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营养支持对营养不良、认知、功能和阿尔茨海默病生物标志物的影响:系统评价。

Effect of nutritional supports on malnutrition, cognition, function and biomarkers of Alzheimer's disease: a systematic review.

机构信息

Department of Molecular Biology, Institute of Science, Üsküdar University, Istanbul, Turkey.

Department of Physiology, Faculty of Medicine, Altınbaş University, Istanbul, Turkey.

出版信息

Int J Neurosci. 2023 Dec;133(12):1355-1373. doi: 10.1080/00207454.2022.2079506. Epub 2022 Jul 3.

Abstract

AIM

To summarize the nutritional supplementation on biochemical parameters, cognition, function, Alzheimer's Disease (AD) biomarkers and nutritional status.

MATERIALS AND METHODS

PubMed, Web of Science, Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, Cochrane Library and Scopus databases were searched until 16 April 2021. 22.193 records in total were reached according to inclusion and exclusion criteria. Included Studies were evaluated through the Modified Jadad Scale and gathered under four subheadings.

RESULTS

Forty-eight studies with a total of 7009 AD patients were included. Souvenaid, ONS (368 ± 69 kcal), Vegenat-med, 500 mg Resveratrol, ONS (200 mL) were effective nutritional supplements on promoting weight gain and protecting malnutrition status but showed conflicting results in Body mass index, Mid-Upper-Arm Circumference and Triceps Skin Fold Thickness. ONS and a lyophilized whole supplementation Vegenat-med intake made an increase in MNA scores. While all nutritional supplements showed controversial results in biochemical parameters but caused a decrease in Hcy levels which caused reductions in brain Aβ plaque (increase serum Aβ), p-Tau and cognitive improvement. Folic acid and vitamin D decreased serum APP, BACE1, BACE1mRNA. Resveratrol, mycelia, vitamin D and Betaine supplements improved cognitive, functional prognosis and quality of life unlike other nutritional supplements had no effect on cognitive scales.

CONCLUSIONS

Better designed trials with holistic measures are needed to investigate the effect of nutritional support on the AD biomarkers, cognitive status, biochemical parameters and functional states. Also, more beneficial results can be obtained by examining the simultaneous effects of nutritional supplements with larger sample groups.

摘要

目的

总结营养补充对生化参数、认知、功能、阿尔茨海默病(AD)生物标志物和营养状况的影响。

材料和方法

检索了 PubMed、Web of Science、韩国期刊数据库、俄罗斯科学引文索引、SciELO 引文索引、Cochrane 图书馆和 Scopus 数据库,截至 2021 年 4 月 16 日,共检索到 22193 条记录,根据纳入和排除标准进行筛选。对纳入的研究采用改良 Jadad 量表进行评估,并分为四个副标题进行汇总。

结果

共纳入 48 项研究,共计 7009 例 AD 患者。Souvenaid、ONS(368±69kcal)、Vegenat-med、500mg 白藜芦醇、ONS(200mL)是促进体重增加和保护营养不良状态的有效营养补充剂,但在体重指数、中臂围和三头肌皮褶厚度方面的结果存在差异。ONS 和冻干全补充 Vegenat-med 摄入可提高 MNA 评分。虽然所有营养补充剂在生化参数方面的结果存在争议,但均能降低 Hcy 水平,从而减少脑内 Aβ斑块(增加血清 Aβ)、p-Tau 和认知改善。叶酸和维生素 D 降低血清 APP、BACE1、BACE1mRNA。与其他营养补充剂相比,白藜芦醇、菌丝体、维生素 D 和甜菜碱补充剂改善了认知、功能预后和生活质量,而其他营养补充剂对认知量表没有影响。

结论

需要设计更好的试验,采用全面的措施来研究营养支持对 AD 生物标志物、认知状态、生化参数和功能状态的影响。此外,通过检查更大样本量的营养补充剂的同时作用,可以获得更好的效果。

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