ImportanceCurcuma-based nutritional supplements (CBNS) are natural anti-inflammatory and antioxidant agents that may confer benefits against age-related macular degeneration (AMD).ObjectiveTo examine the association between the use of CBNS and the risk of development or progression of AMD.Design, Setting, and ParticipantsThis was a retrospective cohort study with data collection in June of 2024. Data were gathered from the aggregated electronic health records research network, TriNetX (Cambridge, Massachusetts). Patients without AMD were included in the study before propensity score matching (PSM); these included those taking and not taking CBNS. Patients with no history of AMD were stratified by instances of CBNS prescription records. Patients with a history of early nonexudative AMD stratified by instances of CBNS prescription records were also identified. PSM was performed to control for baseline demographics and medical comorbidities.ExposuresPatients were stratified by whether or not they were taking CBNS using RxNorm (National Library of Medicine) codes.Main Outcome MeasuresRelative risk (RR) of developing nonexudative AMD, exudative AMD, advanced nonexudative AMD or geographic atrophy (GA), blindness, or requiring intravitreal anti–vascular endothelial growth factor (VEGF) therapy.ResultsA total of 66 804 patients (mean [SD] age, 64.9 [10.1] years; 44 124 female [66.1%]) taking CBNS and 1 809 440 patients (mean [SD] age, 67.0 [9.5] years; 999 534 female [55.2%]) not taking CBNS were included in this study. Among patients without a history of AMD aged 50 years or older, CBNS use was associated with lower rates of developing nonexudative AMD (RR, 0.23; 95% CI, 0.21-0.26; P < .001), advanced nonexudative AMD or GA (RR, 0.11; 95% CI, 0.07-0.17; P < .001), exudative AMD (RR, 0.28; 95% CI, 0.24-0.32; P < .001), blindness (RR, 0.46; 95% CI, 0.36-0.59; P < .001), or requiring intravitreal anti-VEGF therapy (RR, 0.15; 95% CI, 0.13-0.17; P < .001) when compared with matched patients not taking CBNS. Results were consistent among subsets of patients 60 and 70 years or older, respectively. Among patients with early nonexudative AMD, subsequent instances of CBNS prescription records were associated with lower rates of developing advanced nonexudative AMD or GA (RR, 0.58; 95% CI, 0.41-0.81; P < .001) when compared with matched patients with early nonexudative AMD without a CBNS prescription record.Conclusion and RelevanceResults of this cohort study suggest that a reduced risk of developing AMD or progression to later stages of AMD was associated with subsequent use of CBNS. Further investigation to validate these findings, safety, and potential pharmacoprotective mechanisms of CBNS in AMD are suggested.

中文翻译：

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基于姜黄的营养补充剂和年龄相关性黄斑变性的风险


重要性姜黄营养补充剂 （CBNS） 是天然的抗炎和抗氧化剂，可能对年龄相关性黄斑变性 （AMD） 有益。目的检查 CBNS 的使用与 AMD.Design、环境和参与者的发育或进展风险之间的关联这是一项回顾性队列研究，于 2024 年 6 月收集数据。数据来自聚合的电子健康记录研究网络 TriNetX（马萨诸塞州剑桥市）。在倾向评分匹配 （PSM） 之前，无 AMD 的患者被纳入研究;这些包括服用和不服用 CBNS 的人。无 AMD 病史的患者按 CBNS 处方记录实例进行分层。还确定了具有早期非渗出性 AMD 病史的患者，按 CBNS 处方记录实例分层。进行 PSM 以控制基线人口统计学和医学合并症。暴露使用 RxNorm （National Library of Medicine） 代码根据患者是否服用 CBNS 对患者进行分层。主要结局指标发生非渗出性 AMD、渗出性 AMD、晚期非渗出性 AMD 或地理萎缩 （GA）、失明或需要玻璃体内抗血管内皮生长因子 （VEGF） 治疗的相对风险 （RR）。结果本研究共纳入 66 804 例服用 CBNS 的患者 （平均 [SD] 年龄，64.9 [10.1] 岁;44 124 名女性 [66.1%]）和 1 809 440 例未服用 CBNS 的患者 （平均 [SD] 年龄，67.0 [9.5] 岁;999 534 名女性 [55.2%]）。在 50 岁或以上无 AMD 病史的患者中，CBNS 的使用与非渗出性 AMD 的发生率较低相关 （RR，0.23;95% CI，0.21-0.26;P < .001）、晚期非渗出性 AMD 或 GA （RR， 0.11;95% CI， 0.07-0.17;P < .001）、渗出性 AMD （RR， 0.28;95% CI， 0.24-0.32;P < .001）、失明 （RR， 0.46;95% CI， 0.36-0.59;P < .001），或需要玻璃体内抗 VEGF 治疗 （RR， 0.15;95% CI， 0.13-0.17;P < .001）。结果分别在 60 岁和 70 岁或以上的患者亚群中是一致的。在早期非渗出性 AMD 患者中，随后的 CBNS 处方记录与晚期非渗出性 AMD 或 GA 的发生率较低相关 （RR，0.58;95% CI，0.41-0.81;P < .001） 与没有 CBNS 处方记录的早期非渗出性 AMD 匹配患者相比。结论和相关性该队列研究的结果表明，患 AMD 或进展到晚期 AMD 的风险降低与随后使用 CBNS 相关。建议进一步研究以验证 CBNS 在 AMD 中的这些发现、安全性和潜在的药物保护机制。