van Raamt A Fleur, Kalmijn Sandra, Mali Willem P Th M, van Zandvoort Martine J E, van der Graaf Yolanda
Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
J Am Geriatr Soc. 2006 Apr;54(4):575-9. doi: 10.1111/j.1532-5415.2006.00653.x.
To assess the relationship between total plasma homocysteine (tHcy) level and cognitive function in patients with manifest arterial disease.
Cross-sectional.
Patients with symptomatic cerebrovascular disease, cardiovascular disease, peripheral arterial disease, or abdominal aortic aneurysm included in the Second Manifestations of ARTerial disease study, a single-center, longitudinal study with an extensive screening program at baseline.
Three hundred forty-five consecutively included patients, mean age 59.
The patients underwent an extensive neuropsychological test. The cognitive domains assessed were memory, executive function, attention, and visuoperception and construction. Each raw score was transformed into standardized z-scores, and a sum score for global cognitive function was determined. Risk factors and vascular damage were measured in detail.
Linear regression showed that elevated levels of tHcy were related to lower global cognitive function (beta=-0.065, 95% confidence interval (CI)=-0.116 to -0.013) and, more specifically, lower performance on memory (beta=-0.078, 95% CI=-0.155 to -0.002), attention (beta=-0.079, 95% CI=-0.163 to -0.005), and visuoperception and construction (beta=-0.125, 95% CI=-0.236 to -0.014) per standard deviation increase in tHcy (SD=6.4 mol/L), after adjustment for age, sex, educational level, extent of atherosclerosis, and location of vascular disease. Silent cerebral infarcts did not influence this relationship.
A relationship was found between tHcy levels and cognitive function that was independent of extent and location of arterial disease. The results suggest that vascular mechanisms are not responsible for the relationship between tHcy and cognitive function.
评估明显动脉疾病患者血浆总同型半胱氨酸（tHcy）水平与认知功能之间的关系。
横断面研究。
纳入“动脉疾病的二次表现”研究的有症状脑血管疾病、心血管疾病、外周动脉疾病或腹主动脉瘤患者，这是一项单中心纵向研究，在基线时有广泛的筛查项目。
连续纳入345例患者，平均年龄59岁。
患者接受了广泛的神经心理学测试。评估的认知领域包括记忆、执行功能、注意力以及视觉感知和构建。每个原始分数转换为标准化z分数，并确定总体认知功能的总分。详细测量了危险因素和血管损伤情况。
线性回归显示，tHcy水平升高与总体认知功能较低相关（β=-0.065，95%置信区间（CI）=-0.116至-0.013），更具体地说，每增加一个标准差的tHcy（标准差=6.4 μmol/L），在调整年龄、性别、教育水平、动脉粥样硬化程度和血管疾病位置后，记忆（β=-0.078，95%CI=-0.155至-0.002）、注意力（β=-0.079，95%CI=-0.163至-0.005）以及视觉感知和构建（β=-0.125，95%CI=-0.236至-0.014）方面的表现更低。无症状性脑梗死不影响这种关系。
发现tHcy水平与认知功能之间存在一种独立于动脉疾病范围和位置的关系。结果表明血管机制并非tHcy与认知功能之间关系的原因。
