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补充维生素B12和叶酸对多发性硬化症患者血清同型半胱氨酸、贫血状况及生活质量的影响

The Effect of Vitamin B12 and Folic Acid Supplementation on Serum Homocysteine, Anemia Status and Quality of Life of Patients with Multiple Sclerosis.

作者信息

Nozari Ehsan, Ghavamzadeh Saied, Razazian Nazanin

机构信息

Department of Nutrition, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran.

Department of Neurology, Medicine Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Clin Nutr Res. 2019 Jan 25;8(1):36-45. doi: 10.7762/cnr.2019.8.1.36. eCollection 2019 Jan.

Abstract

UNLABELLED

Plasma homocysteine level and megaloblastic anemia status are two factors that can affect the quality of life of patients with multiple sclerosis (MS). We conducted this study to determine the effect of vitamin B12 and folic acid supplementation on serum homocysteine, megaloblastic anemia status and quality of life of patients with MS. A total of 50 patients with relapsing remitting multiple sclerosis (RRMS) included in this study which divided into 2 groups. The vitamin group received 5 mg folic acid tablet daily and 3 doses of vitamin B12 (1,000 mcg) injection and the other group received placebo and normal saline injection (same doses). The quality of life was measured by using Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54). Fully automated fluorescence polarization immunoassay was used to measure serum homocysteine, vitamin B12 and folate. Complete blood count blood test was conducted to determine the anemia status. The mean homocysteine level reduced by 2.49 ± 0.39 µmol/L (p = 0.001), hemoglobin increased from 11.24 ± 1.54 to 13.12 ± 1.05 g/dL (p = 0.001), and mean corpuscular volume decreased from 95.50 ± 6.65 to 89.64 ± 4.24 in the vitamin group (p = 0.001). There was a significant improvement in the mental field of life quality in the placebo group (37.46 ± 19.01 to 50.98 ± 21.64; p = 0.001), whereas both physical and mental fields of quality of life were improved significantly in the vitamin group (40.38 ± 15.07 to 59.21 ± 12.32 and 29.58 ± 15.99 to 51.68 ± 18.22, respectively; p = 0.001). Serum homocysteine level decrease and anemia status improvement with vitamin B12 and folic acid supplementation reveal the potential role of these two vitamins in improving the life quality of MS patients.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials Identifier: IRCT2015100313678N7.

摘要

未标注

血浆同型半胱氨酸水平和巨幼细胞贫血状态是影响多发性硬化症(MS)患者生活质量的两个因素。我们开展本研究以确定补充维生素B12和叶酸对MS患者血清同型半胱氨酸、巨幼细胞贫血状态及生活质量的影响。本研究共纳入50例复发缓解型多发性硬化症(RRMS)患者,分为2组。维生素组每日服用5毫克叶酸片并注射3次维生素B12(1000微克),另一组接受安慰剂和生理盐水注射(相同剂量)。使用多发性硬化症生活质量-54问卷(MSQOL-54)测量生活质量。采用全自动荧光偏振免疫分析法测量血清同型半胱氨酸、维生素B12和叶酸。进行全血细胞计数血液检测以确定贫血状态。维生素组的平均同型半胱氨酸水平降低了2.49±0.39微摩尔/升(p = 0.001),血红蛋白从11.24±1.54克/分升降至13.12±1.05克/分升(p = 0.001),平均红细胞体积从95.50±6.65降至89.64±4.24(p = 0.001)。安慰剂组生活质量的心理领域有显著改善(从37.46±19.01至50.98±21.64;p = 0.001),而维生素组生活质量的身体和心理领域均有显著改善(分别从40.38±15.07至59.21±12.32以及从29.58±15.99至51.68±18.22;p = 0.001)。补充维生素B12和叶酸使血清同型半胱氨酸水平降低且贫血状态改善,揭示了这两种维生素在改善MS患者生活质量方面的潜在作用。

试验注册

伊朗临床试验注册中心标识符:IRCT2015100313678N7。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d250/6355946/6b8e0c114577/cnr-8-36-g001.jpg

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