Rivière S, Birlouez-Aragon I, Nourhashémi F, Vellas B
Hôpital La Grave-Casselar, Toulouse, France.
Int J Geriatr Psychiatry. 1998 Nov;13(11):749-54. doi: 10.1002/(sici)1099-1166(1998110)13:11<749::aid-gps860>3.0.co;2-t.
To compare the vitamin C and E plasma levels in patients with Alzheimer's disease (AD) and to assess the vitamin C intake and nutritional status.
Case-control study. Four groups of sex- and age-matched subjects were compared: severe AD and moderate AD, in patients with moderate AD and controls.
Community and hospitalized patients in the region of Toulouse, France.
Patients with dementia who fulfilled criteria for Alzheimer's disease: severe Alzheimer group (N = 20), Mini-Mental State Examination (MMSE) score range 0-9; moderate Alzheimer group (N = 24), MMSE 10-23; hospitalized Alzheimer group (N = 9), MMSE 10-23. Control group (N = 19), MMSE 24-30.
Plasma vitamin E and C were quantified by HPLC-fluorescence. Consumption of raw and cooked fruit and vegetables was evaluated in order to determine the mean vitamin C intakes. Mini Nutritional Assessment (MNA) and plasma albumin were used to measure nutritional status.
Institutionalized and community subjects were analysed separately. MNA scores were normal in home-living Alzheimer subjects with moderate dementia and significantly lower in those with severe disease, despite normal plasma albumin levels. In the home-living Alzheimer subjects, vitamin C plasma levels decreased in proportion to the severity of the cognitive impairment despite similar vitamin C intakes, whereas vitamin E remained stable. The hospitalized Alzheimer subjects had lower MNA scores and albumin levels but normal vitamin C intakes, but their plasma vitamin C was lower than that of community-living subjects. Institutionalized Alzheimer subjects had significantly lower MNA scores but normal vitamin C and albumin levels and vitamin C intakes compared with community-dwelling subjects of similar degree of cognitive impairment.
Plasma vitamin C is lower in AD in proportion to the degree of cognitive impairment and is not explained by lower vitamin C intake. These results support the hypothesis that oxygen-free radicals may cause damage.
比较阿尔茨海默病（AD）患者血浆中维生素C和维生素E水平，并评估维生素C摄入量和营养状况。
病例对照研究。比较四组性别和年龄匹配的受试者：重度AD组、中度AD组、中度AD患者组和对照组。
法国图卢兹地区的社区和住院患者。
符合阿尔茨海默病标准的痴呆患者：重度阿尔茨海默病组（N = 20），简易精神状态检查表（MMSE）评分范围为0 - 9；中度阿尔茨海默病组（N = 24），MMSE评分为10 - 23；住院阿尔茨海默病组（N = 9），MMSE评分为10 - 23。对照组（N = 19），MMSE评分为24 - 30。
采用高效液相色谱 - 荧光法对血浆维生素E和维生素C进行定量。评估生熟水果和蔬菜的摄入量，以确定维生素C的平均摄入量。采用微型营养评定法（MNA）和血浆白蛋白来测量营养状况。
对机构养老和社区受试者分别进行分析。居家生活的中度痴呆阿尔茨海默病受试者的MNA评分正常，而重度疾病患者的MNA评分显著降低，尽管其血浆白蛋白水平正常。在居家生活的阿尔茨海默病受试者中，尽管维生素C摄入量相似，但血浆维生素C水平随认知障碍严重程度的增加而降低，而维生素E水平保持稳定。住院的阿尔茨海默病受试者的MNA评分和白蛋白水平较低，但维生素C摄入量正常，但其血浆维生素C低于社区生活受试者。与认知障碍程度相似的社区居住受试者相比，机构养老的阿尔茨海默病受试者的MNA评分显著较低，但维生素C、白蛋白水平及维生素C摄入量正常。
AD患者血浆维生素C水平随认知障碍程度的加重而降低，且不能用维生素C摄入量降低来解释。这些结果支持了氧自由基可能造成损害的假说。
