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A prospective study of folate, vitamin B₆, and vitamin B₁₂ intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma.
JAMA Ophthalmol 2014; 132(5):549-59JO

Abstract

IMPORTANCE

Effective strategies for primary prevention are lacking for exfoliation glaucoma (EG), which is the most common type of secondary glaucoma.

OBJECTIVE

To examine the association between B vitamin intake and EG or suspected EG (EG/SEG) risk.

DESIGN, SETTING, AND PARTICIPANTS

National prospective cohort study using more than 20 years of follow-up data from the Nurses' Health Study (all female registered nurses) and the Health Professionals Follow-up Study (all male health professionals) from June 1, 1980, to May 31, 2010 (Nurses' Health Study) and January 1, 1986, to December 31, 2010 (Health Professionals Follow-up Study). We included a subset of 78,980 Nurses' Health Study women and 41,221 Health Professionals Follow-up Study men who were 40 years or older, free of glaucoma, had completed diet questionnaires, and reported eye examinations (follow-up rate, >85%).

EXPOSURES

Cumulatively updated intake of B vitamins (folate, vitamin B6, and vitamin B12) as ascertained by repeated administration of validated questionnaires.

MAIN OUTCOMES AND MEASURES

Incident cases of EG/SEG, totaling 399 (329 women and 70 men), were first identified with the questionnaires and were subsequently confirmed with medical records. Multivariable relative risks for EG/SEG were calculated in each cohort and then pooled with meta-analysis.

RESULTS

Vitamin B₆ and vitamin B₁₂ intake was not associated with EG/SEG risk in pooled analyses (P = .52 and P = .99 for linear trend, respectively). However, a suggestive trend of a reduced risk was observed with higher intake of folate: compared with the lowest quintile of cumulatively averaged updated total folate intake, the multivariable relative risk for EG/SEG for the highest quintile (≥654 μg/d) was 0.75 (95% CI, 0.54-1.04; P = .02 for linear trend). These results were not materially altered after adjustment for vitamin B₆ and vitamin B₁₂ intake. An association was observed for supplemental folate intake but not for dietary folate only (P = .03 and P = .64 for linear trend, respectively). Greater frequency of multivitamin use showed a modest suggestive inverse association (current multivitamin use of ≥6 times per week vs nonuse multivariable relative risk, 0.84; 95% CI, 0.64-1.11; P = .06 for linear trend).

CONCLUSIONS AND RELEVANCE

Higher total folate intake was associated with a suggestive lower risk for EG/SEG, supporting a possible causal role of homocysteine in EG/SEG.

Authors+Show Affiliations

Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts.Glaucoma Service, Massachusetts Eye and Ear, Boston, Massachusetts.Glaucoma Service, Massachusetts Eye and Ear, Boston, Massachusetts.Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts3Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts4Department of Epidemiology, Harvar.Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts2Glaucoma Service, Massachusetts Eye and Ear, Boston, Massachusetts.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24699833

Citation

Kang, Jae H., et al. "A Prospective Study of Folate, Vitamin B₆, and Vitamin B₁₂ Intake in Relation to Exfoliation Glaucoma or Suspected Exfoliation Glaucoma." JAMA Ophthalmology, vol. 132, no. 5, 2014, pp. 549-59.
Kang JH, Loomis SJ, Wiggs JL, et al. A prospective study of folate, vitamin B₆, and vitamin B₁₂ intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma. JAMA Ophthalmol. 2014;132(5):549-59.
Kang, J. H., Loomis, S. J., Wiggs, J. L., Willett, W. C., & Pasquale, L. R. (2014). A prospective study of folate, vitamin B₆, and vitamin B₁₂ intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma. JAMA Ophthalmology, 132(5), pp. 549-59. doi:10.1001/jamaophthalmol.2014.100.
Kang JH, et al. A Prospective Study of Folate, Vitamin B₆, and Vitamin B₁₂ Intake in Relation to Exfoliation Glaucoma or Suspected Exfoliation Glaucoma. JAMA Ophthalmol. 2014;132(5):549-59. PubMed PMID: 24699833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of folate, vitamin B₆, and vitamin B₁₂ intake in relation to exfoliation glaucoma or suspected exfoliation glaucoma. AU - Kang,Jae H, AU - Loomis,Stephanie J, AU - Wiggs,Janey L, AU - Willett,Walter C, AU - Pasquale,Louis R, PY - 2014/4/5/entrez PY - 2014/4/5/pubmed PY - 2014/7/9/medline SP - 549 EP - 59 JF - JAMA ophthalmology JO - JAMA Ophthalmol VL - 132 IS - 5 N2 - IMPORTANCE: Effective strategies for primary prevention are lacking for exfoliation glaucoma (EG), which is the most common type of secondary glaucoma. OBJECTIVE: To examine the association between B vitamin intake and EG or suspected EG (EG/SEG) risk. DESIGN, SETTING, AND PARTICIPANTS: National prospective cohort study using more than 20 years of follow-up data from the Nurses' Health Study (all female registered nurses) and the Health Professionals Follow-up Study (all male health professionals) from June 1, 1980, to May 31, 2010 (Nurses' Health Study) and January 1, 1986, to December 31, 2010 (Health Professionals Follow-up Study). We included a subset of 78,980 Nurses' Health Study women and 41,221 Health Professionals Follow-up Study men who were 40 years or older, free of glaucoma, had completed diet questionnaires, and reported eye examinations (follow-up rate, >85%). EXPOSURES: Cumulatively updated intake of B vitamins (folate, vitamin B6, and vitamin B12) as ascertained by repeated administration of validated questionnaires. MAIN OUTCOMES AND MEASURES: Incident cases of EG/SEG, totaling 399 (329 women and 70 men), were first identified with the questionnaires and were subsequently confirmed with medical records. Multivariable relative risks for EG/SEG were calculated in each cohort and then pooled with meta-analysis. RESULTS: Vitamin B₆ and vitamin B₁₂ intake was not associated with EG/SEG risk in pooled analyses (P = .52 and P = .99 for linear trend, respectively). However, a suggestive trend of a reduced risk was observed with higher intake of folate: compared with the lowest quintile of cumulatively averaged updated total folate intake, the multivariable relative risk for EG/SEG for the highest quintile (≥654 μg/d) was 0.75 (95% CI, 0.54-1.04; P = .02 for linear trend). These results were not materially altered after adjustment for vitamin B₆ and vitamin B₁₂ intake. An association was observed for supplemental folate intake but not for dietary folate only (P = .03 and P = .64 for linear trend, respectively). Greater frequency of multivitamin use showed a modest suggestive inverse association (current multivitamin use of ≥6 times per week vs nonuse multivariable relative risk, 0.84; 95% CI, 0.64-1.11; P = .06 for linear trend). CONCLUSIONS AND RELEVANCE: Higher total folate intake was associated with a suggestive lower risk for EG/SEG, supporting a possible causal role of homocysteine in EG/SEG. SN - 2168-6173 UR - https://www.unboundmedicine.com/medline/citation/24699833/A_prospective_study_of_folate_vitamin_B₆_and_vitamin_B₁₂_intake_in_relation_to_exfoliation_glaucoma_or_suspected_exfoliation_glaucoma_ L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2014.100 DB - PRIME DP - Unbound Medicine ER -