维生素B6、B12、叶酸对高同型半胱氨酸血症致兔动脉粥样硬化脑组织的NF-κB表达的影响

目的 建立兔高同型半胱氨酸（Hcy）血症与动脉粥样硬化模型,观察脑组织核转录因子κB（NF-κB）的阳性表达,探讨VitB6、VitB12、叶酸的干预效果.方法 采用纯种雄性新西兰兔26只,分为三组：对照组、高蛋氨酸组（高Met）、干预组,分别喂以普通兔饲料（200 g/d/只）、普通饲料添加0.5%Met、普通饲料添加0.5%Met＋叶酸2.5 mg＋VitB12 200 mg/d/只,喂养6个月,测定血浆总Hcy （tHcy）,取脑组织标本用免疫组化方法 （SABC法）测定NF-κB的表达.结果 与对照组相比,高蛋氨酸组脑组织中的NF-κB明显升高（P＜0.05）;干预组NF-κB明显降低,但仍高于对照组.结论 高Met引发高Hcy血症致兔动脉粥样硬化,NF-κB的表达与兔动脉粥样硬化脑组织关系密切,且VitB6、VitB12、叶酸的补充可以减轻NF-κB的表达,押制炎症反应.     

VitB12、VitB6和叶酸对兔高同型半胱氨酸血症干预的研究

目的 探讨叶酸、维生素B12、B6对兔血浆同型半胱氨酸（Hcy）水平的影响.方法 采用皮下注射DL-蛋氨酸方法建立兔高Hcy血症模型,用高效液相色谱荧光法检测血浆Hcy水平.结果 模型组实验后Hcy含量显著高于实验前及对照组（P＜0.05）;干预组实验后Hcy含量与实验前和对照组比较无统计学意义,但与模型组实验后比较P＜0.05.结论 叶酸、维生素B12、B6作为酶的辅助因子,加速了Hcy的代谢,有效地降低高Hcy血症.     

血管性认知功能障碍与C-反应蛋白、同型半胱氨酸、维生素B12及叶酸的相关性研究

目的 探讨血管性认知功能障碍(vascular cognitive impairment,VCI)患者血C-反应蛋白(CRP)、血浆同型半胱氨酸(homocystine,Hcy)、VitB12、叶酸(folic acid,FA)水平的差异及其与认知功能障碍严重程度的相关性。方法 选择2014年12月～2016年6月南京鼓楼医院集团宿迁市人民医院神经内科门诊及住院患者共100例,根据MoCA量表评分划分为3组,具体为正常对照(normal control,NC)组30例、非痴呆型血管性认知障碍(vascular cognitive impairment no dementia, VCIND)组 39例和血管性痴呆(vascular dementia,VD)组31例; 所有患者均取晨起空腹肘静脉血测定血CRP、血Hcy、VitB12、FA水平。结果(1)VCIND组患者 CRP和Hcy水平较NC组高,VtimaniB12和血清FA水平较NC组低(P<0.05);(2)VD组患者与VCIND组患者比较血CRP和Hcy水平明显升高(P<0.05),血VitB12和血FA水平明显下降(P<0.05);(3)VD组患者CRP和Hcy水平较NC组高,VtimaniB12和血清FA水平较 NC组低(P<0.01);(4)VCI(VD组+VCIND组)患者血CRP、Hcy水平与MoCA量表评分呈负相关(r=-0.56,P<0.05),血VitB12和FA水平与MoCA量表评分无明显相关性(r=0,P>0.05)。结论 VCI患者血清CRP水平升高,血浆Hcy水平升高与VCI具有相关性,血CRP水平升高及高Hcy可能是VCI发病及认知损害进展的重要因素。     

同型半胱氨酸、叶酸和维生素B12与精神分裂症的关系

目的 探讨精神分裂症患者血浆同型半胱氨酸、血清叶酸和维牛素B12水平的改变及其可能的意义.方法 采用病例对照研究,精神分裂症患者组122例,正常对照组122例.循环酶法测定两组血浆同型半胱氨酸水平;电化学发光仪测定叶酸和维生素B12水平.结果 ①精神分裂症患者组血浆间型半胱氨酸水平[(27.23±21.41)I.Lmob/L]明显高于正常对照组[(14.34±7.45)tunol/L],差异有统计学意义(P<0.001);②精神分裂症患者组维牛素B12水平[(328.93±157.52)pg/mL]明显低于正常对照组[(464.02±166.29)pg/mL],差异有统计学意义(P<0.05);③血浆同型半胱氩酸水平与叶酸水平(r=-0.44,P<0.001)和维生素Bi2水平(r=-0.36,P<0.001)均呈负相关;④Ligistic回归分析结果 显示,同型半胱氨酸与精神分裂症有关(P<0.001),其优势比(OR)为1.14(95%CI:1.08-1.21).结论 血浆同型半胱氨酸水平增高可能是精神分裂症的危险因素;叶酸和维生素B12缺乏与精神分裂症患者血浆同型半胱氨酸水平增高有关.     

