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维生素 C 预防与年龄相关的认知能力下降和阿尔茨海默病的系统评价

A critical review of vitamin C for the prevention of age-related cognitive decline and Alzheimer's disease.

机构信息

Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

J Alzheimers Dis. 2012;29(4):711-26. doi: 10.3233/JAD-2012-111853.

Abstract

Antioxidants in the diet have long been thought to confer some level of protection against the oxidative damage that is involved in the pathology of Alzheimer's disease as well as general cognitive decline in normal aging. Nevertheless, support for this hypothesis in the literature is equivocal. In the case of vitamin C (ascorbic acid) in particular, lack of consideration of some of the specific features of vitamin C metabolism has led to studies in which classification of participants according to vitamin C status is inaccurate, and the absence of critical information precludes the drawing of appropriate conclusions. Vitamin C levels in plasma are not always reported, and estimated daily intake from food diaries may not be accurate or reflect actual plasma values. The ability to transport ingested vitamin C from the intestines into blood is limited by the saturable sodium-dependent vitamin C transporter (SVCT1) and thus very high intakes and the use of supplements are often erroneously considered to be of greater benefit that they really are. The current review documents differences among the studies in terms of vitamin C status of participants. Overall, there is a large body of evidence that maintaining healthy vitamin C levels can have a protective function against age-related cognitive decline and Alzheimer's disease, but avoiding vitamin C deficiency is likely to be more beneficial than taking supplements on top of a normal, healthy diet.

摘要

饮食中的抗氧化剂一直被认为能提供一定程度的保护,防止氧化损伤,这种氧化损伤与阿尔茨海默病的病理学以及正常衰老过程中的认知能力下降有关。然而,文献中对这一假设的支持是有争议的。就维生素 C(抗坏血酸)而言,缺乏对维生素 C 代谢某些特定特征的考虑,导致了一些研究中,根据维生素 C 状态对参与者进行分类不准确,而且缺乏关键信息,使得无法得出适当的结论。血浆中的维生素 C 水平并不总是报告,而从食物日记中估计的每日摄入量可能不准确或不能反映实际的血浆值。肠道吸收的维生素 C 向血液中的转运能力受到可饱和的钠依赖性维生素 C 转运蛋白(SVCT1)的限制,因此,高摄入量和补充剂的使用经常被错误地认为比实际情况更有好处。目前的综述记录了参与者的维生素 C 状态方面的研究差异。总的来说,有大量证据表明,保持健康的维生素 C 水平可以对与年龄相关的认知能力下降和阿尔茨海默病起到保护作用,但避免维生素 C 缺乏可能比在正常健康饮食的基础上补充剂更有益。

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