Associations of serum carotenoids with metabolic‐related diseases in middle‐aged and elderly adults: a cross‐sectional and follow‐up study
Authors: Chen Yu‐ming , Wang Cheng , Cao Yi , Chen Geng‐dong , Liu Jun , Zhang Zhe‐qing , Cao Wen‐ting , Zhu Ying‐ying , Liu Yan‐hua , Shi Wen‐qi Wen‐qi 
Published: November 2023

ObjectivesPrevious studies have suggested that blood values of carotenoids may be inversely associated with various chronic diseases, but limited data are available in Asian populations. This study examined the associations of serum carotenoids with metabolic sysndrome (MS), non‐alcoholic fatty liver disease (NAFLD), carotid intima‐media thickness (cIMT), bone mineral density (BMD) and skeletal muscle mass in adults.MethodsIn this community‐based study, we enrolled 4008 Chinese aged between 40–75 years in Guangzhou, China in 2011–2013. We completed the measurements of overnight fasting serum carotenoids of α‐carotene, β‐carotene, β‐cryptoxanthin, Lutein+zeaxanthin, total of them using a HPLC method, cIMT at the common carotid artery (CCA) and at the bifurcation (BIF) and presence and degree of NAFLD by B‐mode ultrasound, serum lipids, glucose, blood pressure and body measurements, and BMD at the whole body (WB), lumbar spine (LS) and hip (total and neck), and skeletal muscle mass at the limbs using a dual energy x‐ray absorptiometry in about 3000 subjects. Covariates were collected using interviewer‐adminstrated structured questionnaires. Up to date, 1628 subjects had completed the follow‐up measurements of the above outcome variables after a mean interval of 3.1 years (lost rate: 22%).ResultsIn the cross‐sectional analyses after adjusted for multiple covariates, the odds ratios (95%CI) for the individual carotenoids (quartile 4 vs. 1) were ranged between 0·23 (0·15, 0·36) (β‐carotene) to 0·44 0·29, 0·67 (lycopene) for the presence of MS (all p‐trend<0.01), and between 0.32 (0.25,0.41) (β‐carotene) to 0.62 (0.49,0.79) (β‐cryptoxanthin) for the presence of NAFLD (all p‐trend<0.01). The values of IMT in quartie 4 (vs. 1) were lower by 4.16%–5.12% and 2.69%–5.63% for all carotenoids (p‐trend: <0.001), except for lycopene (2.09% & 1.19%) at the CCA and BIF. Greater levels of α‐carotene, β‐carotene, and β‐cryptoxanthin were significantly associated with higher BMD values (difference for quartile 4 vs. 1: 1.5%–4.0%). All carotenoids (except β‐cryptoxanthin) had significant and favorable associations with skeletal muscle mass index (SMI, total muscle mass/height2, kg/m2). The percent differences for quartile 4 (vs. 1) were 1.77%–2.34%. In the follow‐up analyses, the favorable associations of the carotenoids with the changes in IMT, the severity of NAFLD, BMD and SMI were less significant possibly due to smaller number of subjects followed‐up at present, although similar trends were observed to those in the cross‐sectional results.ConclusionsGreater concentrations of serum carotenoids was associated with lower presenc of MS and NAFLD, lower values of cIMT, and higher levels of BMD and skeletal muscle mass, and might be benefit to their changes in middle‐aged and elderly adults.Support or Funding InformationThe study was jointly supported by the National Natural Science Foundation of China (no. 81472965, 81273049, 81130052) and the 5010 Program for Clinical Researches (No. 2007032) by the Sun Yat‐sen University, Guangzhou, China