叶酸和维生素B6、B12联合治疗青年脑卒中合并高同型半胱氨酸血症的疗效观察

目的 观察叶酸和维生素B6、B12联合治疗青年脑卒中合并高同型半胱氨酸(Hcy)血症的疗效.方法 将150例青年脑卒中合并高Hcy血症患者随机分为低剂量叶酸和维生素B6、B12治疗组(低剂量组)、高剂量叶酸和维生素B6、B12治疗组(高剂量组)、对照组,每组50例.用药剂量:低剂量组给予叶酸2.5mg/d、维生素B6 10 mg/d、维生素B12 0.5 mg/d,高剂量组给予叶酸5 mg/d、维生素B6 30 ms/d、维生素B12 1.5mg/d,连续给药4周,对照组不予叶酸和维生素B6、B12治疗.治疗前后检测血浆Hcy浓度,治疗后血浆Hcy浓度＜15 μmol/L为有效;并观察不良反应.结果 治疗4周后低剂量组、高剂量组临床有效率分别是70.4%、71.6%,与对照组(4.6%)相比差异有统计学意义(均P＜0.01);治疗后低剂量组、高剂量组血浆Hcy浓度比治疗前明显降低(下降33.9%和36.1%)(均P＜0.01);对照组治疗后的血浆Hcy浓度无明显下降.3组治疗过程中均未出现不良反应.结论 叶酸和维生素B6、B12联合治疗青年脑卒中合并的高Hcy血症有明显效果,而且高、低两种剂量均有效;无不良反应.     

VitB12、VitB6和叶酸对兔高同型半胱氨酸血症干预的研究

目的探讨叶酸、维生素B12、B6对兔血浆同型半胱氨酸(Hcy)水平的影响.方法采用皮下注射DL-蛋氨酸方法建立兔高Hcy血症模型,用高效液相色谱荧光法检测血浆Hcy水平.结果模型组实验后Hcy含量显著高于实验前及对照组(P＜0.05);干预组实验后Hcy含量与实验前和对照组比较无统计学意义,但与模型组实验后比较P＜0.05结论叶酸、维生素B12、B6作为酶的辅助因子,加速了Hcy的代谢,有效地降低高Hcy血症.     

急性脑梗死患者血浆同型半胱氨酸、叶酸、维生素B12水平的测定及其临床意义

目的 探讨血浆同型半胱氨酸(Hcy)在急性脑梗死发病过程中的临床意义以及与病情、伴发症、叶酸、维生素B_(12)之间的关系。方法 采用化学发光法测定急性脑梗死患者血浆Hcy、叶酸、维生素B_(12)水平,并与对照组进行比较。结果急性脑梗死组血浆Hcy水平明显高于对照组(P<0.001),叶酸明显低于对照组(P<0.001);重型患者血浆Hcy水平明显高于中型及轻型患者(P<0.01,0.01),叶酸明显低于中型及轻型患者(P<0.01,0.05);伴发高血压病的患者血浆Hcy水平明显高于非高血压病的患者(P<0.05);急性脑梗死组血浆Hcy与叶酸、维生素B_(12)呈负相关(P<0.01,0.01);对照组血浆Hcy与叶酸呈负相关(P<0.05)。结论高Hcy血症是脑梗死的一个新的重要危险因素;Hcy水平与病情密切相关,与叶酸、维生素B_(12)呈负相关。     

