Association of Vitamin B12, Folate, and Sulfur Amino Acids With Brain Magnetic Resonance Imaging Measures in Older Adults A Longitudinal Population-Based Study
Association of Vitamin B12, Folate, and Sulfur Amino Acids With Brain Magnetic Resonance Imaging Measures in Older Adults A Longitudinal Population-Based Study
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DOI：
10.1001/jamapsychiatry.2016.0274
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发表时间：
2016-06-01
期刊：
影响因子：
25.8
通讯作者：
Kivipelto, Miia
中科院分区：
文献类型：
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作者：
Hooshmand, Babak;Mangialasche, Francesca;Kivipelto, Miia
重要性维生素B-12、叶酸和含硫氨基酸可能是临床痴呆前脑结构改变的可改变的危险因素。目的研究维生素B-12、红细胞叶酸和含硫氨基酸的循环水平与老年人总脑体积损失率和通过液体衰减反转恢复测量的脑白质高信号体积变化之间的关系。设计、设置和参与者瑞典国家衰老和护理研究的磁共振成像亚样，在瑞典斯德哥尔摩进行了一项以人群为基础的纵向研究，501名在基线时没有痴呆的60岁或以上的参与者。从2001年9月17日到2009年12月17日，共有299名参与者进行了重复的结构性脑磁共振成像扫描。主要结果和测量脑组织体积损失率和总脑白质高信号体积的进展。结果在多调整线性混合模型中，501名参与者(300名女性[59.9%]；在研究期间，平均年龄70.9[9.1]岁、较高的基线维生素B-12和全反钴胺水平与总脑体积损失率的下降有关：每增加1个SD，维生素B-12的β(SE)为0.048(P<；.001)，全反钴胺为0.040(P=0.002)。在整个样本中，总同型半胱氨酸水平的增加与整个样本中总脑容量损失的速度更快(每1-SD增加一次β[SE]，-0.035[0.015]；P=0.02)以及在收缩压大于140 mm Hg的参与者中白质高强度的进展相关(每1-SD增加一次β[SE]，0.000019[0.00001]；P=.047)。未发现红细胞叶酸和其他含硫氨基酸的纵向相关性。结论和相关性本研究提示维生素B-12和总同型半胱氨酸浓度可能与大脑加速衰老有关。需要随机临床试验来确定补充维生素B-12在延缓老年人大脑衰老方面的重要性。
IMPORTANCE Vitamin B-12, folate, and sulfur amino acids may be modifiable risk factors for structural brain changes that precede clinical dementia.OBJECTIVE To investigate the association of circulating levels of vitamin B-12, red blood cell folate, and sulfur amino acids with the rate of total brain volume loss and the change in white matter hyperintensity volume as measured by fluid-attenuated inversion recovery in older adults.DESIGN, SETTING, AND PARTICIPANTS The magnetic resonance imaging subsample of the Swedish National Study on Aging and Care in Kungsholmen, a population-based longitudinal study in Stockholm, Sweden, was conducted in 501 participants aged 60 years or older who were free of dementia at baseline. A total of 299 participants underwent repeated structural brain magnetic resonance imaging scans from September 17, 2001, to December 17, 2009.MAIN OUTCOMES AND MEASURES The rate of brain tissue volume loss and the progression of total white matter hyperintensity volume.RESULTS In the multi-adjusted linear mixed models, among 501 participants (300 women [59.9%]; mean [SD] age, 70.9 [9.1] years), higher baseline vitamin B-12 and holotranscobalamin levels were associated with a decreased rate of total brain volume loss during the study period: for each increase of 1 SD, beta (SE) was 0.048 (0.013) for vitamin B-12 (P < .001) and 0.040 (0.013) for holotranscobalamin (P = .002). Increased total homocysteine levels were associated with faster rates of total brain volume loss in the whole sample (beta [SE] per 1-SD increase, -0.035 [0.015]; P = .02) and with the progression of white matter hyperintensity among participants with systolic blood pressure greater than 140mmHg (beta [SE] per 1-SD increase, 0.000019 [0.00001]; P = .047). No longitudinal associations were found for red blood cell folate and other sulfur amino acids.CONCLUSIONS AND RELEVANCE This study suggests that both vitamin B-12 and total homocysteine concentrations may be related to accelerated aging of the brain. Randomized clinical trials are needed to determine the importance of vitamin B-12 supplementation on slowing brain aging in older adults.