Center for Epidemiology and Research in POPulation health (CERPOP), University of Toulouse, Toulouse, France.
Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France.
J Gerontol A Biol Sci Med Sci. 2022 Jul 5;77(7):1335-1343. doi: 10.1093/gerona/glac074.
Frailty is a geriatric syndrome that combines physiological decline, disruptions of homeostatic mechanisms across multiple physiologic systems and thus, strong vulnerability to further pathological stress. Previously, we provided the first evidence that increased risk of poor health outcomes, as quantified by a frailty index (FI), is associated with an alteration of the central nervous system (CNS) biomechanical response to blood pulsatility. In this study, we explored correlation between 14 biological parameters, the CNS elastance coefficient and FI. We included 60 adults (52-92 years) suspected of normal pressure hydrocephalus and presenting with markers of multiple coexisting brain pathologies, including Parkinson disease, Alzheimer disease, and vascular dementia. We showed that the homocysteine (Hcy) level was independently and positively associated with both the FI and the CNS elastance coefficient (adjusted R² of 10% and 6%). We also demonstrated that creatinine clearance and folate level were independently associated with Hcy level. Based on previous literature results describing the involvement of Hcy in endothelial dysfunction, glial activation, and neurodegeneration, we discuss how Hcy could contribute to the altered biomechanical response of the CNS and frailty.
衰弱是一种老年综合征，它结合了生理衰退、多个生理系统稳态机制的破坏，因此，对进一步的病理压力非常脆弱。此前，我们提供了第一个证据，即健康结果不良风险的增加（如衰弱指数（FI）所量化的）与中枢神经系统（CNS）对血液脉动的生物力学反应的改变有关。在这项研究中，我们探讨了 14 个生物学参数、CNS 弹性系数和 FI 之间的相关性。我们纳入了 60 名成年人（52-92 岁），他们疑似患有正常压力脑积水，并出现了多种共存脑部病变的标志物，包括帕金森病、阿尔茨海默病和血管性痴呆。我们表明，同型半胱氨酸（Hcy）水平与 FI 和 CNS 弹性系数独立且呈正相关（调整后的 R²分别为 10%和 6%）。我们还表明，肌酐清除率和叶酸水平与 Hcy 水平独立相关。基于先前描述 Hcy 参与内皮功能障碍、神经胶质激活和神经退行性变的文献结果，我们讨论了 Hcy 如何导致 CNS 生物力学反应和衰弱的改变。
