农村和城市印度老年人同型半胱氨酸、维生素 B12 和叶酸含量的比较及其与轻度认知障碍和心血管风险因素的关系:横断面分析。

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2024-10-15 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae343
Divya N Mallikarjun, Palash Kumar Malo, Abhishek Mensegere, Ajith Partha, Jonas S Sundarakumar, Thomas Gregor Issac, Latha Diwakar
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引用次数: 0

摘要

血液中同型半胱氨酸(HCY)、维生素 B12、叶酸水平与认知障碍之间的关系尚无定论。由于同型半胱氨酸(HCY)是心血管疾病的独立风险因素,因此了解其与弗雷明汉风险评分(FRS)之间的关系可能有助于深入了解心血管疾病与认知障碍之间的共同潜在机制。横断面分析利用了两项正在进行的纵向研究的基线数据:城市队列 "塔塔老龄化纵向研究"(n = 923)和农村队列 "斯里尼瓦斯普拉老龄化、神经衰老和认知障碍"(n = 4239)。研究比较了不同队列和正常与轻度认知障碍(MCI)参与者的 HCY、维生素 B12 和叶酸水平。使用回归模型确定了 HCY 与认知状况之间的关联。对三个模型进行了分析:模型 1 未经调整;模型 2 对年龄、性别、吸烟、饮酒、饮食、高血压、心脏病、糖尿病进行了调整;模型 3 对模型 2 中的变量加上维生素 B12 和叶酸进行了调整。计算了 HCY 与 FRS 之间的相关性。与农村队列相比,城市队列的 HCY [中位数(IQR)(17.70(10.2)对 14.70(9.7);P < 0.001)]、维生素 B12(251(231)对 219(138);P < 0.001)和叶酸(8.21(8)对 5.48(4);P < 0.001)水平明显更高。在城市队列中,正常人和 MCI 患者的 HCY、维生素 B12 和叶酸水平没有显著差异。在农村队列中,与年龄性别匹配的 MCI 正常者相比,认知正常者的维生素 B12 水平(≥60 岁)[227(152)对 217(175);P = 0.03]和叶酸水平(P = 0.04]更高。在两个队列中,HCY 与认知状况之间没有关联,但在特定年龄组中,维生素 B12 缺乏与临床痴呆评级-方框总和(CDR-SOB)之间以及叶酸缺乏与农村和城市队列中的 CDR-SOB 之间分别存在显著的正相关关系。在农村队列中,FRS 和 HCY 之间存在明显的相关性(r = 0.17,P < 0.001),而在城市队列中则没有。这项研究显示,不同人群的 HCY、维生素 B12 和叶酸水平存在明显差异。在农村队列中,患有 MCI 的参与者在某一年龄组的维生素 B12 和叶酸水平较低。在两个队列中,HCY 与认知状况之间的关系都不显著。在农村队列中,FRS 与 HCY 之间存在微小的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of homocysteine, vitamin B12 and folic acid between rural and urban ageing Indians and its association with mild cognitive impairment and cardiovascular risk factors: a cross-sectional analysis.

The relationship between blood levels of homocysteine (HCY), vitamin B12, folic acid and cognitive impairment is inconclusive. Since HCY is an independent risk factor for cardiovascular diseases, understanding its association with Framingham risk score (FRS) may provide insight into the shared underlying mechanism between cardiovascular disease and cognitive impairment. Cross-sectional analyses utilized baseline data from two ongoing longitudinal studies: the Tata Longitudinal Study of Ageing (n = 923), an urban cohort, and Srinivaspura Ageing, NeuroSenescence and COGnition (n = 4239), a rural cohort. The study compared the HCY, vitamin B12 and folic acid levels across cohorts and normal versus mild cognitive impairment (MCI) participants. The association between HCY and cognitive status was established using regression models. Three models were analysed: model 1-unadjusted; model 2-adjusted for age, gender, smoking, alcohol consumption, diet, hypertension, cardiac illness, diabetes; and model 3-adjusted for variables in model 2 plus vitamin B12 and folic acid. Correlation was calculated between HCY and FRS. The urban cohort exhibited a significantly higher level of HCY [median (IQR) (17.70 (10.2) versus 14.70 (9.7); P < 0.001)], vitamin B12 (251 (231) versus 219 (138); P < 0.001) and folic acid (8.21 (8) versus 5.48 (4); P < 0.001) levels compared to rural cohort. HCY, vitamin B12 and folic acid levels did not differ significantly between normal and MCI participants in the urban cohort. In the rural cohort, among the age-gender matched MCI-normal, participants with normal cognition had higher levels of vitamin B12 (≥60 years) [227 (152) versus 217 (175); P = 0.03] and folic acid (<60 years) [5.91 (4) versus 5.40 (4); P = 0.04] compared to MCI. There was no association between HCY and cognitive status in both the cohorts, but there was a significant positive relationship between vitamin B12 deficiency and Clinical Dementia Rating-Sum of the Boxes (CDR-SOB), as well as folic acid deficiency and CDR-SOB in rural and urban cohorts, respectively, within a specific age group. A significant correlation was observed between FRS and HCY in the rural cohort (r = 0.17, P < 0.001), but not in the urban cohort. This study revealed significant differences in HCY, vitamin B12 and folic acid levels between the cohorts. In the rural cohort, participants with MCI had lower vitamin B12 and folic acid levels in a certain age group. Association between HCY and cognitive status was insignificant in both the cohorts. A small significant correlation between FRS and HCY was seen in the rural cohort.

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