轻度认知障碍和阿尔茨海默病中的维生素D。一项针对希腊老年成年人的研究。
Vitamin D in mild cognitive impairment and Alzheimer's disease. A study in older Greek adults.
作者信息
Mavraki E, Ioannidis P, Tripsianis G, Gioka T, Kolousi M, Vadikolias K
机构信息
Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece.
Second Department of Neurology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.
出版信息
Hippokratia. 2020 Jul-Sep;24(3):120-126.
BACKGROUND
In recent years, accumulating evidence has linked vitamin D deficiency to cognitive dysfunction and dementia. This study aimed at determining the relevance of serum 25-hydroxyvitamin D concentrations in mild cognitive impairment (MCI) and Alzheimer's disease (AD) in older Greek adults. It also examined whether the vitamin D level could be considered a predisposing factor for conversion from MCI to AD.
METHODS
The study enrolled 350 subjects aged 65 years and over, allocated into three groups consisting of 103 healthy subjects (HS), 109 individuals with MCI, and 138 patients with AD, respectively. Serum 25-hydroxyvitamin D [25(OH)D] concentrations, measured in ng/ml, were determined by electrochemiluminescence, and we used the Mini-Mental State Examination (MMSE) and the Cambridge Cognition Examination (CAMGOG) to evaluate the subjects' cognitive status. One follow-up examination was performed for the MCI patients 30 months ± three months after the initial evaluation.
RESULTS
Compared to HS, serum 25(OH)D levels were significantly decreased in individuals with MCI (p =0.012) and patients with AD (p <0.001). Moreover, serum 25(OH)D concentrations were significantly decreased in patients with AD compared to individuals with MCI (p =0.003) and also significantly lower in individuals with MCI who progressed to AD compared to those who remained MCI (p =0.028). After adjusting for confounders, multivariate analysis revealed that an increase of vitamin D concentration by one ng/mL reduces the risk of MCI by 4 % (OR =0.96, 95 % CI =0.92-0.99, p =0.006), the risk of AD by 8 % (OR =0.92, 95 % CI =0.89-0.95, p <0.001), and in an individual with MCI reduces the risk of conversion to AD by 10 % (OR =0.90, 95 % CI =0.83-0.96, p =0.003).
CONCLUSIONS
The present study reveals that serum vitamin D levels are significantly decreased in subjects with MCI and patients with AD compared to HS. Additionally, individuals with MCI who progressed to AD presented significantly lower vitamin D levels than those who remained MCI. These results suggest that preserving adequate vitamin D status in older adults could delay or prevent cognitive decline. HIPPOKRATIA 2020, 24(3): 120-126.
背景
近年来，越来越多的证据表明维生素D缺乏与认知功能障碍和痴呆症有关。本研究旨在确定希腊老年成年人中血清25-羟基维生素D浓度与轻度认知障碍（MCI）和阿尔茨海默病（AD）的相关性。该研究还探讨了维生素D水平是否可被视为MCI转化为AD的一个诱发因素。
方法
该研究招募了350名65岁及以上的受试者，分别分为三组，包括103名健康受试者（HS）、109名MCI患者和138名AD患者。采用电化学发光法测定血清25-羟基维生素D [25(OH)D]浓度，单位为ng/ml，并使用简易精神状态检查表（MMSE）和剑桥认知检查表（CAMGOG）评估受试者的认知状态。在初次评估后30个月±3个月对MCI患者进行了一次随访检查。
结果
与HS相比，MCI患者（p =0.012）和AD患者（p <0.001）的血清25(OH)D水平显著降低。此外，与MCI患者相比，AD患者的血清25(OH)D浓度显著降低（p =0.003），与仍为MCI的患者相比，进展为AD的MCI患者的血清25(OH)D浓度也显著更低（p =0.028）。在对混杂因素进行校正后，多变量分析显示，维生素D浓度每增加1 ng/mL，MCI风险降低4%（OR =0.96，95% CI =0.92 - 0.99，p =0.006），AD风险降低8%（OR =0.92，95% CI =0.89 - 0.95，p <0.001），MCI个体转化为AD的风险降低10%（OR =0.90，95% CI =0.83 - 0.96，p =0.003）。
结论
本研究表明，与HS相比，MCI患者和AD患者的血清维生素D水平显著降低。此外，进展为AD的MCI患者的维生素D水平显著低于仍为MCI的患者。这些结果表明，维持老年人充足的维生素D状态可能会延缓或预防认知衰退。《希波克拉底》2020年，24(3): 120 - 126。
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