Indiana University Center for Aging Research, Indianapolis, Indiana, USA.
Int Psychogeriatr. 2013 Nov;25(11):1859-66. doi: 10.1017/S1041610213001294. Epub 2013 Jul 30.
High levels of homocysteine have been associated with increased risk for dementia although results have been inconsistent. There are no reported studies from the developing world including Africa.
In this longitudinal study of two community-dwelling cohorts of elderly Yoruba and African Americans, levels of homocysteine, vitamin B12 and folate were measured from blood samples taken in 2001. These levels were compared in two groups, participants who developed incident dementia in the follow-up until 2009 (59 Yoruba and 101 African Americans) and participants who were diagnosed as cognitively normal or in the good performance category at their last follow-up (760 Yoruba and 811 African Americans). Homocysteine levels were divided into quartiles for each site.
After adjusting for age, education, possession of ApoE, smoking, and time of enrollment the higher quartiles of homocysteine were associated with a non-significant increase in dementia risk in the Yoruba (homocysteine quartile 4 vs. 1 OR: 2.19, 95% CI 0.95-5.07, p = 0.066). For the African Americans, there was a similar but non-significant relationship between higher homocysteine levels and dementia risk. There were no significant relationships between levels of vitamin B12 and folate and incident dementia in either site although folate levels were lower and vitamin B12 levers were higher in the Yoruba than in the African Americans.
Increased homocysteine levels were associated with a similar but non-significant increase in dementia risk for both Yoruba and African Americans despite significant differences in folate levels between the two sites.
同型半胱氨酸水平升高与痴呆风险增加相关,但结果并不一致。目前还没有来自发展中国家(包括非洲)的报告研究。
在这项针对两个居住在社区的老年约鲁巴人和非裔美国人队列的纵向研究中,于 2001 年采集血样测量同型半胱氨酸、维生素 B12 和叶酸水平。将这些水平与随访至 2009 年期间发生新发痴呆的两组参与者进行比较(59 名约鲁巴人和 101 名非裔美国人)和最后一次随访时被诊断为认知正常或表现良好的参与者(760 名约鲁巴人和 811 名非裔美国人)。根据每个地点将同型半胱氨酸水平分为四分位。
在校正年龄、教育程度、载脂蛋白 E 基因型、吸烟和入组时间后,较高四分位数的同型半胱氨酸与约鲁巴人痴呆风险的非显著性增加相关(同型半胱氨酸四分位 4 与 1 的比值:2.19,95%置信区间 0.95-5.07,p=0.066)。对于非裔美国人,较高的同型半胱氨酸水平与痴呆风险之间也存在类似但非显著性的关系。在两个地点,维生素 B12 和叶酸水平与新发痴呆均无显著相关性,尽管约鲁巴人的叶酸水平较低,而维生素 B12 水平较高。
尽管两个地点的叶酸水平存在显著差异,但同型半胱氨酸水平升高与约鲁巴人和非裔美国人的痴呆风险增加相似但无统计学意义。