阿尔茨海默病与维生素 B12及同型半胱氨酸的相关性

背景维生素 B12缺乏会产生神经功能障碍,影响中枢神经系统及全身的代谢,补充维生素 B12对预防及延缓阿尔茨海默病( Alzheimer disease, AD)的发展作用机制尚不清楚. 目的 研究 AD与血清维生素 B12,叶酸及血浆同型半胱氨酸水平之间的关系,探讨导致痴呆的机制. 设计以诊断为依据的非随机对照研究. 地点和对象 2002-10/2003-05于华中科技大学同济医学院附属协和医院住院治疗的 AD患者 30例( AD组),均符合美国神经病学语言障碍和卒中-阿尔茨海默病和相关疾病学会( NINCDS- ADRDA)的很可能 AD标准.对照组为同期参加体检的健康正常人 30例. 方法 采用简易精神状态量表( MMSE)对两组患者进行评分,并用放免分析法测定血清维生素 B12及叶酸水平,荧光偏振免疫法( fluorescence polarization immunoassay, FPIA)测定血浆同型半胱氨酸水平. 主要观察指标 ① AD组及对照组之间维生素 B12水平差异.② AD组及对照组之间 Hcy的水平差异.③ MMSE得分与维生素 B12及 Hcy之间的相关性. 结果 AD组维生素 B12水平( 217.3± 134.2) pmol/L明显低于对照组( 313.6± 184.7) pmol/L,二者差异有极显著性 (t=3.93,P< 0.001). AD组血浆同型半胱氨酸 (18.9± 6.8) μ mol/L高于对照组 (9.4± 4.1) μ mol/L,差异有极显著性意义 (t=7.66,P< 0.001). AD组叶酸水平( 29.2 ± 12.7) nmol/L低于对照组( 37.2± 21.2) nmol/L,但差异无显著性 (P >0.05). AD患者维生素 B12水平与 MMSE得分呈正相关( r=0.87).结论 AD患者血清维生素 B12水平与智能障碍及其程度有关.

Correlations of Alzheimer disease with vitamin B12 and homocysteine

BACKGROUND:The deficiency of vitamin B12 will lead to neurological disorder and affect the metabolism of central nervous system(CNS) and the whole body.The mechanism of filling up vitamin B12 in preventing and retarding the development of Alzheimer disease(AD) remains uncertain. OBJECTIVE:To explore the correlations of AD with serum vitamin B12,folate and plasma homocysteine(Hcy)and its mechanism of inducing AD. DESIGN:A non randomized control study based on diagnosis. SETTINGS and PARTICIPANTS:Thirty AD inpatients(AD group),admitted from October 2002 to May 2003 to the Affiliated Xiehe Hospital,Tongji Medical College,Huazhong University of Science and Technology,conformed to the probable AD standard of NINCDS- ADRDA.Thirty healthy normal persons who took the health examinaltion at the same time period were recruited to control group. INTERVENTIONS:Patients of the two groups were scored with mini mental state examination(MMSE).The concentration of serum vitamin B12 and folate were examined with the radioimmunoassay. Plasma Hcy was measured with fluorescence polarization immunoassay(FPIA).MAIN OUTCOME MEASURES:①differences of vitamin B12 level in the AD group and the control group.②differences of Hcy level in the AD group and the control group.③ the correlations of MMSE score with vitamin B12 and Hcy. RESULTS:The level of serum vitamin B12 in the AD group(217.3 ± 134.2) pmol/L] was significantly lower than that of the control group(313.6± 184.7) pmol/L].There was extremely significant difference between them(t=3.93,P< 0.001).The plasma Hcy in the AD group(18.9± 6.8) μ mol/L]was significantly higher than that in the normal group(9.4± 4.1) μ mol/L].The differences were significant(t=7.66,P< 0.01).The serum folate concentration in the AD group(29.2± 12.7) nmol/L] was lower than that in the control group(37.2 ± 21.2) nmol/L]but without significant differences(P > 0.05).There was positive correlation between serum vitamin B12 and MMSE scores. CONCLUSION:The level of serum vitamin B12 of AD patients is related to the disorder of intelligence.