Tully A M, Roche H M, Doyle R, Fallon C, Bruce I, Lawlor B, Coakley D, Gibney M J
Unit of Nutrition, Department of Clinical Medicine, Trinity Centre for Health Sciences, St James Hospital, Dublin, 8, Republic of Ireland.
Br J Nutr. 2003 Apr;89(4):483-9. doi: 10.1079/BJN2002804.
Low n-3 polyunsaturated fatty acid (PUFA) status may be associated with neuro-degenerative disorders, in particular Alzheimer's disease, which has been associated with poor dietary fish or n-3 PUFA intake, and low docosahexaenoic acid (DHA) status. The present case-control study used an established biomarker of n-3 PUFA intake (serum cholesteryl ester-fatty acid composition) to determine n-3 PUFA status in patients with Alzheimer's disease, who were free-living in the community. All cases fulfilled the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association criteria for Alzheimer's disease. Detailed neuropsychological testing and neuroimaging established the diagnosis in all cases. The subjects (119 females and twenty-nine males) aged 76.5 (SD 6.6) years had a clinical dementia rating (CDR) of 1 (SD 0.62) and a mini mental state examination (MMSE) score of 19.5 (SD 4.8). The control subjects (thirty-six females and nine males) aged 70 (SD 6.0) years were not cognitively impaired (defined as MMSE score <24): they had a mean MMSE score of 28.9 (SD 1.1). Serum cholesteryl ester-eicosapentaenoic acid and DHA levels were significantly lower (P<0.05 and P<0.001 respectively) in all MMSE score quartiles of patients with Alzheimer's disease compared with control values. Serum cholesteryl ester-DHA levels were progressively reduced with severity of clinical dementia. DHA levels did not differ in patients with Alzheimer's disease across age quartiles: all were consistently lower than in control subjects. Step-wise multiple regression analysis showed that cholesteryl ester-DHA and total saturated fatty acid levels were the important determinants of MMSE score and CDR. It remains to be determined whether low DHA status in Alzheimer's disease is a casual factor in the pathogenesis and progression of Alzheimer's disease.
n-3多不饱和脂肪酸（PUFA）水平较低可能与神经退行性疾病有关，尤其是阿尔茨海默病，这与鱼类或n-3 PUFA摄入不足以及二十二碳六烯酸（DHA）水平较低有关。本病例对照研究使用一种既定的n-3 PUFA摄入量生物标志物（血清胆固醇酯脂肪酸组成）来确定社区中自由生活的阿尔茨海默病患者的n-3 PUFA水平。所有病例均符合美国国立神经疾病与中风研究所及阿尔茨海默病及相关疾病协会的阿尔茨海默病标准。详细的神经心理学测试和神经影像学检查确诊了所有病例。研究对象（119名女性和29名男性）年龄为76.5（标准差6.6）岁，临床痴呆评定量表（CDR）评分为1（标准差0.62），简易精神状态检查表（MMSE）得分为19.5（标准差4.8）。对照组（36名女性和9名男性）年龄为70（标准差6.0）岁，无认知障碍（定义为MMSE得分<24）：他们的MMSE平均得分为28.9（标准差1.1）。与对照组相比，阿尔茨海默病患者所有MMSE得分四分位数的血清胆固醇酯二十碳五烯酸和DHA水平均显著降低（分别为P<0.05和P<0.001）。血清胆固醇酯-DHA水平随着临床痴呆严重程度的增加而逐渐降低。阿尔茨海默病患者的DHA水平在不同年龄四分位数之间没有差异：均持续低于对照组。逐步多元回归分析表明，胆固醇酯-DHA和总饱和脂肪酸水平是MMSE得分和CDR的重要决定因素。阿尔茨海默病患者中DHA水平较低是否是该病发病机制和进展中的一个偶然因素仍有待确定。
