Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
J Am Med Dir Assoc. 2013 Nov;14(11):852.e9-17. doi: 10.1016/j.jamda.2013.06.010. Epub 2013 Aug 3.
The primary objective was to explore the possible association of serum 25-hydroxyvitamin D (25[OH]D) and vitamin D intake with markers of glucose metabolism, depression, and cognitive performance. In addition, we examined to what extent the associations between vitamin D and cognitive performance were modified or mediated by fasting plasma glucose (FPG) levels.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study using data of 127 frail or prefrail Dutch elderly, aged 65 years or older. Frailty was defined according to the criteria of Fried and colleagues. A participant was classified prefrail when 1 to 2 criteria were met; frailty was classified as the presence of 3 or more criteria.
Associations of 25(OH)D and vitamin D intake with markers of glucose metabolism and domain-specific cognitive performance were examined by multivariable regression analyses. The possible association of vitamin D with depression and global cognitive performance was explored by Poisson regression.
No associations were observed for 25(OH)D with FPG, fasting plasma insulin (FPI), Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR), or depression. In contrast, serum 25(OH)D was positively associated with executive functioning (β 0.007, P = .01) and tended to be associated with information-processing speed (β 0.006, P = .06). FPG did not modify or mediate these associations. Vitamin D intake was not associated with cognitive performance, glucose metabolism, or depression.
This cross-sectional study suggests an association of serum 25(OH)D with domain-specific cognitive performance, in particular executive functioning and possibly information-processing speed, but not with FPG, FPI, HOMA-IR, or depression. Whether these associations are causal is yet to be demonstrated.
主要目的是探讨血清 25-羟维生素 D(25[OH]D)和维生素 D 摄入量与糖代谢标志物、抑郁和认知表现的可能关联。此外,我们还研究了维生素 D 与认知表现之间的关联在多大程度上受到空腹血糖(FPG)水平的改变或中介。
设计、地点和参与者:这是一项使用 127 名荷兰虚弱或衰弱老年人的数据进行的横断面研究,年龄在 65 岁或以上。根据 Fried 等人的标准定义衰弱。当满足 1 至 2 项标准时,将参与者归类为虚弱前期;如果存在 3 项或更多标准,则将虚弱归类为存在。
通过多变量回归分析检查 25(OH)D 和维生素 D 摄入量与糖代谢标志物和特定领域认知表现的关联。通过泊松回归探索维生素 D 与抑郁和整体认知表现的可能关联。
25(OH)D 与 FPG、空腹血浆胰岛素(FPI)、稳态模型评估估计的胰岛素抵抗(HOMA-IR)或抑郁均无关联。相比之下,血清 25(OH)D 与执行功能呈正相关(β 0.007,P =.01),且与信息处理速度呈正相关(β 0.006,P =.06)。FPG 没有改变或介导这些关联。维生素 D 摄入量与认知表现、糖代谢或抑郁无关。
这项横断面研究表明,血清 25(OH)D 与特定领域的认知表现,特别是执行功能和可能的信息处理速度相关,而与 FPG、FPI、HOMA-IR 或抑郁无关。这些关联是否具有因果关系还有待证明。