血中叶酸、维生素B_(12)及蛋氨酸循环产物与阿尔茨海默病关系的人群研究

目的探讨阿尔茨海默病(Alzheimer’s disease,AD)与血清叶酸、维生素B12(VB12)以及血浆中蛋氨酸循环代谢产物水平的关系。方法选取在天津市环湖医院门诊确诊的50例阿尔茨海默病患者作为病例组,塘沽某社区50例正常老年人作为对照组,进行血液样本分析,通过高效液相色谱法测定血浆中同型半胱氨酸(homocysteine,Hcy)、S-腺苷甲硫氨酸(S-adenosylmethionine,SAM)、S-腺苷高半胱氨酸(S-adenosylhomocysteine,SAH)浓度并计算SAM/SAH,采用化学发光法试剂盒测定血清VB12、叶酸水平,并进行统计学分析。结果 AD组血清叶酸、VB12、血浆SAM浓度以及SAM/SAH低于对照组(P0.05),血浆SAH、Hcy浓度高于对照组(P0.05)。多因素分析结果显示,叶酸、VB12、SAM水平升高可能是AD的保护因素(OR=0.863、0.994、0.623),Hcy、SAH升高可能是AD的危险因素(OR=1.213、1.493)。结论血清叶酸、VB12以及血浆中蛋氨酸循环代谢产物水平均与AD相关。     

叶酸和甲钴胺联合治疗血管性痴呆患者高同型半胱氨酸血症

目的探讨血管性痴呆（VD）病人血浆同型半胱氨酸（Hcy）水平的变化及叶酸和甲钴胺干预治疗对VD病人血浆Hcy水平的影响。方法选取85例VD病人为病例组,81例同龄非痴呆老人为对照组,测定2组血浆中Hcy、叶酸、维生素B12水平,并随机选取20例VD病人接受口服叶酸5 mg及肌内注射甲钴胺500μg,每日1次,干预治疗4周。结果VD病人血浆中Hcy水平显著高于对照组（P〈0.01）,血浆中叶酸水平、维生素B12显著低于对照组（P〈0.01）,接受叶酸和甲钴胺干预治疗的20例VD病人,4周后血浆中Hcy水平下降（P〈0.01）,叶酸及维生素B12水平均升高（P〈0.01）。结论VD病人血浆中Hcy水平高;使用叶酸和甲钴胺干预治疗能够有效地降低VD病人血浆中Hcy水平。     

阿尔茨海默病与维生素B12及同型半胱氨酸的相关性

目的研究阿尔茨海默病(AD)与血清维生素B12、叶酸及血浆同型半胱氨酸水平之间的关系。方法采用简易精神状态量表(MMSE)对30例AD患者和30例同龄健康人进行评分,并用放射免疫分析法测定血清维生素B12及叶酸水平;用荧光偏振免疫法测定血浆同型半胱氨酸。结果AD组维生素B12水平为(217.3±134.2)pmol/L明显低于对照组(313.6±184.7)pmol/L,两者差异有极显著性(P<0.001)。AD组血浆同型半胱氨酸为(18.9±6.8)μmol/L高于对照组(9.4±4.1)μmol/L,差异有极显著性(P<0.001)。AD组叶酸水平为(29.2±12.7)nmol/L低于对照组(37.2±21.2)nmol/L,但差异无显著性(P>0.05)。AD患者血清维生素B12水平与MMSE得分呈正相关(r=0.87,P<0.01)。结论AD患者血浆维生素B12水平与智能障碍及其程度有关。     

恶性血液病患者的血浆同型半胱氨酸和血清叶酸水平的临床研究

目的 探讨血浆同型半胱氨酸(Hcy)和血清叶酸(FA)水平与恶性血液病患者的关系.方法 采用电化学发光法检测86名恶性血液病患者血浆中Hcy浓度、血浆叶酸、维生素B12的浓度.其中急性白血病63例,恶性淋巴瘤8例,多发性骨髓瘤8例;慢性粒细胞白血病慢性期(CML-CP)7例.并同时检查健康成人30名作为正常对照.结果 急性白血病、恶性淋巴瘤、多发性骨髓瘤、慢性白血病患者组中血浆Hcy水平显著高于健康对照组(P＜0.05),而FA水平明显降低(P＜0.05).结论 高同型半胱氨酸血症可能是恶性血液病患者的危险因素.     

