维生素D与新发痴呆或认知障碍无关:一项针对社区居住老年男性的18年随访研究。
Vitamin D is not associated with incident dementia or cognitive impairment: an 18-y follow-up study in community-living old men.
作者信息
Olsson Erika, Byberg Liisa, Karlström Brita, Cederholm Tommy, Melhus Håkan, Sjögren Per, Kilander Lena
机构信息
Departments of Public Health and Caring Sciences/Clinical Nutrition and Metabolism,
Surgical Sciences, Orthopedics,
出版信息
Am J Clin Nutr. 2017 Apr;105(4):936-943. doi: 10.3945/ajcn.116.141531. Epub 2017 Feb 15.
Vitamin D has been implicated as being important for maintaining cognitive function in old age. Results from longitudinal studies examining the association of vitamin D with incident dementia and cognitive impairment have been inconsistent. We investigated the relation between vitamin D, assessed in 3 different ways, and the risk of dementia. We measured plasma 25-hydroxyvitamin D [25(OH)D] with the use of high-performance liquid chromatography-mass spectrometry, assessed dietary vitamin D intake with the use of 7-d dietary records, and created a vitamin D-synthesis genetic risk score (GRS) at baseline (1991-1995) in a cohort of 1182 Swedish men (mean age: 71 y). In a maximum of 18 y (median: 12 y) of follow-up, 116 men developed Alzheimer disease, 64 men developed vascular dementia, and 250 men developed all-cause dementia. An additional 80 men declined in cognitive function as assessed with the use of the Mini-Mental State Examination. Adjusted HRs and ORs were calculated with the use of Cox and logistic regressions. The mean ± SD plasma 25(OH)D concentration was 68.7 ± 19.1 nmol/L. Plasma 25(OH)D, dietary vitamin D intake, and vitamin D-synthesis GRS were not associated with any cognitive outcomes (crude and adjusted HRs and ORs were ∼1.0 for all continuous exposures). The adjusted HR for all-cause dementia was 0.88 (95% CI: 0.59, 1.31) in men with plasma 25(OH)D concentrations ≤50 compared with >75 nmol/L. The adjusted HR for all-cause dementia was 0.92 (95% CI: 0.63, 1.32) for the lowest compared with highest tertiles of vitamin D intake. The adjusted HR for the continuous GRS for all-cause dementia was 1.04 (95% CI: 0.91, 1.19). In this cohort study, we show that there is no association between baseline vitamin D status and long-term risk of dementia or cognitive impairment over an 18-y period of time.
维生素D被认为对维持老年人的认知功能很重要。关于维生素D与新发痴呆症和认知障碍之间关联的纵向研究结果并不一致。我们调查了以三种不同方式评估的维生素D与痴呆症风险之间的关系。我们使用高效液相色谱-质谱法测量血浆25-羟基维生素D [25(OH)D],使用7天饮食记录评估饮食中维生素D的摄入量,并在一个由1182名瑞典男性(平均年龄:71岁)组成的队列中,在基线期(1991 - 1995年)创建了一个维生素D合成遗传风险评分(GRS)。在最长18年(中位数:12年)的随访中,116名男性患了阿尔茨海默病,64名男性患了血管性痴呆,250名男性患了全因性痴呆。另外80名男性在使用简易精神状态检查表评估时认知功能下降。使用Cox回归和逻辑回归计算调整后的风险比(HR)和比值比(OR)。血浆25(OH)D的平均±标准差浓度为68.7±19.1 nmol/L。血浆25(OH)D、饮食中维生素D的摄入量和维生素D合成GRS与任何认知结果均无关联(所有连续暴露的粗风险比和调整后风险比以及比值比均约为1.0)。与血浆25(OH)D浓度>75 nmol/L相比,血浆25(OH)D浓度≤50 nmol/L的男性全因性痴呆的调整后风险比为0.88(95%置信区间:0.59,1.31)。与维生素D摄入量最高三分位数相比,最低三分位数的全因性痴呆调整后风险比为0.92(95%置信区间:0.63,1.32)。全因性痴呆连续GRS的调整后风险比为1.04(95%置信区间:0.91,1.19)。在这项队列研究中,我们表明在18年的时间里,基线维生素D状态与痴呆症或认知障碍的长期风险之间没有关联。