Turcu-Stiolica Adina, Naidin Mihaela-Simona, Halmagean Steliana, Ionescu Ana Maria, Pirici Ionica
Pharmaceutical Management and Marketing, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Neuro Therapy Clinic, 300425 Timisoara, Romania.
Diagnostics (Basel). 2024 Jul 26;14(15):1609. doi: 10.3390/diagnostics14151609.
Previous studies have shown that the levodopa treatment of Parkinson's disease (PD) elevates circulating homocysteine levels, which are associated with an increased risk of cardiovascular and neurological disorders, or thrombosis. The present trial aimed to examine whether the intake of vitamin B12, folic acid, and vitamin D3 supplements improved homocysteine level and quality of life (QoL).
An interventional prospective trial was conducted in multiple centers across Romania. Participants with clinically established PD taking at least 300 mg/day of levodopa for more than 1 year received a daily tablet of a supplement containing 800 UI of vitamin D3, 1000 µg of folic acid, and 15 µg of vitamin B12. They were followed for 6 months and their serum homocysteine, vitamin B12, vitamin D, and QoL scores were measured at baseline and at 6 months of treatment. QoL was measured using a 15D questionnaire, which assesses mobility, vision, hearing, breathing, sleeping, eating, speech, excretion, usual activities, mental function, discomfort and symptoms, depression, distress, vitality, and sexual activity.
Twenty-four PD patients with a mean age of 71 ± 5.04 years (54.2% male and 45.8% female) finished the study. After the intervention, the mean score of speech, mental function, discomfort and symptoms, depression, and QoL significantly increased ( < 0.05 for all). Also, the serum homocysteine and vitamin D were significantly enhanced ( < 0.0001 and = 0.025, respectively). Changes in vitamin B12 were not statistically significant at 6 months of treatment ( = 0.996). No gender differences were found among the changes that we have demonstrated for homocysteine, vitamin B12, vitamin D, and QoL levels ( < 0.05 for all).
The findings of this study showed that the dietary intake of vitamin B12, folic acid, and vitamin D3 remarkably decreased the dimensions of homocysteine and finally increased the total score of QoL in PD patients. We have successfully captured the potential benefits of the supplementation regimen over time and provided insights into the broader implications for managing PD with a focus on nutritional support.
既往研究表明，帕金森病（PD）患者接受左旋多巴治疗会使循环中同型半胱氨酸水平升高，这与心血管疾病、神经疾病或血栓形成风险增加相关。本试验旨在研究补充维生素B12、叶酸和维生素D3是否能改善同型半胱氨酸水平及生活质量（QoL）。
在罗马尼亚多个中心进行了一项前瞻性干预试验。临床确诊为PD且服用左旋多巴至少300mg/天超过1年的参与者，每天服用一片含有800国际单位维生素D3、1000微克叶酸和15微克维生素B12的补充剂。对他们进行6个月的随访，并在基线和治疗6个月时测量其血清同型半胱氨酸、维生素B12、维生素D及生活质量评分。生活质量采用15D问卷进行测量，该问卷评估活动能力、视力、听力、呼吸、睡眠、饮食、言语、排泄、日常活动、心理功能、不适与症状、抑郁、痛苦、活力及性活动。
24例平均年龄为71±5.04岁的PD患者（男性占54.2%，女性占45.8%）完成了研究。干预后，言语、心理功能、不适与症状、抑郁及生活质量的平均评分显著提高（均P<0.05）。此外，血清同型半胱氨酸和维生素D显著升高（分别为P<0.0001和P = 0.025）。治疗6个月时维生素B12的变化无统计学意义（P = 0.996）。在我们所展示的同型半胱氨酸、维生素B12、维生素D及生活质量水平的变化中，未发现性别差异（均P<0.
