Effect Of LA Single Or Combined With VC, VE And Zn Supplementation On Serum Lipids And Antioxidative Stress In Patients With Agerelated Macular Degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in elderly population. genetic and environmental factors have been implicated in the pathogenesis of AMD, but the exact cause of this disease remains unknown at present. So there was no effectived treatment with AMD. In recent years, the majority of studies have shown that oxidative stress was an important pathogenesis of AMD, and anti-oxidant stress became a hot spot of this disease. The antioxidant properties of LA have recently received great attention. lipoic acid (LA) has recently been reported to afford protection against oxidative damage in various disease processes, including Glucose metabolism, diabetic cataract, multiple neuritis and diabetic syndrome. Our treatment strategy aimde to explore the risks and benefits of supplementing with either LA, or combined with LA, vitamin C (VC), vitamin E (VE) and zinc (Zn) on serum lipid level, on oxidative stress and progression of AMD, provides a theoretical basis to prevention and treatment of AMD.Object and Method一. Research object1. Selection of case groupCollected AMD patients 69 cases whose agreed with participate in as subject case of this study group, aged above 45 from ophthalmology hospital in Shenyang from May, 2008 to December,2009.2. Selection of control groupSelected 30 cases whose age above 45 years old volunteers as control group from the middle quality life community of Shenyang during 2008. All participants are required to sign informed consent, and with a history of RPE-related eye disease, heart, liver, kidney and endocrine system diseases were excluded.二. Research methodInformed consent was obtained from the Participants with AMD prior to the study. Participants were randomly assigned to receive daily oral adminisstration containing: LA group (I group); LA, VC, VE and Zn group(II group); placebo group(IIIgroup). Every group was administred with three months. According eyeground photography, fundus photograph, eye chart, Amsler Grid and patients complained to understanding fundus, visual acuity and visual material changes in deformation of patients before and after intervention. Total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) concentrations superoxide dismutase malondialdehyde total antioxidant capacity vitamin E, vitamin C in the serum were determined before and after intervention.Results1. The basic characteristics of the AMD group and the control groupCompared with the control group, there was no statistically significant difference in age, sex, BMI, smoking history and antioxidants (VC, VE, Zn) intake of the AMD group (P>0.05).2. Parameters of oxidative stress in blood of AMD group and control groupCompared with the control group, the level of malondialdehyde (MDA) in serum of the AMD group which before intervention significantly increased(P<0.01), total antioxidant capacity (T-AOC), VE, VC significantly decreased(P<0.05), superoxide dismutase (SOD) activity had no statistically significant(P>0.05).3. Baseline characteristics of AMD before and after interventionA total of 69 AMD subjects were identified for the first blood draw, the average age was 65.00±8.61 years, and 35 males,34 females. Mainly in patients with dry AMD, there were 42 patients, accounting for 60.9%. There were 18 wet AMD patients, accounting for 26.1%. there were 9 mixed-type AMD patients, accounting for 13.0%. Judging from aged above 65 group, there were 40 patients, accounting for 57.97%. followed by the 45～64 age group, there were 29 patients, accounting for 42.03%. there were 52 AMD subjects remained for the second blood draw after intervention for three months, complianced rate was 75.4%. There was no significant visual increase before and after intervention.4. Oxidative stress parameters of three AMD groups before and after interventionCompared with baseline parameter, there was a statistically significant higher in serum SOD activity after intervention of I group (P＜0.01), there was no statistically significant difference in serum MDA, T-AOC, VE, VC between oral administration of I group for three months in AMD subjects (P>0.05). Compared with baseline parameter, there was a statistically significant higher in serum SOD, VC, VE after intervention.of II group (P＜0.01), there was no statistically significant difference in serum MDA, T-AOC between oral administration ofⅡgroup for three months in AMD subjects (P>0.05). SOD activity, the levels of VC, VE and MDA in blood had no statistically significant differences before and after intervention of III groups (P>0.05).5. Oxidative stress parameters of three AMD groups before and after intervention between different agesCompared with 45～64 age group baseline parameter, SOD activity in serum of I group significantly increased (P＜0.01). There was no statistically significant difference in serum MDA, T-AOC, VC, VE after intervention of III groups in AMD subjects (P>0.05). Compared with 45～64 age group baseline parameter, there was a statistically significant higher in serum T-AOC after intervention of II group (P＜0.05), there was no statistically significant difference in serum MDA, SOD, VC, VE between oral administration of II group for three months in AMD subjects (P>0.05). Compared with 65～80 age group baseline parameter, there was a statistically significant higher in serum SOD, VC, VE after intervention of I group and II group (P<0.05), there was no statistically significant difference in serum MDA, T-AOC between oral administration of I group and II group for three months in AMD subjects (P>0.05). There was no statistically significant differences in serum SOD, VC, VE and MDA before and after intervention of III groups (P>0.05).6. Serum lipid parameters of three AMD groups before and after intervention Compared with baseline parameter, there was no statistically significant difference in serum TC, TG, HDL-C and LDL-C between oral administration of three groups for three months in AMD subjects (P>0.05).7. Serum lipid parameters of three AMD groups before and after intervention between different agesCompared with 45～64 age group baseline parameter, there was no statistically significant difference in serum TC, TG, HDL-C and LDL-C after intervention ofⅢgroups (P>0.05). Compared with 65-80 age group baseline Parameter, there was no statistically significant difference in serum TC, TG, HDL-C and LDL-C after intervention ofⅢgroups (P>0.05).Conclusion1. LA or LA combined with VC, VE, Zn had a improving trend on visual distortion, but there was no significant change on visual loss.2. LA or LA combined with VC, VE, Zn had an apparent effect on SOD acitivity increased, and can increase the capacity of antioxidant system.3. LA or LA combined with VC, VE, Zn had no apparent effect on TC, TG, HDL-C and LDL-C level.