中国老年人群中叶酸代谢生物标志物与认知障碍的关联：一项横断面研究
Associations between folate metabolism biomarkers and cognitive impairment in older Chinese adults: a cross-sectional study.
作者信息
Lv Huimin, Li Jia, Chen Lu, Lu Keyi, Zhao Xudong, Guo Mengyuan, Lu Hailong
机构信息
Department of Geriatrics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of General Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
出版信息
Front Med (Lausanne). 2025 Aug 18;12:1522531. doi: 10.3389/fmed.2025.1522531. eCollection 2025.
BACKGROUND
The role of folate metabolism-related biomarker profiles in age-related cognitive impairment (ARCI) remains unclear. This cross-sectional study aimed to examine the association between folate metabolism-related biomarkers and cognitive performance in older Chinese adults.
METHODS
We conducted a cross-sectional analysis of 100 participants aged between 56 and 87 years. Cognitive status was classified as ARCI if participants met the cutoff criteria on both the MMSE (<27) and MoCA (<26). Those meeting the cutoff criteria on both MMSE (≥27) and MoCA (≥26) were classified as cognitively normal (CN). Serum levels of folate metabolism-related biomarkers were compared between groups and analyzed for their associations with cognitive scores. Logistic regression was used to examine associations between individual biomarkers and cognitive impairment status. Multiple linear regression analyses were conducted to assess relationships with MMSE and MoCA scores, adjusting for age and education.
RESULTS
Cognitive impairment was prevalent among older adults at a rate of 56.3% ( < 0.05). The ARCI group showed significantly lower levels of vitamin B2 (VB2), folate (VB9) and lower MMSE and MoCA scores compared to the CN, while S-adenosylhomocysteine (SAH) and homocysteine (Hcy) levels were higher. MMSE and MoCA scores were positively correlated with serum VB2, VB9, and plasma S-adenosylmethionine (SAM) levels and negatively correlated with Hcy levels. Logistic regression showed that education and serum Hcy were significantly associated with cognitive impairment (AUC = 0.73). In addition to age, VB2, SAM and Hcy in the folate metabolic profile were significantly associated with MMSE and MoCA scores, accounting for 45.9 and 42.7% of the variance in these scores, respectively.
CONCLUSIONS
VB2, SAM and Hcy may be associated with cognitive impairment in older Chinese adults and warrant further investigation as potential biomarkers.
背景
叶酸代谢相关生物标志物谱在年龄相关性认知障碍（ARCI）中的作用尚不清楚。这项横断面研究旨在探讨中国老年人群中叶酸代谢相关生物标志物与认知功能之间的关联。
方法
我们对100名年龄在56至87岁之间的参与者进行了横断面分析。如果参与者在简易精神状态检查表（MMSE，<27）和蒙特利尔认知评估量表（MoCA，<26）上均符合截断标准，则将其认知状态分类为ARCI。那些在MMSE（≥27）和MoCA（≥26）上均符合截断标准的参与者被分类为认知正常（CN）。比较两组之间叶酸代谢相关生物标志物的血清水平，并分析它们与认知分数的关联。采用逻辑回归分析个体生物标志物与认知障碍状态之间的关联。进行多元线性回归分析以评估与MMSE和MoCA分数的关系，并对年龄和教育程度进行校正。
结果
老年人中认知障碍的患病率为56.3%（<0.05）。与CN组相比，ARCI组的维生素B2（VB2）、叶酸（VB9）水平显著较低，MMSE和MoCA分数也较低，而S-腺苷同型半胱氨酸（SAH）和同型半胱氨酸（Hcy）水平较高。MMSE和MoCA分数与血清VB2、VB9以及血浆S-腺苷甲硫氨酸（SAM）水平呈正相关，与Hcy水平呈负相关。逻辑回归显示，教育程度和血清Hcy与认知障碍显著相关（曲线下面积=0.73）。除年龄外，叶酸代谢谱中的VB2、SAM和Hcy与MMSE和MoCA分数显著相关，分别占这些分数变异的45.9%和42.7%。
结论
VB2、SAM和Hcy可能与中国老年人群的认知障碍有关，作为潜在生物标志物值得进一步研究。
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