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Renaud D, Höller A, Michel M. Potential Drug-Nutrient Interactions of 45 Vitamins, Minerals, Trace Elements, and Associated Dietary Compounds with Acetylsalicylic Acid and Warfarin-A Review of the Literature. Nutrients 2024; 16:950. [PMID: 38612984 PMCID: PMC11013948 DOI: 10.3390/nu16070950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
In cardiology, acetylsalicylic acid (ASA) and warfarin are among the most commonly used prophylactic therapies against thromboembolic events. Drug-drug interactions are generally well-known. Less known are the drug-nutrient interactions (DNIs), impeding drug absorption and altering micronutritional status. ASA and warfarin might influence the micronutritional status of patients through different mechanisms such as binding or modification of binding properties of ligands, absorption, transport, cellular use or concentration, or excretion. Our article reviews the drug-nutrient interactions that alter micronutritional status. Some of these mechanisms could be investigated with the aim to potentiate the drug effects. DNIs are seen occasionally in ASA and warfarin and could be managed through simple strategies such as risk stratification of DNIs on an individual patient basis; micronutritional status assessment as part of the medical history; extensive use of the drug-interaction probability scale to reference little-known interactions, and application of a personal, predictive, and preventive medical model using omics.
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Affiliation(s)
- David Renaud
- DIU MAPS, Fundamental and Biomedical Sciences, Paris-Cité University, 75006 Paris, France
- DIU MAPS, Health Sciences Faculty, Universidad Europea Miguel de Cervantes, 47012 Valladolid, Spain
- Fundacja Recover, 05-124 Skrzeszew, Poland
| | - Alexander Höller
- Department of Nutrition and Dietetics, University Hospital Innsbruck, 6020 Innsbruck, Austria
| | - Miriam Michel
- Department of Child and Adolescent Health, Division of Pediatrics III—Cardiology, Pulmonology, Allergology and Cystic Fibrosis, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Wang Y, Sun Y, Wang Y, Jia S, Qiao Y, Zhou Z, Shao W, Zhang X, Guo J, Song X, Niu X, Peng D. Urine metabolomics phenotyping and urinary biomarker exploratory in mild cognitive impairment and Alzheimer's disease. Front Aging Neurosci 2023; 15:1273807. [PMID: 38187356 PMCID: PMC10768723 DOI: 10.3389/fnagi.2023.1273807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/20/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Alzheimer's disease is a prevalent disease with a heavy global burden and is suggested to be a metabolic disease in the brain in recent years. The metabolome is considered to be the most promising phenotype which reflects changes in genetic, transcript, and protein profiles as well as environmental effects. Aiming to obtain a comprehensive understanding and convenient diagnosis of MCI and AD from another perspective, researchers are working on AD metabolomics. Urine is more convenient which could reflect the change of disease at an earlier stage. Thus, we conducted a cross-sectional study to investigate novel diagnostic panels. Methods We first enrolled participants from China-Japan Friendship Hospital from April 2022 to November 2022, collected urine samples and conducted an LC-MS/MS analysis. In parallel, clinical data were collected and clinical examinations were performed. After statistical and bioinformatics analyzes, significant risk factors and differential urinary metabolites were determined. We attempt to investigate diagnostic panels based on machine learning including LASSO and SVM. Results Fifty-seven AD patients, 43 MCI patients and 62 CN subjects were enrolled. A total of 2,140 metabolites were identified among which 125 significantly differed between the AD and CN groups, including 46 upregulated ones and 79 downregulated ones. In parallel, there were 93 significant differential metabolites between the MCI and CN groups, including 23 upregulated ones and 70 downregulated ones. AD diagnostic panel (30 metabolites+ age + APOE) achieved an AUC of 0.9575 in the test set while MCI diagnostic panel (45 metabolites+ age + APOE) achieved an AUC of 0.7333 in the test set. Atropine, S-Methyl-L-cysteine-S-oxide, D-Mannose 6-phosphate (M6P), Spiculisporic Acid, N-Acetyl-L-methionine, 13,14-dihydro-15-keto-tetranor Prostaglandin D2, Pyridoxal 5'-Phosphate (PLP) and 17(S)-HpDHA were considered valuable for both AD and MCI diagnosis and defined as hub metabolites. Besides, diagnostic metabolites were weakly correlated with cognitive functions. Discussion In conclusion, the procedure is convenient, non-invasive, and useful for diagnosis, which could assist physicians in differentiating AD and MCI from CN. Atropine, M6P and PLP were evidence-based hub metabolites in AD.
