随机、双盲、安慰剂对照试验研究叶酸联合 DHA 补充对轻度认知障碍老年人认知功能和淀粉样β相关生物标志物的影响。
Effects of Folic Acid Combined with DHA Supplementation on Cognitive Function and Amyloid-β-Related Biomarkers in Older Adults with Mild Cognitive Impairment by a Randomized, Double Blind, Placebo-Controlled Trial.
机构信息
Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
Department of Nutrition, Tianjin First Central Hospital, Tianjin, China.
出版信息
J Alzheimers Dis. 2021;81(1):155-167. doi: 10.3233/JAD-200997.
BACKGROUND
The neuroprotective benefits of combined folic acid and docosahexaenoic acid (DHA) on cognitive function in mild cognitive impairment (MCI) patients are suggested but unconfirmed.
OBJECTIVE
To explore the effects of 6-month folic acid + DHA on cognitive function in patients with MCI.
METHODS
Our randomized controlled trial (trial number ChiCTR-IOR-16008351) was conducted in Tianjin, China. We divided 160 MCI patients aged > 60 years into four regimen groups randomly: folic acid (0.8 mg/day) + DHA (800 mg/day), folic acid (0.8 mg/day), DHA (800 mg/day), and placebo, for 6 months. Cognitive function and blood amyloid-β peptide (Aβ) biomarker levels were measured at baseline and 6 months. Cognitive function was also measured at 12 months.
RESULTS
A total of 138 patients completed this trial. Folic acid improved the full-scale intelligence quotient (FSIQ), arithmetic, and picture complement scores; DHA improved the FSIQ, information, arithmetic, and digit span scores; folic acid + DHA improved the arithmetic (difference 1.67, 95% CI 1.02 to 2.31) and digital span (1.33, 0.24 to 2.43) scores compared to placebo. At 12 months, all scores declined in the intervention groups. Folic acid and folic acid + DHA increased blood folate (folic acid + DHA: 7.70, 3.81 to 11.59) and S-adenosylmethionine (23.93, 1.86 to 46.00) levels and reduced homocysteine levels (-6.51, -10.57 to -2.45) compared to placebo. DHA lower the Aβ40 levels (-40.57, -79.79 to -1.35) compared to placebo (p < 0.05), and folic acid + DHA reduced the Aβ42 (-95.59, -150.76 to -40.43) and Aβ40 levels (-45.75, -84.67 to -6.84) more than DHA (p < 0.05).
CONCLUSION
Folic acid and DHA improve cognitive function and reduce blood Aβ production in MCI patients. Combination therapy may be more beneficial in reducing blood Aβ-related biomarkers.
背景
联合使用叶酸和二十二碳六烯酸（DHA）对轻度认知障碍（MCI）患者的认知功能具有神经保护作用，但尚未得到证实。
目的
探讨 6 个月叶酸+DHA 对 MCI 患者认知功能的影响。
方法
我们在中国天津进行了这项随机对照试验（试验编号 ChiCTR-IOR-16008351）。我们将 160 名年龄大于 60 岁的 MCI 患者随机分为四组方案：叶酸（0.8mg/天）+DHA（800mg/天）、叶酸（0.8mg/天）、DHA（800mg/天）和安慰剂组，治疗 6 个月。在基线和 6 个月时测量认知功能和血液淀粉样蛋白-β 肽（Aβ）生物标志物水平。12 个月时还测量了认知功能。
结果
共有 138 名患者完成了这项试验。叶酸可提高全智商（FSIQ）、算术和图片补充分数；DHA 可提高 FSIQ、信息、算术和数字跨度分数；与安慰剂相比，叶酸+DHA 可改善算术（差值 1.67，95%置信区间 1.02 至 2.31）和数字跨度（1.33，0.24 至 2.43）分数。在 12 个月时，干预组的所有分数都下降了。与安慰剂相比，叶酸和叶酸+DHA 增加了血液叶酸（叶酸+DHA：7.70，3.81 至 11.59）和 S-腺苷甲硫氨酸（23.93，1.86 至 46.00）水平，并降低了同型半胱氨酸水平（-6.51，-10.57 至-2.45）。与安慰剂相比，DHA 降低了 Aβ40 水平（-40.57，-79.79 至-1.35）（p<0.05），而叶酸+DHA 降低了 Aβ42（-95.59，-150.76 至-40.43）和 Aβ40 水平（-45.75，-84.67 至-6.84）比 DHA 更多（p<0.05）。
结论
叶酸和 DHA 可改善 MCI 患者的认知功能并降低血液 Aβ 生成。联合治疗可能更有益于降低与血液 Aβ 相关的生物标志物。
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