血清同型半胱氨酸、叶酸、维生素B12浓度与多发性硬化的关系研究

目的：探讨血清同型半胱氨酸水平（Hcy）与多发性硬化（MS）的关系。方法：检测41例MS患者（MS组）和42例正常对照者（NC组）血清中Hcy浓度、叶酸及维生素B12浓度,并将结果进行比较分析。结果：MS组和NC组血清中Hcy浓度分别为（25.82±1.724）μmol/L、（13.60±1.517）μmol/L。MS组的Hcy浓度明显高于NC组,差异有统计学意义（P〈0.01）,而两组的叶酸、维生素B12浓度比较差异均无统计学意义（P〉0.05）。结论：MS患者血清Hcy水平升高,同型半胱氨酸可能在多发性硬化病理过程中起作用。     

血浆同型半胱氨酸与高血压病的关系探讨

目的探讨同型半胱氨酸、叶酸和维生素B12水平变化与高血压病的关系。方法用生物酶学法和平衡竞争放射免疫法检测80例高血压病患者血中同型半胱氨酸、叶酸、维生素B12水平,并与30例健康体检者进行对照。结果脑血管疾病患者血清中同型半胱氨酸含量明显高于健康对照组,差异有统计学意义（P〈0．05）;叶酸和维生素B12水平明显低于健康对照组,差异有统计学意义（P〈0．05）。结论高同型半胱氨酸血症为高血压病发病的危险因素之一,并与叶酸和维生素B。2水平下降有关。     

同型半胱氨酸与脑梗死关系的实验研究

目的探讨血浆同型半胱氨酸和脑梗死之间的关系。方法测定120例脑梗死患者及41例健康对照者的血浆同型半胱氨酸、维生素B12和叶酸水平。结果脑梗死组的血浆同型半胱氨酸水平(17.15±4.63)μmol/L显著高于对照组(10.12±2.62)μmol/L,P<0.01;血浆同型半胱氨酸水平与叶酸和维生素B12均呈负相关;男女患者之间同型半胱氨酸的差异有显著性(P<0.01);高血压脑梗死患者的同型半胱氨酸水平高于单纯脑梗死患者(P<0.01)。结论同型半胱氨酸是脑梗死的一个重要发病因素,血浆同型光胱氨酸水平与叶酸和维生素B12均呈负相关,雌激素水平对血浆同型半胱氨酸也有影响,高同型半胱氨酸血症与高血压性脑梗死有关。     

西北地区老年冠心病与血浆同型半胱氨酸的相关性分析

冠心病是老年人常见的疾病之一,其发病率要明显高于其他年龄段,严重危害老年人的生命健康。随着冠心病临床研究的不断深入,除了高血压、高血脂和糖尿病等致病因素外,同型半胱氨酸（Hcy）对冠心病的致病作用逐渐引起了临床的关注。同型半胱氨酸血症与叶酸、维生素B12代谢障碍有关,血浆Hcy浓度的升高常会引起冠状动脉粥样硬化性心血管系统病变。血浆Hcy水平与冠状动脉病变程度及预后存在一定的相关性,是冠心病的独立危险因素。     

叶酸及维生素B_（12）对2型糖尿病患者血浆Hcy的干预作用

目的：观察叶酸及维生素B12对2型糖尿病（T2DM）患者血浆同型半胱氨酸（Hcy）水平的影响。方法：选择临床确诊的2型糖尿病伴有高同型半胱氨酸血症患者65例,分为治疗组（33例）与对照组（32例）,两组患者均给予二甲双胍降糖治疗,治疗组在此基础上加用叶酸及维生素B12治疗,3周为1疗程。对比分析治疗后两组患者Hcy及血糖水平的变化情况。结果：治疗组患者治疗后血清Hcy水平较治疗前明显下降,比较差异有统计学意义（P〈0.05）;对照组治疗后Hcy水平较治疗前有所下降,但比较差异无统计学意义（P〉0.05）。两组患者治疗后FPG及2hPG水平较治疗前下降,比较差异均有统计学意义（P〈0.05）。结论：叶酸及维生素B12对降低2型糖尿病患者血浆Hcy水平有明显作用。     

同型半胱氨酸与轻度认知障碍的相关性

轻度认知功能障碍（mild cognitive impairment,MCI）是指介于痴呆和正常衰老之间的认知功能损害状态,但未达痴呆标准。同型半胱氨酸（homocysteine,Hcy）是蛋氨酸循环的代谢产物,血浆Hcy水平升高参与了轻度认知功能障碍的发病机制,目前研究显示同型半胱氨酸含量的增加是轻度认知功能障碍的一种独立危险因素。叶酸、维生素B12的干预治疗能显著影响血浆同型半胱氨酸的水平。本文将综述近几年对高同型半胱氨酸血症（Hyperhomocysteinemia,HhcyM）与轻度认知功能障碍的研究概况。     

