Effects of vitamin D3 supplementation on cognition and blood lipids: a 12-month randomised, double-blind, placebo-controlled trial
Effects of vitamin D3 supplementation on cognition and blood lipids: a 12-month randomised, double-blind, placebo-controlled trial
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补充维生素 D3 对认知和血脂的影响：一项为期 12 个月的随机、双盲、安慰剂对照试验
DOI：
10.1136/jnnp-2018-318594
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发表时间：
2018-12-01
影响因子：
11
通讯作者：
Ma, Fei
中科院分区：
文献类型：
--
作者：
Hu, Jing;Jia, Jingya;Ma, Fei
阿尔茨海默病（Alzheimer's disease，AD）是老年人痴呆和丧失自主性和独立性的主要原因。1目前，没有有效的药物干预改变AD的发作或进展。2轻度认知障碍（MCI）可能是可检测到的痴呆的最早阶段，可能是干预的最佳时机。3 4探索与老年痴呆症相关的因素和生化标志物引起了人们的广泛关注。越来越多的流行病学证据表明，营养成分缺乏可能与认知能力下降有关。5维生素D可以在大脑健康和功能中发挥重要作用，并在对认知至关重要的大脑区域发挥各种神经保护作用。6严重缺乏维生素D与患痴呆症的风险增加两倍以上有关。7维生素D对认知和病理的保护作用也在动物模型中得到了结论。Sonnenberg等9发现，1，25-二羟基维生素D（1，25-D）处理增加了特定大鼠脑核中的胆碱乙酰转移酶活性。补充维生素D3可能通过增加乙酰胆碱浓度而有助于观察到的记忆改善。维生素D的研究近年来受到越来越多的关注，因为它的作用超出了骨骼健康和钙稳态，如神经认知。10然而，结果并不确定。111机制仍不清楚。脑是体内脂质最丰富的器官，12几乎所有主要类别的脂质都与AD的发病机制有一定的相关性。13几项基于人群的研究报告称，患有AD、痴呆或认知障碍的老年人的血浆总胆固醇（TC）高于性别和年龄匹配的非痴呆同龄人。14-16脑和外周脂质水平曾被认为是通过血脑屏障彼此完全隔离的，但最近的证据表明它们通过氧化固醇分子（例如，24 S-羟基胆固醇和27-羟基胆固醇）持续相互作用。17因此，血脂对于预测患有痴呆症的风险更大的个体是重要和有用的。
Alzheimer’s disease (AD) is the leading cause of dementia and loss of autonomy and independency in the elderly. 1 Currently, no effective pharmacological interventions change the onset or progression of AD. 2 Mild cognitive impairment (MCI) is possibly the earliest stage of detectable dementia and may be the optimal time to intervene. 3 4 Exploring factors and biochemical markers that are associated with late-life dementia has attracted much attention. A growing body of epidemiological evidence has suggested that deficiency of nutrition components may be related to the development of cognitive decline. 5Vitamin D can play an important role in brain health and function, and exert various neuroprotective effects in brain areas essential for cognition. 6 Being severely deficient in vitamin D is associated with a more than twofold increased risk of developing dementia. 7 Protective effects of vitamin D on cognition and pathology are also concluded in animal models. 8 9 Sonnenberg et al 9 found that 1, 25-dihydroxyvitamin D (1, 25-D) treatment increases choline acetyltransferase activity in specific rat brain nuclei. Supplementation of vitamin D3 may have contributed to the observed improvements to memory via increasing acetylcholine concentration. Vitamin D research has gained increased attention in recent times due to its roles beyond bone health and calcium homeostasis, such as neurocognitive. 10 However, results have been inconclusive. 1 11 The mechanisms still remain unclear. The brain is the most lipid-rich organ in the body, 12 and almost all major classes of lipids have some correlation with AD pathogenesis. 13 Several population-based studies reported that elderly people with AD or with dementia or cognitive impairment have higher plasma total cholesterol (TC) than sex and age-matched non-demented peers. 14–16 Brain and peripheral lipid levels were once thought to be entirely isolated from one another by the blood–brain barrier, but recent evidence indicates they interact continuously via oxysterol molecules (eg, 24S-hydroxycholesterol and 27-hydroxycholesterol). 17 Therefore, blood lipid is important and useful for predicting individuals who are at a greater risk of developing dementia.