J Neurol Neurosur Ps:血清同型半胱氨酸与痴呆风险

2020-04-02 MedSci原创 MedSci原创

血清高tHcy水平与痴呆、AD和VaD风险增高呈非线性关系,仅在tHcy水平相对高的范围内存在剂量-反应相关性。

近日,神经病学领域权威取杂志Journal Of Neurology Neurosurgery And Psychiatry上发表了一篇研究文章,该研究旨在探讨血清总同型半胱氨酸水平(tHcy)与痴呆风险之间的关系。

研究人员对日本1588例年龄≥60岁的无痴呆老年人进行前瞻性随访,随访时间为2002-2012年。Cox比例风险模型和受限三次样条被用来估计tHcy水平对痴呆风险影响的HRs。

随访期间,372名受试者出现全因性痴呆;247人患有阿尔茨海默病(AD),98人患有血管性痴呆(VaD)。相比血浆半胱氨酸水平处于最低五分位数(≤6.4µmol/L)的个体,最高五分位数(≥11.5µmol/L)个体对于全因痴呆的调整后HR(95%CI)为2.28(1.51-3.43),AD为1.96(1.19-3.24),VaD为2.51(1.14-5.51)。在限制三次样条函数中,因各种原因引起的痴呆风险稳步上升,大约在8-15µmol/L之间达到平台,在AD和VaD中观察到了类似的非线性关系(所有非线性p≤0.02)。在影响血浆tHcy水平最认可的遗传多态性(亚甲基四氢叶酸还原酶C677T)的分层分析中,tHcy与全因痴呆之间的正相关性在非携带者和风险等位基因携带者中均存在,甚至在前者中更强(异质性p=0.07)。

由此可见,血清高tHcy水平与痴呆、AD和VaD风险增高呈非线性关系,仅在tHcy水平相对高的范围内存在剂量-反应相关性。影响血清tHcy浓度的非遗传因素可能在tHcy与痴呆关联中发挥重要作用,而与tHcy升高的遗传易感性无关。

原始出处:

Sanmei Chen.et al.Serum homocysteine and risk of dementia in Japan.Journal Of Neurology Neurosurgery And Psychiatry. 2020. http://dx.doi.org/10.1136/jnnp-2019-322366

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    2021-05-20 kx

    好文

    0

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    2020-11-02 yinhl1978
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    2020-04-04 lsndxfj
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    2020-04-03 junJUN

    老年人痴呆何药可用??

    0

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