Brain atrophy in cognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in a randomized controlled trial
Brain atrophy in cognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in a randomized controlled trial
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DOI：
10.3945/ajcn.114.103283
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发表时间：
2015-07-01
影响因子：
7.1
通讯作者：
Smith, A. David
中科院分区：
文献类型：
--
作者：
Jerneren, Fredrik;Elshorbagy, Amany K.;Smith, A. David
背景：脑萎缩率增加在认知障碍的老年人中很常见，特别是在那些最终转变为阿尔茨海默病的人中。目的：在一项安慰剂对照试验(VITACOG)中，我们研究了血浆omega-3脂肪酸浓度(二十碳五烯酸和二十二碳六烯酸)是否影响降低同型半胱氨酸的B维生素对脑萎缩率的治疗效果。设计：这项回顾性分析包括168名患有轻度认知障碍的老年患者，随机分为安慰剂组(n=83)和每日大剂量补充维生素B组(叶酸，0.8 mg；维生素B-6，20 mg；维生素B-12，0.5 mg)(n=85)。受试者在基线和2年后接受头颅磁共振成像扫描。结果：维生素B治疗与血浆结合omega-3脂肪酸(二十碳五烯酸和二十二碳六烯酸)之间存在显著的交互作用(P=0.024)。在基线w-3脂肪酸水平较高的受试者(590umol/L)中，维生素B治疗使平均萎缩率与安慰剂相比减缓了40.0%(P=0.023)。维生素B治疗对基线omega-3脂肪酸水平较低的受试者的萎缩率没有显著影响(
Background: Increased brain atrophy rates are common in older people with cognitive impairment, particularly in those who eventually convert to Alzheimer disease. Plasma concentrations of omega-3 (omega-3) fatty acids and homocysteine are associated with the development of brain atrophy and dementia.Objective: We investigated whether plasma omega-3 fatty acid concentrations (eicosapentaenoic acid and docosahexaenoic acid) modify the treatment effect of homocysteine-lowering B vitamins on brain atrophy rates in a placebo-controlled trial (VITACOG).Design: This retrospective analysis included 168 elderly people (>= 70 y) with mild cognitive impairment, randomly assigned either to placebo (n = 83) or to daily high-dose B vitamin supplementation (folic acid, 0.8 mg; vitamin B-6, 20 mg; vitamin B-12, 0.5 mg) (n = 85). The subjects underwent cranial magnetic resonance imaging scans at baseline and 2 y later. The effect of the intervention was analyzed according to tertiles of baseline omega-3 fatty acid concentrations.Results: There was a significant interaction (P = 0.024) between B vitamin treatment and plasma combined omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) on brain atrophy rates. In subjects with high baseline w-3 fatty acids (>590 mu mol/L), B vitamin treatment slowed the mean atrophy rate by 40.0% compared with placebo (P = 0.023). B vitamin treatment had no significant effect on the rate of atrophy among subjects with low baseline omega-3 fatty acids (