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Affiliation(s)
- Yuye Wang
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yu Sun
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yu Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Shuhong Jia
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yanan Qiao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Zhi Zhou
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Wen Shao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Xiangfei Zhang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Jing Guo
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Xincheng Song
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Xiaoqian Niu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Dantao Peng
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
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Andrews V, Zammit G, O’Leary F. Dietary pattern, food, and nutritional supplement effects on cognitive outcomes in mild cognitive impairment: a systematic review of previous reviews. Nutr Rev 2023; 81:1462-1489. [PMID: 37027832 PMCID: PMC10563860 DOI: 10.1093/nutrit/nuad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
CONTEXT Nutritional interventions may benefit cognition in people with mild cognitive impairment (MCI). However, evidence is yet to be synthesized in a way that can inform recommendations for clinical and public health settings. OBJECTIVE To systematically review evidence on the effect of dietary patterns, foods, and nutritional supplements on cognitive decline in individuals with MCI. DATA SOURCES Guided by the Preferred Reporting items for Systematic Review and Meta-Analysis Protocols 2015 statement, the Medline, EMBASE, and CINAHL databases, the JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects were searched (publication years 2005 to 2020). Included studies were English-language systematic reviews and meta-analyses of randomized controlled trials and cohort studies reporting on the effectiveness of nutritional interventions on cognition of individuals with MCI. DATA EXTRACTION Two reviewers independently selected studies and extracted data on cognitive outcomes and adverse events. Review quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2). Primary study overlap was managed following Cochrane Handbook guidelines. DATA ANALYSIS Of the 6677 records retrieved, 20 reviews were included, which, in turn, reported on 43 randomized controlled trials and 1 cohort study that, together, addressed 18 nutritional interventions. Most reviews were limited by quality and the small number of primary studies with small sample sizes. Reviews were mostly positive for B vitamins, omega-3 fatty acids, and probiotics (including 12, 11 and 4 primary studies, respectively). Souvenaid and the Mediterranean diet reduced cognitive decline or Alzheimer's disease progression in single trials with <500 participants. Findings from studies with a small number of participants suggest vitamin D, a low-carbohydrate diet, medium-chain triglycerides, blueberries, grape juice, cocoa flavanols, and Brazil nuts may improve individual cognitive subdomains, but more studies are needed. CONCLUSIONS Few nutritional interventions were found to convincingly improve cognition of individuals with MCI. More high-quality research in MCI populations is required to determine if nutritional treatments improve cognition and/or reduce progression to dementia. SYSTEMATIC REVIEW REGISTRATION Open Science Framework protocol identifier DOI:10.17605/OSF.IO/BEP2S.
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Affiliation(s)
- Victoria Andrews
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Gabrielle Zammit
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Fiona O’Leary
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Chang B, Wang Z, Xu T, Chen J, Zhang Y, Huang Y, Sun D. Effectiveness of vitamin-B supplements on cognition in older adults: A meta-analysis. Geriatr Nurs 2023; 51:143-149. [PMID: 36940509 DOI: 10.1016/j.gerinurse.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/22/2023]
Abstract
OBJECTIVES We aimed to investigate the efficacy of B-vitamin and folic acid supplementation in slowing down cognitive function decline among older adults. METHODS We searched databases for trials comparing B-vitamin and folate supplementation versus placebo in older adults identified with or without impaired cognition. RESULTS 23 articles were eligible and included in this meta-analysis. The mean difference (MD) in homocysteine levels was significant between the compared groups (MD:-4.52; 95%CI:-5.41 to 3.63, P < 0.001). However, the difference in the Mini-Mental State Examination (MMSE) was non-significant between the compared groups with or without cognitive impairment (MD:0.19; 95%CI: -0.148 to 0.531, P = 0.27), and (MD:0.04; 95%CI:-0.1 to 0.18, P = 0.59), respectively. The difference in Clinical Dementia Rating-sum of box (CDR-SOB) scores was non-significant (MD:-0.16; 95%CI:-0.49 to 0.18; P = 0.36). CONCLUSIONS B-vitamin and folate supplementations significantly reduced homocysteine levels. However, it failed to provide significant benefits over placebo in preventing or slowing the decline in cognitive function.
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Affiliation(s)
- Binbin Chang
- Department of Geriatrics, The General Hospital of Western Theater Command, Sichuan 610083, China
| | - Zhang Wang
- Department of Geriatrics, The General Hospital of Western Theater Command, Sichuan 610083, China
| | - Tingyuan Xu
- Department of Geriatrics, The General Hospital of Western Theater Command, Sichuan 610083, China
| | - Jieyu Chen
- Department of Geriatrics, The General Hospital of Western Theater Command, Sichuan 610083, China
| | - Yong Zhang
- Department of Geriatrics, The General Hospital of Western Theater Command, Sichuan 610083, China
| | - Yan Huang
- Department of Critical Care Medicine, The 942 Hospital of the PLA Joint Logistic Support Force, Ningxia 750000, China
| | - Diwu Sun
- The Second Outpatient Department,The General Hospital of Western Theater Command, Sichuan 610083, China.