Association of B vitamins status and homocysteine levels in elderly Taiwanese

To investigate the relationship between homocysteine (Hcy) and B vitamins status in the Taiwanese elderly population, an analysis was made of the plasma Hcy levels in elderly persons. The study sample was taken from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT) and included 1094 males and 1135 females aged 65-90 years. The results showed that average plasma Hcy was 13.3+/-0.6 micromol/ L for males and 10.6+/-0.7 micromol/L for females. The average plasma Hcy levels of males from all age groups were significantly higher than those of females, and significantly increased with age (P<0.0001). The overall prevalence of hyperhomocysteinemia (Hcy>15 micromol/L) was 23.4% for elderly males and 11.2% for elderly females, and this also increased with age (P<0.0001). In subjects with normal renal function, folate, vitamin B2, B6, and B12 status were significantly lower in males with hyperhomocysteinemia, while only folate and vitamin B12 were significantly lower in females with hyperhomocysteinemia. Further analysis suggested that folate, vitamin B6 or B12 insufficiency were associated with hyperhomocysteinemia in both sexes, while vitamin B2 insufficiency was significantly associated only in males. In elderly persons with adequate folate, vitamin B6, and B12 status, there was no significant association between vitamin B2 and hyperhomocysteinemia. This association occurred only in those who had concurrent poor folate, vitamin B6, or B12 status. The strength of the association between vitamin B12 insufficiency and hyperhomocysteinemia was not affected by simultaneous vitamin B2 or B6 insufficiency, but increased about 3-fold when combined with folate. This suggests that poor folate and vitamin B12 status has a synergistic effect on the risk of hyperhomocysteinema in the elderly, as did a poor folate and vitamin B6 status. Therefore, maintaining adequate vitamin B12 status and avoiding multiple B vitamin insufficiency, especially that of folate and vitamin B12 or B6, should be emphasized as an important measure for reducing plasma Hcy levels among elderly Taiwanese.     

妊高征患者亚甲基四氢叶酸还原酶基因多态的检测

目的　探讨妊高征患者亚甲基四氢叶酸还原酶 (MTHFR)基因C6 77T多态与血浆同型半胱氨酸 (Homo cysteine ,Hcy)、叶酸及维生素B12 水平的关系。方法　采用 (PCR -RFLPCPR -restrictionfragmentlengthpolymdor phism)法对 82例妊高征患者 (Hcy血症组和无Hcy血症组 )及 90例正常孕妇 (对照组 )进行MTHFR基因C6 77T等位基因检测 ,并同时测量孕妇血浆中的同型半胱氨酸、叶酸和维生素B12 水平。结果　妊高征组A(Hcy血症组 )纯合变异型T6 77/T6 77频率 (0 34)显著高于妊高征组B(无Hcy血症组 ) (0 11,P <0 0 1)和正常对照组 (0 13,P <0 0 1) ;各组中随 6 77T等位基因数量的增加 ,血浆Hcy水平也增加 ,但是对叶酸和维生素B12 水平没有明显影响。结论　MTH FR基因C6 77T多态可以导致妊高征孕妇血液中同型半胱氨水平升高 ,MTHFR基因C6 77T多态是妊高征发病的遗传危险因素之一     

B-vitamins and prevention of dementia

Elevated plasma homocysteine (Hcy) concentrations have been implicated with risk of cognitive impairment and dementia, but it is unclear whether low vitamin B12 or folate status is responsible for cognitive decline. Most studies reporting associations between cognitive function and Hcy or B-vitamins have used a cross-sectional or case-control design and have been unable to exclude the possibility that such associations are a result of the disease rather than being causal. The Hcy hypothesis of dementia has attracted considerable interest, as Hcy can be easily lowered by folic acid and vitamin B12, raising the prospect that B-vitamin supplementation could lower the risk of dementia. While some trials assessing effects on cognitive function have used folic acid alone, vitamin B12 alone or a combination, few trials have included a sufficient number of participants to provide reliable evidence. An individual-patient-data meta-analysis of all randomised trials of the effects on cognitive function and vascular risk of lowering Hcy with B-vitamins will maximise the power to assess the epidemiologically-predicted differences in risk. Among the twelve large randomised Hcy-lowering trials for prevention of vascular disease, data should be available on about 30 000 participants with cognitive function. The principal investigators of such trials have agreed to combine individual-participant data from their trials after their separate publication.     

