dos Santos Eliseu Felippe, Busanello Estela Natacha Brandt, Miglioranza Anelise, Zanatta Angela, Barchak Alethea Gatto, Vargas Carmen Regla, Saute Jonas, Rosa Charles, Carrion Maria Júlia, Camargo Daiane, Dalbem André, da Costa Jaderson Costa, de Sousa Miguel Sandro René Pinto, de Mello Rieder Carlos Roberto, Wajner Moacir
Universidade Luterana do Brasil, RS, Brazil.
Metab Brain Dis. 2009 Jun;24(2):257-69. doi: 10.1007/s11011-009-9139-4. Epub 2009 Mar 18.
In the present work we measured blood levels of total homocysteine ((t)Hcy), vitamin B(12) and folic acid in patients with Parkinson s disease (PD) and in age-matched controls and searched for possible associations between these levels with smoking, alcohol consumption, L-DOPA treatment and disease duration in PD patients. We initially observed that plasma (t)Hcy levels were increased by around 30 % in patients affected by PD compared to controls. Linear correlation, multiple regression and comparative analyses revealed that the major determinant of the increased plasma concentrations of (t)Hcy in PD patients was folic acid deficiency, whereas in controls (t)Hcy levels were mainly determined by plasma vitamin B(12) concentrations. We also observed that alcohol consumption, gender and L-DOPA treatment did not significantly alter plasma (t)Hcy, folic acid and vitamin B(12) levels in parkinsonians. Furthermore, disease duration was positively associated with (t)Hcy levels and smoking was linked with a deficit of folic acid in PD patients. Considering the potential synergistic deleterious effects of Hcy increase and folate deficiency on the central nervous system, we postulate that folic acid should be supplemented to patients affected by PD in order to normalize blood Hcy and folate levels, therefore potentially avoiding these risk factors for neurologic deterioration in this disorder.
在本研究中，我们测量了帕金森病（PD）患者及年龄匹配的对照组的总同型半胱氨酸（(t)Hcy）、维生素B12和叶酸的血液水平，并探究这些水平与PD患者吸烟、饮酒、左旋多巴治疗及病程之间可能存在的关联。我们最初观察到，与对照组相比，PD患者的血浆(t)Hcy水平升高了约30%。线性相关、多元回归和比较分析显示，PD患者血浆(t)Hcy浓度升高的主要决定因素是叶酸缺乏，而在对照组中，(t)Hcy水平主要由血浆维生素B12浓度决定。我们还观察到，饮酒、性别和左旋多巴治疗并未显著改变帕金森病患者的血浆(t)Hcy、叶酸和维生素B12水平。此外，病程与(t)Hcy水平呈正相关，吸烟与PD患者叶酸缺乏有关。鉴于同型半胱氨酸升高和叶酸缺乏对中枢神经系统可能存在协同有害作用，我们推测应补充叶酸给PD患者，以使血液中的同型半胱氨酸和叶酸水平正常化，从而可能避免该疾病中导致神经功能恶化的这些风险因素。
