丙戊酸钠和卡马西平对癫痫患者血同型半胱氨酸、叶酸、维生素B12水平的影响

目的探讨丙戊酸钠(VPA)和卡马西平(CBZ)对癫痫患者血同型半胱氨酸(Hcy)、叶酸、维生素(Vit)B12水平的影响。方法检测VPA组、CBZ组、未服药组患者和正常对照组血Hcy、叶酸、VitB12浓度,并对结果进行比较。结果与未服药组及正常对照组比较,VPA组和CBZ组的血浆Hcy水平显著升高(均P<0.01),血清叶酸水平显著降低(均P<0.05);且VPA组血清VitB12水平有升高趋势,CBZ组血清VitB12水平有降低趋势,但差异均无统计学意义。结论 VPA和CBZ可引起癫痫患者的血浆Hcy水平升高和血清叶酸水平降低,对血清VitB12水平无显著影响。     

抑郁症患者血清叶酸和维生素B12浓度研究

目的：探讨抑郁症患者血清叶酸和维生素B12浓度改变。方法：收集门诊患者76例,均符合国际疾病分类第10版抑郁症诊断标准,病程至少半年;健康对照组67名。测定血清叶酸和维生素B12浓度。结果：两组之间叶酸平均浓度和叶酸缺乏的发生差异均无显著性（P〉0．05）。抑郁症组维生素B12平均浓度显著较低（P〈0．05）,维生素B12缺乏的发生率显著较高（P〈0．01）。结论：抑郁症与维生素B12缺乏有关,与叶酸无关。     

轻度认知障碍患者血浆同型半胱氨酸和血清维生素B12及叶酸水平变化研究

目的 探讨轻度认知障碍(MCI)患者血浆同型半胱氨酸(Hcy)、血清维生素B12及叶酸水平的变化及相互关系.方法 MCI组80例,正常对照组80例,检测所有观察对象的血浆同型半胱氨酸、血清VitB12及叶酸水平并分析相互关系.结果 MCI组血浆Hey水平较正常组显著增高为(18.9±8.8)μmol/L vs(14.35±5.7)μmol/L,而血清叶酸和VitB12水平在正常组和MCI组之间并没有显著差异;相对于血浆Hey正常组,MCI比值比(0R)在轻、中度高同型半胱氨酸血症组中增高(OR=1.85,95%CI=1.56～2.95;OR=3.32,95%CI=1.61～6.48;P=0.001);无论在MCI组还是在正常组中,血浆Hey与血清叶酸及Vit B12的水平均呈负相关.结论 血浆Hey水平升高与MCI相关,叶酸和VitB122缺乏可能导致血浆Hcy水平升高.     

Decreased vitamin B12 and folate levels in cerebrospinal fluid and serum of multiple sclerosis patients after high-dose intravenous methylprednisolone

Twenty-one patients (15 women, 6 men) with definite multiple sclerosis (MS) were treated with 1000 mg intravenous methylprednisolone-succinate (MP) daily for 10 days. Before MP treatment there was a negative correlation (r = 0.59,P = 0.0084) between serum vitamin B₁₂ and progression rate, defined as the ratio of the score on Kurtzke's Expanded Disability Status Scale and disease duration. A significant decrease was demonstrated in the cerebrospinal fluid (CSF) and serum levels of folate and in the CSF level of Viamin B12 after MP treatment. The decrease in serum B12 was not statistically significant. After MP treatment all median levels of vitamin B₁₂ and folate were below the reference medians. We hypothesize that low or reduced vitamin B₁₂/folate levels found in MS patients may be related to previous corticosteroid treatments. Otherwise a more causal relationship between low Viamin B₁₂/folate and MS cannot be excluded. Further studies may be required to clarify the vitamin B₁₂ and folate metabolism in patients with MS.     