创伤后应激障碍与血同型半胱氨酸、叶酸及维生素B12的相关性

目的 探讨创伤后应激障碍（PTSD）患者应激症状与血同型半胱氨酸、叶酸、维生素B12 代谢的相关性。方法 2016 年11 月—2017 年11 月对驻疆某部官兵经历创伤性事件后,按照创伤后应激障碍筛查量表（PCL-C）评分阳性和美国精神疾病诊断统计手册第五版（DSM-5）的诊断标准,根据是否为PTSD分为PTSD组（n=27）和在相同暴露条件下的未患PTSD的对照组（n=39）。对两组空腹血浆同型半胱氨酸、叶酸、维生素B12 及部分其他血液学指标进行分析。结果 PTSD组血同型半胱氨酸水平高于对照组,叶酸、维生素B12 水平、T3、T4低于对照组,差异均有统计学有意义,而TSH、LDL、HDL-C 组间比较,差异均无统计学意义。结论 PTSD患者其血同型半胱氨酸较高,叶酸及维生素B12 水平较低。     

小剂量叶酸加维生素B12对脑卒中高同型半胱氨酸血症的影响

目的小剂量叶酸加维生素B12对脑卒中高同型半胱氨酸(homoystm,Hcy)血症的影响.方法脑卒中病人73例,随机分成3组,3组年龄、同型半胱氨酸、叶酸、维生素B12水平均无显著差异,并排除糖尿病及肝肾功能异常者.1组服用叶酸(1.25 mg/d),2组服用叶酸(1.25 mg/d)加维生素B12(250μg/d),3组作为对照组,以上3组均服用维生素B6(60 mg/d),而不用其他维生素.结果前两组血浆水平下降显著(P＜0.01),而加用维生素B12组较单用叶酸组下降更显著,两者比较有显著差异(P＜0.01).结论小剂量时叶酸加维生素B12治疗脑卒中高同型半胱氨酸血症效果显著.     

Folate, Vitamin B12, and Homocysteine as Risk Factors for Cognitive Decline in the Elderly

Objective

Cross-sectional studies have shown that the dysregulation of one-carbon metabolism is associated with cognitive impairment. However, the findings of longitudinal studies investigating this association have been inconsistent. This study investigated the prospective associations between cognitive decline and the levels of folate, vitamin B₁₂ and homocysteine both at baseline and over course of the study period.

Methods

A total of 607 (83%) elderly individuals were selected from a group of 732 elderly individuals without dementia at baseline and followed over a 2.4-year study period. The Mini-Mental State Examination (MMSE) was administered to the subjects, and the serum levels of folate, vitamin B₁₂ and homocysteine were assayed both at baseline and at follow-up examinations. Covariates included demographic data, disability, depression, alcohol consumption, physical activity, vascular risk factors, serum creatinine level, vitamin intake, and apolipoprotein E genotype.

Results

Cognitive decline was associated with decreasing quintiles of folate at baseline, a relative decline in folate and an increase in homocysteine across the two examinations after adjustment for relevant covariates.

Conclusion

These results suggest that folate and homocysteine are involved in the etiology of cognitive decline in the elderly.     

Homocysteine,vitamin B12 and folate levels in Iranian patients with Multiple Sclerosis: A case control study

Background

Recently, homocysteine (Hcy), folate, and vitamin B12 have been proposed to have several roles on MS pathogenesis.

Objective

We performed this study to determine the role of serum levels of Hcy, vitamin B12, and folate in patients with relapsing remitting MS (RRMS) and compared them with healthy controls.

Methods

We recruited 75 RRMS patients and 75 subjects as controls with the same age and sex. Homocysteine was measured using fluorimetric high-performance liquid chromatography. Plasma folate and vitamin B12 levels were measured through ion-capture method.

Results

Mean plasma levels of vitamin B12, folate, and Hcy in cases were 342.64 ± 210.66 pg/ml, 9.74 ± 4.77 ng/ml, and 22.73 ± 11.63 μM/L, respectively, which showed significant difference in comparison with the controls. In addition, there were significant correlations between mean serum Hcy levels and duration of disease (r = 0.2, p = 0.05) and treatment with interferon (r = 0.21, p = 0.01). In cases, Hcy level was higher among those on β interferon (24.56 ± 11.87 vs. 19.71 ± 10.75, p = 0.01).

Conclusions

We concluded that serum levels of vitamin B12 and folate decreased in RRMS patients, but Hcy levels increased significantly. It seems necessary to conduct prospective trials to determine whether the treatment with supplements and correct biomarker levels in the early stage of the disease can change the course of the disease. We recommend regular checking of the serum level of Hcy in patients who use disease-modifying drugs.     

