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维生素 D 三种剂量与老年女性认知结局的关系:一项双盲随机对照试验。

Three Doses of Vitamin D and Cognitive Outcomes in Older Women: A Double-Blind Randomized Controlled Trial.

机构信息

Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey.

Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.

出版信息

J Gerontol A Biol Sci Med Sci. 2020 Apr 17;75(5):835-842. doi: 10.1093/gerona/glz041.

Abstract

Vitamin D may affect cognitive performance, but previous studies are either short term or observational. We conducted a randomized controlled trial of vitamin D supplementation on domain-specific cognitive measures in postmenopausal women. Overweight/obese women with serum 25-hydroxyvitamin D (25OHD) levels less than 30 ng/mL were recruited. Vitamin D3 supplementation (600, 2,000, or 4,000 IU/d) was randomly assigned in a double-blinded manner for 1 year. Serum 25-hydroxyvitamin D, osteocalcin (total and undercarboxylated), amyloid beta, parathyroid hormone, and estradiol were analyzed before and after supplementation. Cognitive tests were administered after treatment. The women (58 ± 6 years; body mass index, 30.0 ± 3.5 kg/m2) had a baseline serum 25-hydroxyvitamin D level of 22.6 ± 5.8 ng/mL that increased to 30.2 ± 5.6, 36.0 ± 4.9, and 40.8 ± 7.0 ng/mL in the 600, 2,000, and 4,000 IU/d groups, respectively (p < .001). Participants taking 2,000 IU/d compared to other doses performed better in learning and memory tests (p < .05), yet the 4,000 IU/d group had a slower reaction time compared to the 600 IU/d group. Multiple regression indicated that serum undercarboxylated osteocalcin predicted tasks associated with reaction time and executive function, whereas body mass index and parathyroid hormone negatively predicted reaction time and executive function (p ≤ .01). These data suggest that vitamin D has differential effects on domain-specific cognitive measures and that a higher dose may negatively affect reaction time.

摘要

维生素 D 可能会影响认知表现,但之前的研究要么时间短,要么是观察性的。我们对绝经后妇女进行了一项维生素 D 补充剂对特定领域认知测试的随机对照试验。招募了血清 25-羟维生素 D(25OHD)水平低于 30ng/ml 的超重/肥胖女性。维生素 D3 补充剂(600、2000 或 4000IU/d)以双盲方式随机分配,持续 1 年。补充前后分析血清 25-羟维生素 D、骨钙素(总骨钙素和非羧化骨钙素)、淀粉样蛋白β、甲状旁腺激素和雌二醇。治疗后进行认知测试。这些女性(58±6 岁;体重指数 30.0±3.5kg/m2)的基线血清 25-羟维生素 D 水平为 22.6±5.8ng/ml,分别增加到 600、2000 和 4000IU/d 组的 30.2±5.6、36.0±4.9 和 40.8±7.0ng/ml(p<.001)。与其他剂量相比,服用 2000IU/d 的参与者在学习和记忆测试中表现更好(p<.05),但与 600IU/d 组相比,4000IU/d 组的反应时间较慢。多元回归表明,血清非羧化骨钙素预测与反应时间和执行功能相关的任务,而体重指数和甲状旁腺激素负预测反应时间和执行功能(p≤.01)。这些数据表明,维生素 D 对特定领域的认知测试有不同的影响,高剂量可能会对反应时间产生负面影响。

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