Optimizing serum 25(OH)D levels to mitigate the risk of age-related ocular diseases: insights from a large-scale prospective cohort study.

IF 3.8 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2025-05-31 DOI:10.1186/s12937-025-01156-y

Zhiqian Huang, Shuyu Liu, Chao Chen, Keke Zhang, Yu Du, Xiangjia Zhu

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引用次数: 0

Abstract

Background: Investigations into the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of age-related ocular diseases have yielded inconsistent results. Thus, we aimed to provide robust longitudinal evidence, identify optimal serum thresholds, and explore the underlying mechanisms.

Methods: We analyzed data of 322,953 participants from the UK Biobank. The serum 25(OH)D levels were assessed using chemiluminescent immunoassay. Outcomes were incidences of cataract, primary open-angle glaucoma (POAG), age-related macular degeneration (AMD), and diabetic retinopathy (DR). Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models. Nonlinear relationships were explored using restricted cubic splines, and mediation analyses were performed to delineate potential mechanistic pathways.

Results: Our findings revealed U-shaped associations for cataract and AMD, and L-shaped associations for DR (all P < 0.05), with an optimal threshold of approximately 50 nmol/L, while no association with POAG was observed. Below this threshold, each 10 nmol/L increase in serum 25(OH)D concentration was linked to a 3.5%, 4.2%, and 6.0% reduction in the risk of cataract, AMD, and DR, respectively (HR 0.965 [95% CI 0.951-0.980]; HR 0.958 [95% CI 0.921-0.997]; HR 0.940 [95% CI 0.894-0.989], respectively), while above 50 nmol/L, no significant protective effects were observed. Mediation analyses revealed that the low-grade inflammation score and triglyceride-glucose index may mediate the effects of serum 25(OH)D on cataract and DR.

Conclusions: This study identified 50 nmol/L as the optimal serum 25(OH)D threshold for reducing risks of cataract, AMD and DR, with no benefits beyond this level. The protective effects may be mediated through modulation of inflammation and glucolipid metabolism pathways. The threshold effects highlight the importance of targeted vitamin D supplementation under careful monitoring of serum levels to optimize ocular health outcomes.

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优化血清25(OH)D水平以降低年龄相关眼部疾病的风险：来自一项大规模前瞻性队列研究的见解

背景：对血清25-羟基维生素D （25(OH)D）水平与年龄相关性眼部疾病风险之间关系的研究得出了不一致的结果。因此，我们旨在提供强有力的纵向证据，确定最佳血清阈值，并探索潜在的机制。方法：我们分析了来自UK Biobank的322,953名参与者的数据。采用化学发光免疫分析法测定血清25(OH)D水平。结果是白内障、原发性开角型青光眼（POAG）、年龄相关性黄斑变性（AMD）和糖尿病性视网膜病变（DR）的发病率。使用Cox比例风险模型估计风险比和95%置信区间。利用限制三次样条探索了非线性关系，并进行了中介分析以描绘潜在的机制途径。结论：本研究确定50 nmol/L是降低白内障、AMD和DR风险的最佳血清25(OH)D阈值，超过这个水平没有任何益处。保护作用可能是通过调节炎症和糖脂代谢途径介导的。阈值效应强调了在仔细监测血清水平的情况下靶向补充维生素D以优化眼健康结果的重要性。

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

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.