血清叶酸、维生素B12水平与脑梗死的关系

目的为探讨血清叶酸、维生素B12水平与脑梗死的关系.方法运用放射免疫分析法检测50例脑梗死患者和44例正常对照组的血清叶酸、维生素B12浓度.结果脑梗死组血清叶酸、维生素B12浓度分别为(5.97±1.96)μg/ml、(511.47±212.06)μg/ml;对照组分别为(8.08±2.25)μg/ml、(806.91±254.60)μg/ml.脑梗死组血清叶酸、维生素B12水平均明显低于对照组,两组有显著性差异(P＜0.01).结论提示血清叶酸、维生素B12水平下降与脑梗死的发生有关,可能是其中又一危险因素.     

高同型半胱氨酸血症与卒中的关系

目的 探讨高同型半胱氨酸（Homocysteine,Hcy）血症与卒中的关系。方法 选择卒中患者102例（66例脑梗死和36例脑出血）为卒中组,与病例组年龄、性别、种族等相匹配的未患过卒中来院进行健康体检者102例为对照组。采用高效液相色谱荧光检测法测定两组的血清Hcy水平。同时检测叶酸、维生素B12、血糖、血脂等。结果 卒中组血清Hcy水平显著高于对照组（20±9μmol/L vs 9±6μmol/L,P<0.01）;脑梗死和脑出血患者的血清Hcy水平无统计学差异（P>0.05）;血清叶酸及维生素B12水平与血清Hcy均呈负相关;Logistic回归分析显示,高Hcy血症卒中的独立危险因素（OR 4.875,95%CI 1.902～8.552,P<0.05）。结论 高Hcy血症是卒中的独立危险因素;叶酸和VitB12的缺乏可能是导致高Hcy血症的原因之一。     

Plasma homocysteine, vitamin B12 and folate in Alzheimer's patients and healthy Arabs in Israel

High plasma homocysteine (tHcy) is a risk factor for cardiovascular disease and stroke and Alzheimer's disease (AD). An inverse relationship has been reported between tHcy and plasma B12 and folate levels. Seventy-nine AD patients and 156 controls from three Arab villages in northern Israel participated. Plasma tHcy, B12 and folate levels were determined. Data were analyzed using univariate statistical tests and logistical regression with confounders. tHcy was significantly higher in AD patients (20.6+/-8.7 micromol/l) than in controls (16.4+/-6.5 micromol/l) (p=0.03) after correction for year of birth, gender and smoking status. Plasma B12 (322.9+/-136.0/350.5+/-175.3 pmol/l) and plasma folate (4.5+/-3.8/4.9+/-2.6 nmol/l) levels did not differ significantly between AD patients and controls. Subjects in the highest tHcy tertile or in the lowest B12 and folate tertiles did not have greater risk to develop AD. In this population residing in Arab villages in northern Israel, tHcy levels were significantly higher among AD patients than in controls. Plasma B12 and folate levels were lower among cases but were not significant. There was not a significant association between plasma tHcy, B12 and folate levels in controls or AD patients. High levels of tHcy may suggest the need for folate and vitamin B12 supplementation in this population.     

血浆同型半胱氨酸与脑梗死的相关性研究

目的探讨血浆同型半胱氨酸水平对脑梗死的影响。方法采用高效液相色谱仪HPLC-FD法检测40例急性脑梗死患者的血浆Hcy,采用离子捕获法测定患者叶酸（Fol）、维生素B12（VitB12）等指标,与40名健康对照者比较。结果 脑梗死组血浆Hcy水平和甘油三酯（TG）明显高于对照组,而Fol及VitB12水平则低于对照组,差异有统计学意义（P〈0.05）。高Hcy血症与脑梗死相关,相对危险度OR为8.921（95%CI 2.16～30.32）,脑梗死组和对照组血浆Hcy水平与血Fol、VitB12水平均呈显著负相关。结论 高同型半胱氨酸血症是脑梗死的独立危险因素。     

