社区老年人血清维生素D代谢物水平与认知功能之间的关系：一项横断面研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-03 DOI:10.1016/j.clnesp.2025.08.032

Cai Yu , Minae Ide , Taiki Sugimoto , Rei Otsuka , Koji Takahashi , Masaki Takiwaki , Kiyoshi Tanaka , Hiroaki Kanouchi , Shigeo Takenaka , Takashi Sakurai , Shumpei Niida , Akiko Kuwabara

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引用次数: 0

摘要

背景与目的：维生素D缺乏与认知能力下降和阿尔茨海默病（AD）有关；然而，研究结果仍然不一致。仅基于总25-羟维生素D [25(OH)D]来评估维生素D状态可能是不够的，其他代谢物，如24,25-二羟维生素D3 [24,25(OH)2D3]和3-epimer-25-羟维生素D3 [3-epi-25(OH)D3]，可能会提供额外的见解。本研究旨在研究老年人血清维生素D代谢物浓度与认知功能之间的关系。方法：对289名年龄在65-85岁、临床诊断为AD、轻度认知障碍（MCI）或认知正常（CN）的社区居民进行横断面研究。采用简易精神状态检查（MMSE）评估认知功能。采用LC-MS/MS检测血清25-羟维生素D3 [25(OH)D3]、25(OH)D2、24,25(OH)2D3、3-epi-25(OH)D3和1,25-二羟维生素D3 [1,25(OH)2D3]的浓度。计算维生素D代谢物比率（VMR）为24,25(OH)2D3/25(OH)D3 × 100（%）。分析代谢物浓度、MMSE评分和AD患病率之间的关系。结果：参与者血清总25(OH)D水平相对较高（中位数：23.5 ng/mL），男性显示出更高的维生素D代谢物浓度。总25(OH)D与24,25(OH)2D3, 3-epi-25(OH)D3和VMR相关。在男性中，3-epi-25(OH)D3和24,25(OH)2D3与MMSE评分较低（p < 0.01）和AD风险较高相关（OR = 2.78, p = 0.03）。在女性中，VMR与较高的MMSE评分（p = 0.01）和较低的AD风险相关（OR = 0.64, p < 0.01），而1,25(OH)2D3与较高的AD风险相关（OR = 1.04, p = 0.01），四分位数2与较低的MCI风险相关（p < 0.05）。结论：基于性别的维生素D认知关联差异可能反映了维生素D水平和激素效应的差异，如雌激素增强和睾酮抑制代谢。1,25(OH)2D3、VMR和3-epi-25(OH)D3可能比总25(OH)D更敏感。

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Association between serum vitamin D metabolite levels and cognitive function in community-dwelling older adults: A cross-sectional study

Background & aims

Vitamin D deficiency has been associated with cognitive decline and Alzheimer's disease (AD); however, findings remain inconsistent. Assessing vitamin D status based solely on total 25-hydroxyvitamin D [25(OH)D] may be insufficient, and other metabolites, such as 24,25-dihydroxyvitamin D₃ [24,25(OH)₂D₃] and 3-epimer-25-hydroxyvitamin D₃ [3-epi-25(OH)D₃], may provide additional insights. This study aimed to examine the association between serum vitamin D metabolite concentrations and cognitive function in older adults.

Methods

A cross-sectional study was conducted involving 289 community-dwelling participants aged 65–85 years clinically diagnosed with AD, mild cognitive impairment (MCI), or were cognitively normal (CN). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Serum concentrations of 25-hydroxyvitamin D₃ [25(OH)D₃], 25-hydroxyvitamin D₂ [25(OH)D₂], 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃] were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Vitamin D metabolite ratio (VMR) was calculated as 24,25(OH)₂D₃/25(OH)D₃ × 100 (%). Associations among metabolite concentrations, MMSE scores, and AD prevalence were analyzed.

Results

Participants had relatively high serum total 25(OH)D levels (median: 23.5 ng/mL), with males showing higher vitamin D metabolite concentrations. Total 25(OH)D correlated with 24,25(OH)₂D₃, 3-epi-25(OH)D₃, and VMR. In males, 3-epi-25(OH)D₃ and 24,25(OH)₂D₃ were associated with lower MMSE scores (p < 0.01) and higher AD risk (OR = 2.78, p = 0.03). In females, VMR was associated with higher MMSE scores (p = 0.01) and lower AD risk (OR = 0.64, p < 0.01), while 1,25(OH)₂D₃ was linked to higher AD risk (OR = 1.04, p = 0.01) and quartile 2 with lower MCI risk (p < 0.05).

Conclusions

Sex-based differences in vitamin D–cognition associations may reflect disparities in vitamin D levels and hormonal effects, such as estrogen-enhancing and testosterone-suppressing metabolism. 1,25(OH)₂D₃, VMR, and 3-epi-25(OH)D₃ may be more sensitive than total 25(OH)D.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.