Plasma homocysteine levels in multiple sclerosis

BACKGROUND: There is evidence that homocysteine contributes to various neurodegenerative disorders, and elevated plasma homocysteine levels have been observed in patients with multiple sclerosis (MS). OBJECTIVE: To investigate if and why plasma homocysteine levels are increased in MS, and whether they play a role in the disease course. METHODS: We compared plasma levels of homocysteine in 88 patients with MS and 57 healthy controls. In the MS group, 28 had a benign course, 37 were secondary progressive, and 23 primary progressive. To explore the underlying mechanisms, we measured serum levels of vitamins B6 and B12, folate, interleukin (IL)-12, tumour necrosis factor (TNF)-alpha, leukocyte nitric oxide production, and plasma diene conjugate levels (measure of oxidative stress). RESULTS: Mean (SD) plasma homocysteine concentration was higher in patients (13.8 (4.9) micromol/l) than in controls (10.1 (2.5) micromol/l; p<0.0001). However, there were no significant differences in homocysteine levels between the three clinical subgroups of MS. Serum concentrations of vitamin B6, vitamin B12, and folate were not different between patients with MS and controls. In the MS group, there were no correlations between plasma homocysteine levels and the serum concentrations of IL-12 or TNF-alpha, leukocyte nitric oxide production, or plasma diene conjugate levels. CONCLUSIONS: Elevated plasma homocysteine occurs in both benign and progressive disease courses of MS, and seems unrelated to immune activation, oxidative stress, or a deficiency in vitamin B6, vitamin B12, or folate.     

Multiple sclerosis and vitamin B12 metabolism

Multiple sclerosis (MS) is occasionally associated with vitamin B12 deficiency. Recent studies have shown and increase risk of macrocytosis, low serum and/or CSF vitamin B12 levels, raised plasma homocysteine and raised unsaturated R-binder capacity in MS. The aetiology of the vitamin B12 deficiency in MS is often uncertain and a disorder of vitamin B12 binding or transport is suspected. The nature of the association of vitamin B12 deficiency and MS is unclear but is likely to be more than coincidental. There is a remarkable similarity in the epidemiology of MS and pernicious anaemia. Vitamin B12 deficiency should always be looked for in MS. The deficiency may aggravate MS or impair recovery. There is evidence that vitamin B12 is important for myelin synthesis and integrity but further basic studies are required.     

抑郁症患者血浆同型半胱氨酸水平的测定

目的:测定抑郁症患者及正常人血浆同型半胱氨酸(Hcy)水平,评价其意义. 方法:收集46例抑郁症(抑郁症组)及38名健康者(对照组)血液标本,采用高效液相色谱法测定血浆Hcy水平,放射免疫法测定血浆维生素B12和叶酸水平,比较两组间差异. 结果:抑郁症组血浆Hcy水平(13.2±6.2)μmol/L,显著高于对照组(7.6±2.4)μmol/L.抑郁症组平均血浆维生素B12水平为(334.0±5.7)ng/L,血浆叶酸水平为(5.9±4.0)μg/L;而对照组分别为(344.0±7.5)ng/L和(7.8±3.0)μg/L,均以抑郁症组显著较低(P<0.05). 结论:血浆Hcy水平升高可能与抑郁症有关.     

Vitamin B12 and folic acid serum levels in obsessive compulsive disorder

Vitamin B12 and folate serum levels were studied in 30 patients with obsessive compulsive disorder (OCD), and in two control groups comprised of 30 chronic schizophrenics and 30 normal healthy subjects. Six patients (20%) of the OCD group had abnormal low levels of vitamin B12. This prevalence was significantly higher than that of the control groups. No clinical neurological or haematological abnormalities accompanied the reduced vitamin B12 levels. Possible implication of this finding for the pathophysiology of OCD in a subgroup of patients and the possibility that the B12 deficiency could be the consequence rather than the cause of OCD are suggested.     

Meta-analysis of the relationship between homocysteine, vitamin B12, folate, and multiple sclerosis

A meta-analysis was conducted to assess the relationship between serum homocysteine, vitamin B₁₂, and folate levels in patients with multiple sclerosis (MS). The DerSimonian and Laird Q test was used to evaluate the degree of heterogeneity between studies and a funnel plot was used to assess publication bias. The pooled effect size (standardized mean difference [SMD]) between patients with MS and control patients) from a random effects model was 0.84 (95% confidence interval: 0.18, 1.49) for homocysteine and -0.25 (-0.45, -0.04) for vitamin B₁₂, and from a fixed effects model was 0.98 (0.80, 1.16) for homocysteine and -0.25 (-0.41, -0.09) for vitamin B₁₂. Both nutrients were statistically significant, but the SMD for folate was not. Patients with MS were found to have raised homocysteine levels but low B₁₂ levels, which might contribute to the pathogenesis of MS.     