急性脑梗死患者血浆同型半胱氨酸水平及其干预治疗探讨

目的 探讨急性脑梗死患者给予维生素B_(12)制剂(甲钴胺)和叶酸(Fa)治疗前后血浆同型半胱氨酸(Hcy)、叶酸和维生素B_(12)水平变化及其对预后的影响.方法 检测152例急性脑梗死患者和132例正常人血浆同型半胱氨酸(Hcy)、叶酸、维生素B_(12)水平,并对急性脑梗死患者进行神经功能缺损评分(NIHSS);将急性脑梗死组随机分为干预组和非干预组,干预组给予维生素B_(12)制剂(甲钻胺)联合叶酸治疗,治疗4周后复测血浆同型半胱氨酸(Hcy)、叶酸和维生素B_(12)水平,并再次进行神经功能缺损评分(NIHSS).结果 急性脑梗死组和正常健康对照组之间血浆Hcy水平、叶酸和维生素B_(12)水平存在明显差异(P<0.01),予以补充叶酸和维生素B_(12)(甲钴胺)治疗后,干预组血浆Hcy水平明显下降,神经功能缺损评分显著升高,与非干预组相比有显著性差异(P<0.05).结论 急性脑梗死患者血浆Hcy水平升高,补充叶酸、维生素B_(12)制剂有助于降低血浆Hcy水平,有利于脑梗死疾病的转归.

Abstract：

Objective To explore the changes of the levels of plasma homocysteine ( Hcy), folate and vitamin B_(12) and the relationship between the changes and the prognosis in patients with acute cerebral infarction who were treated with vitamin B_(12) preparation (methylcobalamin) and folate. Methods The plasma level of Hcy, folate and vitamin B_(12) ( VitB_(12)) of 152 patients with cerebral infarction and 132 healthy people were measured, and the patients with acute cerebral infarction were given a mark with the evaluation of neurological impairments (NIHSS). The patients with acute cerebral infarction were randomly divided into intervention group and non-intervention group. The intervention group was treated with vitamin B_(12) preparations (methylcobalamin) and folate. After 4 weeks, retested the plasma homocysteine (Hcy), folate and vitamin B_(12) levels, and carried out NIHSS score once again. Results In the plasma level of Hcy, folate and vitamin B_(12), there were significant differences between the acute cerebral infarction group and the healthy control group (P < 0.01 ). In intervention group, the plasma homocysteine levels decreased significantly, and the evaluation scores increased significantly after intervention treatment, and there was significant differences between intervention group and non-intervention group (P <0.05). Conclusion The levels of plasma Hcy increased in the patients with acute cerebral infarction. Being added with folate and vitamin B_(12) preparations was well to reduce the levels of plasma Hcy, and it was also conducived to the prognosis of acute cerebral infarction.     

Plasma homocysteine, folate and B12 in chronic schizophrenia

Elevated plasma levels of the amino acid homocysteine have been associated with schizophrenia, particularly in young male patients. Among other factors, low folate and vitamin B12 levels have been implicated in the increase in homocysteine. In order to investigate this association, we determined plasma homocysteine, folate and B12 levels in 97 (67 males and 30 females) inpatients with chronic schizophrenia and 103 (46 males and 57 females) controls. Patients and controls did not differ in folate or B12 levels, after adjusting for age. Patients with schizophrenia had higher plasma homocysteine than controls (mean=15.42 micromol/l in cases versus 11.54 micromol/l in controls: F(1,195)=17.978; p<0.001). This difference persisted after controlling for folate and B12 concentrations. Both male and female patients had increased plasma homocysteine compared to controls [(males: mean=16.61 micromol/l in cases versus mean=13.72 in controls: F(1,110)=5.54; p=0.020) (females: mean=12.78 micromol/l in cases versus mean=9.79 micromol/l in controls: F(1,84)=13.54; p<0.001)]. When dividing our sample into two age groups (age < and > or =50 years), both young and older females and younger males with schizophrenia had increased plasma homocysteine compared to controls. We therefore suggest that homocysteinemia is a general risk factor for schizophrenia. We further suggest that it is not limited to young male patients and is not necessarily associated with low folate or B12 levels.     

叶酸、Vit B_(12)干预对高Hcy的急性脑梗死近期预后的影响

目的观察叶酸、维生素B12干预治疗是否能降低高同型半胱氨酸血症的急性脑梗死患者的Hcy水平以及对患者近期预后的影响。方法根据血浆Hcy水平将急性脑梗死患者分为正常组(92例),干预组(39例)及对照组(37例),干预组除常规治疗外给予叶酸5mg.d-1和维生素B12500ug.d-1,其他两组仅予常规治疗。随访患者1年,观察血浆Hcy水平以及患者预后(NIHSS以及不良预后事件)。结果干预组Hcy水平显著降低(P=0.008),但是NIHSS评分较对照组无显著改善,不良预后事件发生率无差异。结论叶酸及维生素B12治疗能显著降低患者血浆Hcy水平,但是不能改善患者预后,考虑可能与维生素治疗不能改善炎症反应有关。维生素治疗能否降低心脑血管病的发生及复发需要进一步研究。