗氧化剂补充剂对眼睛健康的比较或叠加效应，我们进行了一项系统综述和网络荟萃分析。研究人员检索了四个数据库（PubMed、Embase、CINAHL 和 Cochrane），并确定了相关的随机对照试验。在60篇被选中进行系统回顾的文章中，38篇被纳入网络荟萃分析，分为8个不同的抗氧化剂补充剂组和安慰剂组。所有组别都能明显提高黄斑色素光学密度和低空间频率对比敏感度，而只有抗氧化剂混合物+叶黄素（L）+脂肪酸组合能明显改善视力（危险比=-0.15；95%置信区间：-0.28，-0.02），L+玉米黄质组合能明显改善光应激恢复时间（危险比=-5.75；95%置信区间：-8.80，-1.70）。特别是，L+玉米黄质+脂肪酸组合在黄斑色素光学密度方面排名第一（累积排名下的表面积：99.3%），在低空间频率对比敏感度方面排名第二（67.7%）。然而，由于证据质量不高，主要受间接性和潜在发表偏差的影响，这些研究结果应谨慎解读。总体而言，据估计补充抗氧化剂可平均改善眼部健康参数，而不同的抗氧化剂组合也可能从多个角度对改善视觉健康产生不同的效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.