慢性精神分裂症住院患者血清叶酸、维生素B12 及铁蛋白水平的研究

目的 探讨精神分裂症患者的血清叶酸、维生素B12及铁蛋白水平分布特点.方法 对1042例精神分裂患者进行血液采样,采用电化学发光技术检测血清叶酸、维生素B12、铁蛋白水平,并比较不同性别、年龄患者的水平差异.结果 精神分裂症患者中,较低维生素B12、叶酸及铁蛋白水平的发生率普遍>5%,低叶酸水平发生率高达38.29%,低维生素B12的发生率为18.14%.精神分裂症患者的叶酸水平存在性别差异(t=-5.83,P<0.01),维生素B12水平存在年龄差异(t=2.08,P<0.05).结论 慢性精神分裂症患者低血清维生素B12、叶酸及铁蛋白水平的发生率高,需要予以积极关注.     

血清同型半胱氨酸水平与帕金森病的关系

目的探讨帕金森病(PD)患者伴发高同型半胱氨酸血症(HHcy)情况及美多巴对其血清同型半胱氨酸(Hcy)水平的影响。方法选择2006-06-01-2009-12-31入住作者医院的PD患者53例,按入院前是否服用美多巴治疗分为非美多巴组和美多巴组,两组患者入院后均予美多巴口服治疗;另选择31名同期健康体检者为对照。采用荧光偏振免疫分析法(FPIA)检测血清Hcy水平,微粒子酶免分析法(MEIA)检测血清叶酸(FA)及维生素B12(VitB12)水平。收集患者初次就诊及初次复诊时的血清Hcy、FA、VitB12水平资料至2010-01-30,并进行分析比较。结果 (1)初次就诊时非美多巴组和美多巴组PD患者血清Hcy水平〔分别(17.28±6.79)、(18.50±6.56)μmol/L〕均高于健康对照组〔(13.49±3.21)μmol/L〕(均P<0.01),HHcy的比例〔分别为50%(14/28)和76%(19/25)〕亦高于健康对照组〔29%(9/31)〕(均P<0.01),而血清FA、VitB12的水平无统计学差异(均P>0.05)。HHcy患者的血清Hcy水平与FA、VitB12水平无相关性(分别r=0.118,P=0.455;r=0.001,P=0.995)。(2)非美多巴组患者复诊时血清Hcy水平〔(15.84±3.33)μmol/L〕较治疗前〔(12.92±3.15)μmol/L〕升高(P<0.05),血清FA、VitB12水平同治疗前比较无统计学差异(P>0.05)。美多巴组患者服用美多巴治疗后血清Hcy、FA、VitB12水平同初次就诊时比较均无统计学差异(均P>0.05)。结论服用美多巴可能使PD患者血清Hcy水平升高,但可能不是PD患者伴有HHcy的惟一原因。     

Correlations between cognitive, behavioural and psychological findings and levels of vitamin B12 and folate in patients with dementia

BACKGROUND: Associations between low levels of folate and vitamin B12 and cognitive impairment in patients with dementia have been reported. Some studies revealed correlations between low levels of vitamin B12 and behavioural and psychological signs and symptoms of dementia (BPSD) in Alzheimer's disease (AD) patients. Given the lack of studies in frontotemporal dementia (FTD) and on folate and given the methodological shortcomings of former publications, we set up a prospective study. METHODS: At inclusion, AD (n=152) and FTD (n=28) patients underwent a neuropsychological examination. Behaviour was assessed using a battery of behavioural assessment scales. Determination of serum vitamin B12 and red cell folate levels were performed within a time frame of two weeks of inclusion. RESULTS: In both patient groups, significantly negative correlations between levels of serum vitamin B12 and red cell folate and the degree of cognitive deterioration were found. No correlations with BPSD were found in the AD patient group. In FTD patients, levels of vitamin B12 were negatively correlated with both hallucinations (p=0.022) and diurnal rhythm disturbances (p=0.036). CONCLUSIONS: The observed negative correlations between levels of vitamin B12 and folate and cognitive impairment in both AD and FTD patients, raise the possibility of a non-specific etiological role. Although levels of vitamin B12 and folate did not correlate with BPSD in AD patients, negative correlations between serum vitamin B12 levels and BPSD in FTD patients were revealed. Decreased serum vitamin B12 levels may predispose FTD patients to develop hallucinations and diurnal rhythm disturbances.     

