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• W2027359110 abstract "Seddon et al1Seddon J.M. Reynolds R. Shah H.R. Rosner B. Smoking, dietary betaine, methionine, and vitamin D in monozygotic twins with discordant macular degeneration: epigenetic implications.Ophthalmology. 2011; 118: 1386-1394Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar recently reported the results of an interesting case series study on the association of vitamin D dietary intakes with age-related macular degeneration (AMD) among 14 monozygotic twin pairs with discordant AMD phenotypes. The authors found higher dietary intakes of vitamin D in the twins with early AMD compared to co-twins with more severe AMD (200.3±18.5 IU/day versus 170.9±16.9 IU/day respectively, P = 0.01), adjusted for smoking and age.1Seddon J.M. Reynolds R. Shah H.R. Rosner B. Smoking, dietary betaine, methionine, and vitamin D in monozygotic twins with discordant macular degeneration: epigenetic implications.Ophthalmology. 2011; 118: 1386-1394Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar Their findings suggest that some nutritional factors, and more specifically dietary vitamin D, could be involved in the etiology of AMD, in addition to genetic susceptibility. Furthermore, dietary vitamin D intakes might even influence the stage of AMD, since twins with low vitamin D intakes were more exposed to the development of severe AMD compared with their co-twins with higher intakes.1Seddon J.M. Reynolds R. Shah H.R. Rosner B. Smoking, dietary betaine, methionine, and vitamin D in monozygotic twins with discordant macular degeneration: epigenetic implications.Ophthalmology. 2011; 118: 1386-1394Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar We recognize the contribution of this study to the growing body of knowledge about the nonskeletal effects of vitamin D, including its anti-inflammatory and antiangiogenic properties.2Annweiler C. Souberbielle J.C. Schott A.M. et al.Vitamin D in the elderly: 5 points to remember.Geriatr Psychol Neuropsychiatr Vieil. 2011; 9: 259-267PubMed Google Scholar However, we strongly feel that measuring dietary vitamin D intake is only an approximate and insufficient method of assessment of the actual vitamin D status in the body, which may lead to misinterpretations. We suggest that measuring serum 25-hydroxyvitamin D (25[OH]D) concentrations would have been a better approach to explore the relationship between the vitamin D status and the progression of AMD. Indeed, nutrition has only a minor impact on the vitamin D levels in the human body, which is, in the absence of drug supplementation, generated in approximately 90% in the skin through the action of ultraviolet B light (UVB) radiation.2Annweiler C. Souberbielle J.C. Schott A.M. et al.Vitamin D in the elderly: 5 points to remember.Geriatr Psychol Neuropsychiatr Vieil. 2011; 9: 259-267PubMed Google Scholar, 3Garland C.F. French C.B. Baggerly L.L. Heaney R.P. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention.Anticancer Res. 2011; 31: 607-611PubMed Google Scholar For these reasons, serum 25(OH)D concentration is certainly a more effective indicator of vitamin D status,2Annweiler C. Souberbielle J.C. Schott A.M. et al.Vitamin D in the elderly: 5 points to remember.Geriatr Psychol Neuropsychiatr Vieil. 2011; 9: 259-267PubMed Google Scholar in particular since serum 25(OH)D does not rise as a function of vitamin D ingestion in a linear but in a curvilinear fashion.3Garland C.F. French C.B. Baggerly L.L. Heaney R.P. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention.Anticancer Res. 2011; 31: 607-611PubMed Google Scholar In addition, there is considerable interindividual variation in serum 25(OH)D levels with respect to the oral intakes or UVB doses.2Annweiler C. Souberbielle J.C. Schott A.M. et al.Vitamin D in the elderly: 5 points to remember.Geriatr Psychol Neuropsychiatr Vieil. 2011; 9: 259-267PubMed Google Scholar, 3Garland C.F. French C.B. Baggerly L.L. Heaney R.P. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention.Anticancer Res. 2011; 31: 607-611PubMed Google Scholar Therefore, even if Seddon et al1Seddon J.M. Reynolds R. Shah H.R. Rosner B. Smoking, dietary betaine, methionine, and vitamin D in monozygotic twins with discordant macular degeneration: epigenetic implications.Ophthalmology. 2011; 118: 1386-1394Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar controlled for residence north or south of the 37th parallel to account for sunlight exposure, we feel that their evaluation of the vitamin D intake does not effectively reflect the vitamin D status of the studied population. Only 2 previous studies have examined the cross-sectional association of serum 25(OH)D concentration with AMD. Millen et al4Millen A.E. Voland R. Sondel S.A. et al.Vitamin D status and early age-related macular degeneration in postmenopausal women.Arch Ophthalmol. 2011; 129: 481-489Crossref PubMed Scopus (101) Google Scholar showed that increased serum 25OHD concentrations were associated with decreased odds of early AMD among 968 women aged <75 years (odds ratio for highest quintile versus lowest quintile = 0.52; P for trend = 0.02).4Millen A.E. Voland R. Sondel S.A. et al.Vitamin D status and early age-related macular degeneration in postmenopausal women.Arch Ophthalmol. 2011; 129: 481-489Crossref PubMed Scopus (101) Google Scholar In another study, Parekh et al5Parekh N. Chappell R.J. Millen A.E. et al.Association between vitamin D and age-related macular degeneration in the Third National Health and Nutrition Examination Survey, 1988 through 1994.Arch Ophthalmol. 2007; 125: 661-669Crossref PubMed Scopus (126) Google Scholar found among 7752 adults aged 56.6 years on average that the odds ratio for early AMD among participants in the highest versus lowest quintile of serum 25OHD was 0.64 (P trend <0.001). The authors failed yet to demonstrate a significant association with advanced AMD (P = 0.50).5Parekh N. Chappell R.J. Millen A.E. et al.Association between vitamin D and age-related macular degeneration in the Third National Health and Nutrition Examination Survey, 1988 through 1994.Arch Ophthalmol. 2007; 125: 661-669Crossref PubMed Scopus (126) Google Scholar To conclude, further studies, measuring the serum 25(OH)D concentrations rather than the dietary intake of vitamin D, are needed in order to establish whether hypovitaminosis D is involved in the natural history of AMD and if relates to the staging of the disease. Smoking, Dietary Betaine, Methionine, and Vitamin D in Monozygotic Twins with Discordant Macular Degeneration: Epigenetic ImplicationsOphthalmologyVol. 118Issue 7PreviewWe evaluated monozygotic twin pairs with discordant age-related macular degeneration (AMD) phenotypes to assess differences in behavioral and nutritional factors. Full-Text PDF Author replyOphthalmologyVol. 119Issue 5PreviewIn our recent article, “Smoking, dietary betaine, methionine and vitamin D in monozygotic twins with discordant macular degeneration: epigenetic implications,”1 we report associations between dietary nutrients and advanced age-related macular degeneration (AMD), including increased risk of AMD with smoking, reduced risk of advanced AMD with increased dietary intake of methionine, betaine, and vitamin D. Annweiler et al suggest that serum 25(OH)D concentration “may be a more effective indicator of vitamin D status.” Although serum measurements of vitamin D provide data about all sources of vitamin D, our study focused on dietary intake of vitamin D. Full-Text PDF" @default.
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