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维生素D补充与新发痴呆症:性别、年龄和基线认知状态的影响

Vitamin D supplementation and incident dementia: Effects of sex, , and baseline cognitive status.

作者信息

Ghahremani Maryam, Smith Eric E, Chen Hung-Yu, Creese Byron, Goodarzi Zahra, Ismail Zahinoor

机构信息

Department of Psychiatry Cumming School of Medicine University of Calgary Calgary Alberta Canada.

Hotchkiss Brain Institute Cumming School of Medicine University of Calgary Calgary Alberta Canada.

出版信息

Alzheimers Dement (Amst). 2023 Mar 1;15(1):e12404. doi: 10.1002/dad2.12404. eCollection 2023 Jan-Mar.

Abstract

INTRODUCTION

Despite the association of vitamin D deficiency with incident dementia, the role of supplementation is unclear. We prospectively explored associations between vitamin D supplementation and incident dementia in 12,388 dementia-free persons from the National Alzheimer's Coordinating Center.

METHODS

Baseline exposure to vitamin D was considered D+; no exposure prior to dementia onset was considered D-. Kaplan-Meier curves compared dementia-free survival between groups. Cox models assessed dementia incidence rates across groups, adjusted for age, sex, education, race, cognitive diagnosis, depression, and apolipoprotein E () ε4. Sensitivity analyses examined incidence rates for each vitamin D formulation. Potential interactions between exposure and model covariates were explored.

RESULTS

Across all formulations, vitamin D exposure was associated with significantly longer dementia-free survival and lower dementia incidence rate than no exposure (hazard ratio = 0.60, 95% confidence interval: 0.55-0.65). The effect of vitamin D on incidence rate differed significantly across the strata of sex, cognitive status, and ε4 status.

DISCUSSION

Vitamin D may be a potential agent for dementia prevention.

HIGHLIGHTS

In a prospective cohort study, we assessed effects of Vitamin D on dementia incidence in 12,388 participants from the National Alzheimer's Coordinating Center dataset.Vitamin D exposure was associated with 40% lower dementia incidence versus no exposure.Vitamin D effects were significantly greater in females versus males and in normal cognition versus mild cognitive impairment.Vitamin D effects were significantly greater in apolipoprotein E ε4 non-carriers versus carriers.Vitamin D has potential for dementia prevention, especially in the high-risk strata.

摘要

引言

尽管维生素D缺乏与新发痴呆症有关,但补充维生素D的作用尚不清楚。我们前瞻性地探讨了来自国家阿尔茨海默病协调中心的12388名无痴呆症患者中维生素D补充剂与新发痴呆症之间的关联。

方法

将基线时暴露于维生素D的情况视为D+;痴呆症发病前未暴露的情况视为D-。采用Kaplan-Meier曲线比较两组之间的无痴呆症生存期。Cox模型评估了各组的痴呆症发病率,并对年龄、性别、教育程度、种族、认知诊断、抑郁和载脂蛋白E()ε4进行了调整。敏感性分析检查了每种维生素D制剂的发病率。探讨了暴露与模型协变量之间的潜在相互作用。

结果

在所有制剂中,与未暴露相比,维生素D暴露与显著更长的无痴呆症生存期和更低的痴呆症发病率相关(风险比=0.60,95%置信区间:0.55-0.65)。维生素D对发病率的影响在性别、认知状态和ε4状态的分层中存在显著差异。

讨论

维生素D可能是预防痴呆症的潜在药物。

要点

在一项前瞻性队列研究中,我们评估了维生素D对来自国家阿尔茨海默病协调中心数据集的12388名参与者痴呆症发病率的影响。与未暴露相比,维生素D暴露使痴呆症发病率降低了40%。女性与男性相比,正常认知与轻度认知障碍相比,维生素D的作用显著更大。载脂蛋白E ε4非携带者与携带者相比,维生素D的作用显著更大。维生素D具有预防痴呆症的潜力,尤其是在高危人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b915/9976297/4301f7fc93bd/DAD2-15-e12404-g002.jpg

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