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维生素 D 与痴呆风险:鹿特丹研究。

Vitamin D and the Risk of Dementia: The Rotterdam Study.

机构信息

Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.

Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

J Alzheimers Dis. 2017;60(3):989-997. doi: 10.3233/JAD-170407.

Abstract

BACKGROUND

Vitamin D has gained interest as a potentially modifiable risk factor for dementia because of its putative neuroprotective effects. However, longitudinal studies examining the association between vitamin D and dementia have provided inconsistent results.

OBJECTIVE

To determine the relationship of serum vitamin D with prevalent and incident dementia in the general population.

METHODS

Within the prospective Rotterdam Study, we measured serum 25-hydroxyvitamin D concentrations between 1997 and 2001 using electrochemiluminescence-immunoassay in 6220 participants 55 years or older. We assessed dementia at baseline and continuously during follow-up until 1 January 2015. We used appropriate regression models to determine the relationship of vitamin D with prevalent and incident dementia, including Alzheimer's disease (AD). We adjusted models for age, sex, and season of blood collection. Additionally, we adjusted for ethnicity, education, cardiovascular risk factors, serum calcium, kidney function, depression, outdoor-activity and APOEɛ4 carriership.

RESULTS

At baseline, 127 of 6,220 participants had dementia, of whom 97 had AD. Lower vitamin D concentrations were associated with a non-significantly higher prevalence of dementia (adjusted OR, per SD decrease 1.20, 95% CI 0.95;1.52), but not with AD (adjusted OR: 0.97, 95% CI 0.74;1.29). Among 6,087 non-demented participants with 68,884 person-years of follow-up, 795 participants developed dementia, of whom 641 had AD. Lower vitamin D concentrations were associated with higher risk of dementia (adjusted HR, per SD decrease 1.11, 95% CI 1.02;1.20) and AD (adjusted HR: 1.13, 95% CI 1.03;1.24).

CONCLUSION

Lower serum vitamin D concentrations are associated with a higher incidence of dementia.

摘要

背景

由于维生素 D 具有潜在的神经保护作用,因此它作为痴呆的一个潜在可改变的风险因素而受到关注。然而,对维生素 D 与痴呆之间关联的纵向研究结果并不一致。

目的

确定一般人群中血清维生素 D 与现患和新发痴呆的关系。

方法

在前瞻性鹿特丹研究中,我们于 1997 年至 2001 年期间使用电化学发光免疫分析法测量了 6220 名 55 岁或以上参与者的血清 25-羟维生素 D 浓度。我们在基线和随访期间连续评估痴呆情况,直至 2015 年 1 月 1 日。我们使用适当的回归模型来确定维生素 D 与现患和新发痴呆(包括阿尔茨海默病)的关系。我们调整了模型以纳入年龄、性别和采血季节。此外,我们还调整了种族、教育、心血管危险因素、血清钙、肾功能、抑郁、户外活动和 APOEɛ4 携带情况。

结果

在基线时,6220 名参与者中有 127 名患有痴呆症,其中 97 名患有阿尔茨海默病。维生素 D 浓度较低与痴呆的患病率呈非显著升高相关(调整后的 OR,每降低 1 个标准差 1.20,95%CI 0.95;1.52),但与阿尔茨海默病无关(调整后的 OR:0.97,95%CI 0.74;1.29)。在 6087 名无痴呆且随访时间为 68884 人年的非痴呆参与者中,有 795 名发生痴呆,其中 641 名患有阿尔茨海默病。维生素 D 浓度较低与痴呆(调整后的 HR,每降低 1 个标准差 1.11,95%CI 1.02;1.20)和阿尔茨海默病(调整后的 HR:1.13,95%CI 1.03;1.24)的风险升高相关。

结论

血清维生素 D 浓度较低与痴呆的发生率较高相关。

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