Domínguez Raúl O, Marschoff Enrique R, Guareschi Eduardo M, Famulari Arturo L, Pagano Miguel A, Serra Jorge A
Facultad de Medicina, Hospital Sirio-Libanés-UBA, FACENE, Buenos Aires, Argentina.
Clin Chim Acta. 2005 Sep;359(1-2):163-70. doi: 10.1016/j.cccn.2005.03.049.
Increased concentration of plasmatic homocysteine (tHcy) and decreased vitamin B 12 (B12) and folate (FOL) are associated with Alzheimer's (AD) and vascular (VaD) dementias, with type II diabetes mellitus (DM), and reported as risk factors of these diseases.
The sample (n=122; males=60; mean age=73+/-7 years) comprised AD and VaD patients without DM, with a concomitant DM (AD+DM, VaD+DM), DM alone and controls (CTR), resulting in 6 groups. tHcy, B12 and FOL were determined in duplicate.
The one-way ANOVA yielded significant differences between groups for all variables: tHcy p<10(-12); B12 p<10(-3); FOL p<10(-4). Significance for comparisons between groups was set at alpha=0.05, using the Bonferroni's statistic. The comparisons: DM vs. CTR, AD+DM vs. AD, VaD+DM vs. VaD, and DM demented vs. DM non-demented resulted significant for all variables, except for B12 in 2 comparisons.
In demented and control subjects, tHcy and FOL exhibit extreme differences, not so marked between DM and controls. Demented patients with concomitant diabetes are closer to controls than their non-diabetic counterparts. Diabetes affects tHcy and FOL values, which are changed with opposite sign to non-demented. These results suggests a paradoxical phenomenon when diabetes is superimposed to dementias.
血浆同型半胱氨酸（总同型半胱氨酸）浓度升高以及维生素B12（B12）和叶酸（FOL）水平降低与阿尔茨海默病（AD）、血管性痴呆（VaD）、II型糖尿病（DM）相关，并且被报道为这些疾病的危险因素。
样本（n = 122；男性 = 60；平均年龄 = 73±7岁）包括无糖尿病的AD和VaD患者、合并糖尿病的患者（AD + DM、VaD + DM）、单纯糖尿病患者以及对照组（CTR），共分为6组。总同型半胱氨酸、B12和FOL均进行双份测定。
单因素方差分析显示，所有变量在各组之间均存在显著差异：总同型半胱氨酸p < 10⁻¹²；B12 p < 10⁻³；FOL p < 10⁻⁴。使用邦费罗尼统计量，组间比较的显著性设定为α = 0.05。比较结果显示：DM与CTR、AD + DM与AD、VaD + DM与VaD以及糖尿病痴呆患者与非糖尿病痴呆患者之间，所有变量均具有显著性差异，但在2项比较中B12除外。
在痴呆患者和对照受试者中，总同型半胱氨酸和FOL表现出极大差异，而DM与对照组之间差异不那么明显。合并糖尿病的痴呆患者比未患糖尿病的痴呆患者更接近对照组。糖尿病会影响总同型半胱氨酸和FOL值，其变化方向与非痴呆患者相反。这些结果表明，当糖尿病叠加在痴呆症之上时会出现一种矛盾的现象。
