Joosten E, Lesaffre E, Riezler R, Ghekiere V, Dereymaeker L, Pelemans W, Dejaeger E
Department of Pathophysiology, University Hospitals K. U. Leuven, Belgium.
J Gerontol A Biol Sci Med Sci. 1997 Mar;52(2):M76-9. doi: 10.1093/gerona/52a.2.m76.
It is still unclear whether there is an association between Alzheimer's disease and vitamin B-12 or folate deficiency. This study was designed to investigate whether patients with Alzheimer's disease are particularly prone to metabolically significant cobalamin or folate deficiency as compared to nondemented hospitalized controls and healthy elderly controls living at home.
Evaluation for the diagnosis of Alzheimer's disease, routine laboratory tests, serum folate and vitamin B-12, serum methylmalonic acid (MMA), total homocysteine (tHcy), and radiological tests was performed in 52 patients with Alzheimer's disease (AD), 50 nondemented hospitalized controls, and 49 healthy elderly subjects living at home.
Serum vitamin B-12 and folate levels are comparable between patients with AD, hospitalized control patients, and subjects living at home. Patients with AD have the highest serum MMA and tHcy levels. The MMA levels of patients with AD and hospitalized controls are not different, but the mean tHcy level is significantly higher in patients with AD as compared to nondemented patients or subjects living at home.
The interpretation of the vitamin B-12 and folate status in patients with AD depends largely on the methodology (i.e., serum vitamin vs metabolite levels) and the selection of the control group. Although patients with AD have the highest tHcy and MMA levels, metabolically significant vitamin B-12 and folate deficiency is also a substantial problem in nondemented elderly patients.
阿尔茨海默病与维生素B-12或叶酸缺乏之间是否存在关联仍不清楚。本研究旨在调查与非痴呆住院对照以及居家健康老年对照相比，阿尔茨海默病患者是否特别容易出现具有代谢意义的钴胺素或叶酸缺乏。
对52例阿尔茨海默病（AD）患者、50例非痴呆住院对照以及49例居家健康老年受试者进行了阿尔茨海默病诊断评估、常规实验室检查、血清叶酸和维生素B-12、血清甲基丙二酸（MMA）、总同型半胱氨酸（tHcy）以及影像学检查。
AD患者、住院对照患者和居家受试者的血清维生素B-12和叶酸水平相当。AD患者的血清MMA和tHcy水平最高。AD患者和住院对照的MMA水平无差异，但与非痴呆患者或居家受试者相比，AD患者的平均tHcy水平显著更高。
AD患者维生素B-12和叶酸状态的解读很大程度上取决于方法（即血清维生素与代谢物水平）以及对照组的选择。尽管AD患者的tHcy和MMA水平最高，但具有代谢意义的维生素B-12和叶酸缺乏在非痴呆老年患者中也是一个严重问题。
