Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Mov Disord. 2020 Aug;35(8):1462-1466. doi: 10.1002/mds.28070. Epub 2020 Apr 22.
Multiple system atrophy (MSA) is a neurodegenerative disorder from α-synuclein aggregation. in vitro studies suggest vitamin B12 may interrupt α-synuclein-mediated neurodegeneration. The objective of this study was to determine whether serum vitamin B12 level at MSA diagnosis is associated with survival.
One hundred eighty-two MSA patients evaluated at Mayo Clinic with vitamin B12 testing were studied. We determined the risk of death in relationship to serum vitamin B12 levels at MSA diagnosis, adjusting for predictors of poor survival.
Predictors of shorter survival included vitamin B12 < 367 ng/L (HR, 1.8; 95% CI, 1.3-2.7), falls within 3 years of MSA diagnosis (HR, 1.6; 95% CI, 1.1-2.3), bladder symptoms (HR, 1.6; 95% CI, 1.0-2.6), urinary catheter requirement (HR, 1.7; 95% CI, 1.0-2.8), male sex (HR, 1.4; 95% CI, 1.0-2.0), and MSA-P subtype (HR, 1.5; 95% CI, 1.0-2.0).
Low vitamin B12 levels are associated with shorter survival in MSA. Additional studies to explore this observation and assess the potential role of vitamin B12 as a modifiable survival factor are needed. © 2020 International Parkinson and Movement Disorder Society.
多系统萎缩（MSA）是一种由α-突触核蛋白聚集引起的神经退行性疾病。体外研究表明，维生素 B12 可能会中断α-突触核蛋白介导的神经退行性变。本研究旨在确定 MSA 诊断时血清维生素 B12 水平与生存是否相关。
对在 Mayo 诊所接受维生素 B12 检测的 182 例 MSA 患者进行了研究。我们确定了 MSA 诊断时血清维生素 B12 水平与死亡风险的关系，同时调整了影响生存的预测因素。
预测生存时间较短的因素包括维生素 B12<367ng/L（HR，1.8；95%CI，1.3-2.7）、MSA 诊断后 3 年内跌倒（HR，1.6；95%CI，1.1-2.3）、膀胱症状（HR，1.6；95%CI，1.0-2.6）、需要导尿（HR，1.7；95%CI，1.0-2.8）、男性（HR，1.4；95%CI，1.0-2.0）和 MSA-P 亚型（HR，1.5；95%CI，1.0-2.0）。
MSA 患者维生素 B12 水平较低与生存时间较短有关。需要进一步研究来探讨这一观察结果，并评估维生素 B12 作为可改变的生存因素的潜在作用。
