Zhang Cuiping, Hu Yao, Cao Xinyi, Deng Yuhang, Wang Yuting, Guan Ming, Wu Xiaoyan, Jiang Haoqin
Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
Department of Laboratory Medicine, Qingpu District Hospital of Traditional Chinese Medicine, Shanghai, 201700, China.
Sci Rep. 2025 May 29;15(1):18866. doi: 10.1038/s41598-025-03859-y.
Evidence of the effects of water-soluble vitamins (e.g., B vitamins, vitamin C, and total folate) on cognitive function in patients with neurodegenerative diseases is mixed. Furthermore, the relationships among homocysteine (Hcy) metabolism, water-soluble vitamins, and cognitive impairment remain unclear. Therefore, we aimed to investigate the role of the levels of water-soluble vitamins [e.g., vitamins B1, B2, B3, B5, B6, 5-methyltetrahydrofolate (5mTHF), B12, and C and total folate] and Hcy in dementia progression in patients with neurodegenerative diseases. In this retrospective cohort study, we enrolled 280 healthy controls and 646 patients with a neurodegenerative disease. Patients were classified into a Parkinson's disease (PD) group (n = 312), Alzheimer's disease (AD) group (n = 219), or other dementia group (n = 115) according to pathological features. The other dementia group comprised 25 patients with frontotemporal dementia, 38 with Lewy body dementia, 34 with vascular dementia, and 18 with semantic dementia. Serum vitamins (i.e., B1, B2, B3, B5, VB6, 5mTHF, and C) were measured via liquid chromatography-mass spectrometry/mass spectrometry. Total Hcy, vitamin B12 and total folate levels were measured using commercial electrochemiluminescence immunoassays. The serum levels of vitamins B1, B2, B5, B6, 5mTHF, and C were lower in all patient groups than in the control group. The logistic regression results revealed that lower levels of serum vitamins B2, B6, 5mTHF, and B12 were associated with a higher risk of dementia in PD patients, and higher Hcy levels and lower serum vitamin B6 and 5mTHF levels were associated with a higher risk of AD-related cognitive impairment. In addition, the level of vitamins was positively correlated with neuropsychological assessment scores and negatively correlated with Hcy level and stage of dementia. The levels of several water-soluble vitamins are lower in dementia patients. Moreover, lower levels of water-soluble vitamins and higher levels of Hcy increased odds ratios for having neurodegenerative diseases or cognitive impairment. These findings suggest that estimating water-soluble vitamin levels in older adults may be valuable given that they may help improve cognitive function.
水溶性维生素（如B族维生素、维生素C和总叶酸）对神经退行性疾病患者认知功能影响的证据不一。此外，同型半胱氨酸（Hcy）代谢、水溶性维生素与认知障碍之间的关系仍不明确。因此，我们旨在研究水溶性维生素[如维生素B1、B2、B3、B5、B6、5-甲基四氢叶酸（5mTHF）、B12、C和总叶酸]水平及Hcy在神经退行性疾病患者痴呆进展中的作用。在这项回顾性队列研究中，我们纳入了280名健康对照者和646名神经退行性疾病患者。根据病理特征，患者被分为帕金森病（PD）组（n = 312）、阿尔茨海默病（AD）组（n = 219）或其他痴呆组（n = 115）。其他痴呆组包括25例额颞叶痴呆患者、38例路易体痴呆患者、34例血管性痴呆患者和18例语义性痴呆患者。血清维生素（即B1、B2、B3、B5、VB6、5mTHF和C）通过液相色谱-质谱/质谱法测定。总Hcy、维生素B12和总叶酸水平采用商业电化学发光免疫分析法测定。所有患者组血清维生素B1、B2、B5、B6、5mTHF和C水平均低于对照组。逻辑回归结果显示，血清维生素B2、B6、5mTHF和B12水平较低与PD患者患痴呆风险较高相关，Hcy水平较高以及血清维生素B6和5mTHF水平较低与AD相关认知障碍风险较高相关。此外，维生素水平与神经心理学评估得分呈正相关，与Hcy水平和痴呆分期呈负相关。痴呆患者中几种水溶性维生素水平较低。此外，水溶性维生素水平较低和Hcy水平较高会增加患神经退行性疾病或认知障碍的比值比。这些发现表明，鉴于估计老年人水溶性维生素水平可能有助于改善认知功能，因此其可能具有重要价值。