Associations between B Vitamins and Parkinson’s Disease

B vitamins may correlate with Parkinson’s disease (PD) through regulating homocysteine level. However, there is no comprehensive assessment on the associations between PD and B vitamins. The present study was designed to perform a meta-analytic assessment of the associations between folate, vitamin B6, and vitamin B12 and PD, including the status of B vitamins in PD patients compared with controls, and associations of dietary intakes of B vitamins and risk of PD. A literature search using Medline database obtained 10 eligible studies included in the meta-analyses. Stata 12.0 statistical software was used to perform the meta-analysis. Pooled data revealed that there was no obvious difference in folate level between PD patients and healthy controls, and PD patients had lower level of vitamin B12 than controls. Available data suggested that higher dietary intake of vitamin B6 was associated with a decreased risk of PD (odds ratio (OR) = 0.65, 95% confidence intervals (CI) = (0.30, 1.01)), while no significant association was observed for dietary intake of folate and vitamin B12 and risk of PD. PD patients had lower level of vitamin B12 and similar level of folate compared with controls. Dietary intake of vitamin B6 exhibited preventive effect of developing PD based on the available data. As the number of included studies is limited, more studies are needed to confirm the findings and elucidate the underpinning underlying these associations.     

B-group vitamins, MTHFR C677T polymorphism and carotid intima-media thickness in clinically healthy subjects

OBJECTIVE: Plasma B-group vitamins and age may affect the carotid intima-media thickness (IMT) in subjects with different 677TT genotype of the methylenetetrahydrofolate reductase (MTHFR) gene. DESIGN: A hospital-based cross-study. SETTING: Genomic and Vascular Center, Changhua Christian Hospital, Changhua, Taiwan. SUBJECTS: Five hundred and forty-one clinically healthy subjects. INTERVENTION: Fasting plasma, homocysteine (Hcy), vitamin B(6), vitamin B(12), folate and B-mode carotid ultrasound. RESULTS: MTHFR genotype, plasma concentrations of folate, vitamin B(6) and vitamin B(12) and age were significantly correlated to the plasma Hcy concentration. MTHFR 677TT carriers had higher concentrations of Hcy than did subjects with the CC and CT genotypes. Age, sex, body mass index and plasma Hcy were independent contributors to increase carotid IMT. However, with stratification by mean value of age and B-group vitamins concentrations, we found that at advanced age, lower plasma folate and vitamin B(12) were three risk factors involved in the enhancing effect of the MTHFR 677TT genotype on the increase of plasma Hcy and carotid IMT. CONCLUSION: MTHFR 677TT-related carotid atherosclerosis was only identified in healthy elderly subjects with lower level of plasma folate and vitamin B(12). SPONSORSHIP: Changhua Christian Hospital.     

Diet, serum homocysteine levels and ischaemic heart disease in a Mediterranean population

Homocysteine (Hcy) is recognised as a risk factor for IHD. Serum Hcy is negatively correlated with serum folate levels, the main sources of which are fruits, vegetables and legumes. The present case-control study was designed to examine the relationship between serum Hcy levels and IHD and to assess the role of dietary factors in the southern Mediterranean population of Crete, Greece. Serum Hcy, folate, vitamin B12, creatinine and glucose levels and a full lipid profile were measured in 152 patients with established IHD, median age 64 (range 33-77) years, and 152 healthy control subjects, age- and sex-matched. Dietary data were assessed using a 3 d food intake record. Compared with controls, patients with IHD had significantly higher daily intakes of vitamin B12 and MUFA and significantly lower intakes of carbohydrate, fibre, folate, cholesterol, n-3 fatty acids and total trans unsaturated fatty acids. Moreover, patients had significantly higher serum Hcy, vitamin B12 and creatinine levels, but significantly lower folate. Serum folate concentrations in both groups had a significant positive correlation with dietary fibre consumption and a significant inverse correlation with vitamin B12 intake. IHD patients should be encouraged to increase their daily dietary intake of fibre, folate and n-3 fatty acids, which are significant components of the traditional Cretan Mediterranean diet. Where dietary folate intake is inadequate, folate supplements are recommended to reduce elevated Hcy levels.     

