Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; The Cross-innovation Laboratory of Evidence-based Social Sciences, Lanzhou University, Lanzhou, Gansu, China.
The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China.
Am J Clin Nutr. 2024 Nov;120(5):1009-1018. doi: 10.1016/j.ajcnut.2024.08.027. Epub 2024 Aug 30.
The associations between 1-carbon metabolism (OCM) nutrients (methionine, folate, vitamin B-6, and vitamin B-12) and Alzheimer disease (AD) remains inconclusive.
This study aimed to investigate the association of dietary OCM nutrients with subsequent risk of AD and further assess whether participants with high genetic risk for AD might benefit from dietary OCM nutrients.
We analyzed data from 192,214 participants who completed at least one 24-h dietary questionnaire and had no previous history of AD based on the UK Biobank. Nutrients intake was calculated using McCance and Widdowson's The Composition of Food and USDA's Food and Nutrient Database for Dietary Studies. Cox proportional models with restricted cubic splines were applied to explore the associations.
Over a median follow-up of 13.35 y, 959 cases of AD (41 early-onset cases and 918 late-onset cases) were identified. Compared with those in the low-intake OCM group (quartile 1), participants in the high-intake OCM group (quartile 4) had reduced risk of developing AD. The corresponding hazard ratios (HRs) and 95% confidence intervals (CIs) for methionine, folate, vitamin B-6, and vitamin B-12 intake were 0.66 (0.54, 0.80), 0.71 (0.58, 0.87), 0.71 (0.59, 0.87), and 0.77 (0.64, 0.93), respectively. Similar associations were observed in late-onset AD. In early-onset AD, high methionine and vitamin B-12 intake were associated with 70% (HR: 0.30; 95% CI: 0.10, 0.86) and 71% (HR: 0.29; 95% CI: 0.09, 0.96) reduction in risk, respectively. Participants with low genetic risk and high OCM nutrients intake had >75% reduced AD risk compared with high-risk, low-intake participants.
In this prospective cohort study, we found that higher intake of OCM nutrients is associated with reduced risk of AD. Participants with high genetic risk of AD are more likely to benefit from dietary OCM nutrients intake.
1 碳代谢（OCM）营养素（蛋氨酸、叶酸、维生素 B-6 和维生素 B-12）与阿尔茨海默病（AD）之间的关联仍不确定。
本研究旨在探讨膳食 OCM 营养素与 AD 后续风险的关系，并进一步评估 AD 遗传风险高的参与者是否可能受益于膳食 OCM 营养素。
我们分析了来自英国生物银行的 192214 名参与者的数据，这些参与者至少完成了一次 24 小时膳食问卷调查，且之前没有 AD 病史。营养素摄入量是使用 McCance 和 Widdowson 的《食物成分》和美国农业部的《食物和营养数据库用于膳食研究》计算得出的。应用 Cox 比例风险模型和限制立方样条来探讨相关性。
在中位随访 13.35 年后，共确定了 959 例 AD（41 例早发性病例和 918 例晚发性病例）。与低 OCM 摄入量组（四分位 1）相比，高 OCM 摄入量组（四分位 4）参与者发生 AD 的风险降低。蛋氨酸、叶酸、维生素 B-6 和维生素 B-12 摄入的相应危险比（HR）和 95%置信区间（CI）分别为 0.66（0.54，0.80）、0.71（0.58，0.87）、0.71（0.59，0.87）和 0.77（0.64，0.93）。在晚发性 AD 中也观察到类似的相关性。在早发性 AD 中，高蛋氨酸和维生素 B-12 摄入分别与风险降低 70%（HR：0.30；95%CI：0.10，0.86）和 71%（HR：0.29；95%CI：0.09，0.96）相关。与高遗传风险、低 OCM 营养素摄入的参与者相比，低遗传风险和高 OCM 营养素摄入的参与者发生 AD 的风险降低了>75%。
在这项前瞻性队列研究中，我们发现 OCM 营养素的摄入量较高与 AD 风险降低有关。AD 遗传风险高的参与者可能更受益于膳食 OCM 营养素的摄入。
