Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
J Alzheimers Dis. 2014;38(1):111-20. doi: 10.3233/JAD-130722.
Oxidative stress, inflammation, and increased cholesterol levels are all mechanisms that have been associated with Alzheimer's disease (AD) pathology. Several epidemiologic studies have reported a decreased risk of AD with fish consumption. This pilot study was designed to evaluate the effects of supplementation with omega-3 fatty acids alone (ω-3) or omega-3 plus alpha lipoic acid (ω-3 + LA) compared to placebo on oxidative stress biomarkers in AD. The primary outcome measure was peripheral F2-isoprostane levels (oxidative stress measure). Secondary outcome measures included performance on: Mini-Mental State Examination (MMSE), Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL), and Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Thirty-nine AD subjects were randomized to one of three groups: 1) placebo, 2) ω-3, or 3) ω-3 + LA for a treatment duration of 12 months. Eighty seven percent (34/39) of the subjects completed the 12-month intervention. There was no difference between groups at 12 months in peripheral F2-isoprostane levels (p = 0.83). The ω-3 + LA and ω-3 were not significantly different than the placebo group in ADAS-cog (p = 0.98, p = 0.86) and in ADL (p = 0.15, p = 0.82). Compared to placebo, the ω-3 + LA showed less decline in MMSE (p < 0.01) and IADL (p = 0.01) and the ω-3 group showed less decline in IADL (p < 0.01). The combination of ω-3 + LA slowed cognitive and functional decline in AD over 12 months. Because the results were generated from a small sample size, further evaluation of the combination of omega-3 fatty acids plus alpha-lipoic acid as a potential treatment in AD is warranted.
氧化应激、炎症和胆固醇水平升高都是与阿尔茨海默病（AD）病理相关的机制。几项流行病学研究报告称，食用鱼类可降低 AD 的风险。这项初步研究旨在评估单独补充ω-3 脂肪酸（ω-3）或 ω-3 加α-硫辛酸（ω-3 + LA）与安慰剂相比对 AD 氧化应激生物标志物的影响。主要结局测量指标是外周 F2-异前列腺素水平（氧化应激测量指标）。次要结局测量指标包括：简易精神状态检查（MMSE）、日常生活活动/工具性日常生活活动（ADL/IADL）和阿尔茨海默病评估量表认知分量表（ADAS-cog）的表现。39 名 AD 受试者被随机分为三组之一：1）安慰剂，2）ω-3，或 3）ω-3 + LA，治疗持续 12 个月。87%（34/39）的受试者完成了 12 个月的干预。在 12 个月时，各组外周 F2-异前列腺素水平无差异（p = 0.83）。ω-3 + LA 和 ω-3 在 ADAS-cog 方面与安慰剂组无显著差异（p = 0.98，p = 0.86），在 ADL 方面无显著差异（p = 0.15，p = 0.82）。与安慰剂相比，ω-3 + LA 组在 MMSE（p < 0.01）和 IADL（p = 0.01）方面的下降幅度较小，而 ω-3 组在 IADL（p < 0.01）方面的下降幅度较小。ω-3 + LA 联合治疗可在 12 个月内减缓 AD 的认知和功能下降。由于结果来自小样本量，因此需要进一步评估 ω-3 脂肪酸加α-硫辛酸作为 AD 潜在治疗方法的组合。
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