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

Objective. Cognitive impairment (CI) in multiple sclerosis (MS) can develop any time. CI is associated with the degree of neuronal loss, but disease duration, fatigue, comorbid affective disorder, and drug dose may also affect cognition. Our aim was to assess which cognitive domain was disturbed primarily in mild MS patients and to see whether CI was related with clinical and psychiatric features. Method. Neurological and psychiatric evaluation of 31 MS patients and 31 age, sex, and education-matched healthy controls were made with Structured Clinical Interview for Axis I Disorders (SCID-I). Depression, anxiety, functionality, fatigue, and disability scoring were determined with Hamilton Depression-Anxiety scales, Global Assessment of Functionality, Fatigue Severity and Expanded Disability Status Scales. Cognitive functions were assessed using Mini Mental, Serial Digit Learning, Verbal and Nonverbal Cancellation, Stroop and Rey Auditory Verbal Learning tests. Results. Retrieval from long-term memory and psychomotor speed were significantly worse in MS group. CI was correlated with disease duration, number of attacks, and physical disability but not with depression and anxiety severity. Disease duration predicted disturbances in recall and psychomotor speed, whereas fatigue and disability predicted depression. Conclusion. Psychomotor speed and memory were primarily impaired in MS patients, and CI was closely associated with clinical aspects of MS rather than with depression and anxiety.     

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多发性硬化的关系初探

目的:探讨血清总同型半胱氨酸(tHcy)与多发性硬化(MS)的关系。方法:采用高效液相色谱法检测37例MS患者(MS组)和40名正常对照(NC组)血清中tHcy浓度。结果:MS组和NC组血清中tHcy浓度分别为(23.76±1.659)μmol·L-1、(15.50±1.764)μmol·L-1。MS组tHcy浓度明显高于NC组(P<0.01),而两组叶酸、维生素B12浓度差异无统计学意义(P>0.05);原发进展型、继发进展型和缓解复发型,各型MS组血清tHcy、叶酸、维生素B12水平相比较差异均无统计学意义(P>0.05)。结论:MS患者血清中tHcy水平升高,可能在病理过程中发挥作用。     

多发性硬化患者血清尿酸水平变化的研究

目的　探讨多发性硬化 (MS)患者血清尿酸 (UA)水平的变化及其临床意义。方法　采用酶定量分析法对 4 3例MS患者和 4 5名正常对照者的血清UA水平进行检测。结果　MS组血清UA水平明显低于对照组 (P <0 0 1)。MS组中病程越长 (P <0 0 1)、神经伤残程度越重 (DSS评分越高 ) (P <0 0 5 ) ,血清UA水平越低 ;女性患者UA水平明显低于男性患者 (P <0 0 0 1) ;经过糖皮质激素治疗后血清UA水平明显回升 (P <0 0 0 1) ,但治疗前血清UA水平越低则疗效越差 (P <0 0 1、P <0 0 5 )。结论　MS患者血清UA水平降低 ,且与MS的病程、伤残程度、疗效及性别密切相关。UA水平升高可能为激素治疗MS的一个作用机制     

复发—缓解型多发性硬化患者血清中CRP及Hcy水平分析

目的探讨复发—缓解型多发性硬化(RRMS)患者血清中C反应蛋白(CRP)、同型半胱氨酸(Hcy)、维生素B_(12)及叶酸水平,并探讨上述因子与RRMS发病的关系。方法选取21例急性期的RRMS患者作为RRMS组,21例同期住院的神经性头痛患者作为对照组,测定其血清中CRP、Hcy、叶酸及维生素B_(12)水平,并比较两组之间的水平差异;并比较RRMS组中不同性别、不同残疾程度组之间的血清CRP、Hcy、叶酸及维生素B_(12)水平。结果 RRMS组患者血清中CRP及Hcy水平高于对照组,而叶酸及维生素B_(12)水平低于对照组,(P0.05)。而扩展残疾状况评分量表评分(EDSS)4分的RRMS患者血清中Hcy及CRP水平高于EDSS评分≤4分的RRMS患者,(P0.05)。结论血清中高CRP、Hcy水平可能与RRMS发病及残疾程度有关。