血清维生素 D 状况和维生素 D 补充剂使用与全因痴呆、阿尔茨海默病和血管性痴呆的关联:一项基于英国生物库的前瞻性队列研究。
The associations of serum vitamin D status and vitamin D supplements use with all-cause dementia, Alzheimer's disease, and vascular dementia: a UK Biobank based prospective cohort study.
机构信息
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany.
Network Aging Research, Heidelberg University, Heidelberg, Germany.
出版信息
Am J Clin Nutr. 2024 Apr;119(4):1052-1064. doi: 10.1016/j.ajcnut.2024.01.020. Epub 2024 Jan 29.
BACKGROUND
Prior studies on vitamin D and dementia outcomes yielded mixed results and had several important limitations.
OBJECTIVES
We aimed to assess the associations of both serum vitamin D status and supplementation with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD) incidence.
METHODS
With a prospective cohort study design, we comprehensively assessed the associations of vitamin D and multivitamin supplementation, as well as vitamin D deficiency {25-hydroxyvitamin D [25(OH)D] <30 nmol/L}, and insufficiency [25(OH)D 30 to <50 nmol/L], with the 14-year incidence of all-cause dementia, AD, and VD in 269,229 participants, aged 55 to 69, from the UK Biobank.
RESULTS
Although 5.0% reported regular vitamin D use and 19.8% reported multivitamin use, the majority of participants exhibited either vitamin D deficiency (18.3%) or insufficiency (34.0%). However, vitamin D deficiency was less prevalent among users of vitamin D (6.9%) or multivitamin preparations (9.5%) than among nonusers (21.5%). Adjusted Cox regression models demonstrated 19% to 25% increased risk of all 3 dementia outcomes for those with vitamin D deficiency [hazard ratio (HR) 95% confidence interval (CI)]: 1.25 (1.16, 1.34) for all-cause dementia; 1.19 (1.07-1.31) for AD; 1.24 (1.08-1.43) for VD] and 10% to 15% increased risk of those with vitamin D insufficiency [HR (95% CI): 1.11 (1.05, 1.18) for all-cause dementia; 1.10 (1.02-1.19) for AD; 1.15 (1.03-1.29) for VD]. Regular users of vitamin D and multivitamins had 17% and 14% lower risk of AD [HR (95% CI): 0.83 (0.71, 0.98)] and VD [HR (95% CI): 0.86 (0.75, 0.98)] incidence, respectively.
CONCLUSIONS
Although our findings indicate the potential benefits of vitamin D supplementation for dementia prevention, randomized controlled trials are essential for definitive evidence.
背景
先前关于维生素 D 和痴呆结局的研究结果不一,且存在一些重要的局限性。
目的
我们旨在评估血清维生素 D 状态和补充剂与全因痴呆、阿尔茨海默病 (AD) 和血管性痴呆 (VD) 发生率之间的关联。
方法
采用前瞻性队列研究设计,我们全面评估了维生素 D 和多种维生素补充剂以及维生素 D 缺乏症[25-羟维生素 D(25(OH)D)<30 nmol/L]和不足症[25(OH)D 30-<50 nmol/L]与 269229 名年龄在 55-69 岁的英国生物银行参与者 14 年全因痴呆、AD 和 VD 发生率之间的关联。
结果
尽管 5.0%的参与者报告定期使用维生素 D,19.8%的参与者报告使用多种维生素,但大多数参与者表现为维生素 D 缺乏症(18.3%)或不足症(34.0%)。然而,维生素 D 缺乏症在维生素 D(6.9%)或多种维生素制剂(9.5%)使用者中比在非使用者(21.5%)中更为少见。调整后的 Cox 回归模型显示,维生素 D 缺乏症患者发生所有 3 种痴呆结局的风险增加 19%-25%[风险比(HR)95%置信区间(CI)]:全因痴呆症 1.25(1.16,1.34);AD 1.19(1.07-1.31);VD 1.24(1.08-1.43)],维生素 D 不足症患者的风险增加 10%-15%[HR(95%CI):全因痴呆症 1.11(1.05,1.18);AD 1.10(1.02-1.19);VD 1.15(1.03-1.29)]。定期使用维生素 D 和多种维生素的患者发生 AD[HR(95%CI):0.83(0.71,0.98)]和 VD[HR(95%CI):0.86(0.75,0.98)]的风险分别降低 17%和 14%。
结论
尽管我们的研究结果表明维生素 D 补充剂对预防痴呆具有潜在益处,但仍需开展随机对照试验以提供明确的证据。