Homocysteine,vitamin B(6), and lipid in cardiovascular disease

OBJECTIVES: Elevated homocysteine (Hcy) is considered an independent risk factor for cardiovascular disease (CVD). An elevated plasma Hcy level may interact with conventional CVD risk factors to further increase vascular disease risk. Therefore, we investigated the plasma levels of Hcy, vitamin B(6) status (pyridoxal phosphate and pyridoxal), and lipid profile in patients with CVD. METHODS: Possible associations between sex, age, body mass index (BMI), and waist-to-hip ratio (WHR) to levels of plasma Hcy and plasma Hcy to vitamin B(6) status and lipid profile were examined. RESULTS: Plasma Hcy level, body mass index, and waist-to-hip ratio were significantly higher in patients with CVD than in controls. Male CVD patients had significantly higher plasma Hcy levels than did female patients. Plasma levels of pyridoxal phosphate and total B(6) aldehyde were significantly higher in male than in female patients. Plasma Hcy levels of patients did not correlate to their plasma vitamin B(6) status or to their lipid profiles. Plasma Hcy level correlated positively with age, body mass index, and waist-to-hip ratio (P < 0.0001). CONCLUSIONS: This suggested that patients with CVD have higher levels of plasma Hcy that are influenced by sex, age, body mass index, and waist-to-hip ratio and not by their plasma vitamin B(6) status and lipid profiles.     

高同型半胱氨酸血症与颈动脉粥样硬化对老年急性脑梗死影响的研究

目的：探讨老年急性脑梗死患者血清同型半胱氨酸（Hcy）水平与颈动脉硬化（CAA）程度之间的关系。方法：对80例老年急性脑梗死患者进行空腹血浆Hcy、空腹血糖、胆固醇、甘油三酯、叶酸、维生素B12（VitB12）水平的测定,并且进行彩超检查颈动脉内膜-中层厚度（IMT）、斑块大小、狭窄程度及血流速度的检测,按照颈动脉狭窄程度及IMT值分为A、B、C、D四组;对Hcy水平与叶酸、VitB12及其他相关因素进行分析。结果：（1）随着CAA程度的加重,Hcy水平升高,A、B、C组和D组之间比较差异均有统计学意义（P〈0.05）;（2）叶酸与VitB12的水平随着CAA程度的加重而降低,仅在A组和D组之间比较差异有统计学意义（P〈0.05）;（3）统计学分析表明血清Hcy水平与血叶酸和VitB12水平负相关（r=-0.328、-0.442,P〈0.05）。结论：高Hcy血症与颈动脉粥样硬化程度密切相关,是脑梗死发生的独立危险因素。     

血清同型半胱氨酸、叶酸浓度水平与老年阿尔茨海默病发病的相关性研究

目的研究血清同型半胱氨酸(Hcy)、叶酸浓度水平与老年阿尔茨海默病(AD)发病的相关性,以期为临床防治提供指导。方法将2016年5月-2018年10月于本院接受诊治的92例老年阿尔茨海默病患者作为研究组,另选择同期于本院健康体检者80例为对照组。选择高效液相法对2组人员的血清Hcy表达水平进行测定,并应用化学发光法对血清叶酸水平进行检测;分析血清Hcy、叶酸与AD患者认知功能、生活质量的相关性。结果研究组患者的血清Hcy水平高于对照组,但血清叶酸水平、MMSE评分均低于对照组,差异有统计学意义(P<0.05);研究组患者的血清Hcy过高表达检出率、叶酸过低表达检出率均高于对照组,差异有统计学意义(P<0.05);AD过高Hcy组患者的血清叶酸水平显著低于AD正常Hcy组,差异有统计学意义(P<0.05);经Spearman相关性分析发现,血清叶酸和认知功能、生活质量显示为正相关(r=0.328、r=0.339,P<0.05),而血清Hcy和认知功能、生活质量显示为负相关(r=-0.517、r=-0.502,P<0.05)。结论血清同型半胱氨酸过高表达和老年阿尔茨海默病发病存在直接相关性,即高Hcy血症可能是引发AD的独立危险因素;而人体缺乏叶酸能导致血清Hcy表达升高,故认为叶酸的缺乏可能是引发AD的间接危险因素。     

脑卒中患者血浆同型半胱氨酸水平变化及临床意义

目的：探讨脑卒中患者血浆同型半胱氨酸（Hcy）水平及影响Hcy的因素。方法：选取2013年1月-2014年3月在本院住院治疗的脑卒中和同期体检的健康人作为研究对象,分为脑出血组、脑梗死组和对照组,比较三组人群Hcy、叶酸等指标的水平差异,探讨脑卒中发病、神经缺损程度与Hey的关系。结果：脑出血组和脑梗死组的Hcy水平高于对照组,叶酸、维生素B12：水平低于对照组,差异均有统计学意义（P〈0．05）;脑卒中患者体内的Hey水平与叶酸和维生素B12水平呈负相关;Hcy每上升1μmol／L,发生脑卒中的风险上升11．8％;Hev每上升1μmol／L,神经功能缺损程度评分上升3．124分。结论：高Hcy水平是脑卒中的独立危险因素,Hcv水平与叶酸、维生素B12呈负相关,能反映神经功能缺损程度。