Oxidative and anti-oxidative stress markers in age-related macular degeneration: a systematic review and meta-analysis
Résumé
Topic: We conducted a systematic review and meta-analysis to evaluate the blood levels of oxidative and antioxidant markers in age-related macular degeneration (AMD) compared with acontrol group.
Clinical relevance: AMD is multifactorial disease among which oxidative stress may play amajor pathophysiological role.
Methods: The PubMed, Cochrane Library and Embase databases were searched on July 23th 2020 for studies reporting oxidative stress and antioxidant markers in AMD and in healthy controls using a combination of AMD, oxidative stress, and antioxidant keywords. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias. We stratified our meta-analysis on the type of biomarkers, the type of AMD, and the origin of the sample (plasma, serum, red blood cells). When possible (sufficient sample size), meta-regressions were proposed for comparison between subgroups and to study the effects of putative influencing factors.
Results: We included 67 case-control studies with a total of 37079 patients: 8521 with AMD and 28558 healthy controls. We included 33 studies in the meta-analysis on oxidative stress markers and 49 on antioxidant markers. We demonstrated a large increase in oxidative stress markers in AMD (Standard mean deviation = 1.48; 95% CI 1.03–1.93, P < 0.001) and a moderate decrease in antioxidant stress marker in AMD (-0.63; -0.80 to -0.46, P < 0.001). Glutathione peroxidase had the lowest blood levels among antioxidant markers (effect size = -1.57; 95% CI -2.42 to -0.73, P < 0.001). No significant differences were found between types of AMD. The differences in the blood levels of antioxidant markers between AMD patients and controls were significantly higher in plasma vs other samples (-1.11; -1.60 to -0.63, P < 0.001).
Conclusion: In conclusion, despite heterogeneity between studies, AMD patients had a higher oxidative stress status and lower antioxidant markers compared with healthy controls. Glutathione peroxidase seemed the best antioxidant biomarkers in blood.
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