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Gong X, Shi L, Wu Y, Luo Y, Kwok T. B Vitamin Supplementation Slows Cognitive Decline in Mild Cognitive Impairment Patients with Frontal Lobe Atrophy. J Alzheimers Dis 2022; 89:1453-1461. [PMID: 36057827 DOI: 10.3233/jad-220685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The effects of B vitamins on mild cognitive impairment (MCI) patients' cognition have been mixed, suggesting the existence of moderating factors. OBJECTIVE A post hoc analysis of a negative B vitamin trial was performed to examine the potential modulating effect of regional brain atrophy on the cognitive response to B vitamins in MCI patients. METHODS In the 24-month randomized trial, 279 MCI outpatients took 500μ#x03BC;g methylcobalamin and 400μ#x03BC;g folic acid once per day or placebo tablets once per day. Sixty-four aspirin users were excluded from analysis as aspirin use has been found to have significant negative interaction effects. Subjects were followed up at months 12 and 24. The primary cognitive outcome was clinical dementia rating scale sum of boxes (CDR_SOB). In a subgroup of 83 subjects, MRI brain scans were performed at baseline to estimate regional brain atrophy ratios. RESULTS Among the trial subjects who had MRI data, B vitamin supplementation had no significant effect on CDR_SOB, despite having significant homocysteine lowering effects. The atrophy ratio of the left frontal lobe significantly moderated the effect of B vitamin supplementation on CDR_SOB, after adjusting for confounders, in that B vitamin supplementation was associated with lower CDR_SOB scores (i.e., better cognitive function) at the 24th month among those patients with above median atrophy ratios, but not among those with lower atrophy ratios, in the left frontal lobe. CONCLUSION B vitamins may be more effective in slowing down cognitive decline in MCI patients with atrophy in the left frontal lobe.
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Affiliation(s)
- Xianmin Gong
- Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China.,Department of Psychology, The Chinese Universityof Hong Kong, Hong Kong SAR, China
| | - Lin Shi
- Department ofImaging and Interventional Radiology, The Chinese University of HongKong, Hong Kong SAR, China
| | - Yuanyuan Wu
- Health Management Center, The Second Affiliated Hospital of Chongqing MedicalUniversity, Chongqing Medical University, Chongqing, China
| | - Yishan Luo
- Brain Now Research Institute, Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - Timothy Kwok
- Departmentof Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR, China
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Hu M, Hu H, Shao Z, Gao Y, Zeng X, Shu X, Huang J, Shen S, Wu IXY, Xiao LD, Feng H. Effectiveness and acceptability of non-pharmacological interventions in people with mild cognitive impairment: Overview of systematic reviews and network meta-analysis. J Affect Disord 2022; 311:383-390. [PMID: 35597472 DOI: 10.1016/j.jad.2022.05.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/30/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To explore effectiveness and acceptability of non-pharmacological interventions in mild cognitive impairment (MCI). METHODS Overview of systematic reviews and network meta-analysis were conducted. Systematic reviews (SRs) were searched via seven databases from June 2015 to June 2020. Randomized controlled trials (RCTs) were retrieved. The Methodological quality was assessed by AMSTAR 2 and RoB 2. Outcomes were effectiveness and acceptability measured by standardized mean differences (SMDs) and odd ratios (ORs) with 95% confidence interval (CI). Pairwise meta-analysis was first conducted, followed by network meta-analysis. RESULTS A total of 22 SRs and 42 RCTs with 4401 participants were included. The methodological quality of included SRs and RCTs were moderate. There were four interventions, with three types of physical activity (aerobic, muscle-strengthening, and mind-body), three types of cognitive (rehearsal-based, compensatory, and mixed), multicomponent (physical and cognitive component), and nutrition intervention. No significant inconsistency was identified. Regarding intervention effectiveness, muscle-strengthening (SMDs 0.87, 95% CI 0.31-1.43; rank 1), mind-body (0.76, 0.38-1.14; rank 2) and aerobic (0.34, 0.13-0.50; rank 3) were significantly better than the control group and there was no significant difference among these types of intervention . Cognitive intervention of rehearsal-based (1.33, 0.30-2.35; rank 1) and mixed (0.55, 0.00-1.11; rank 2) were significantly better than the control group and there was no significant difference among these types of intervention. Multicomponent intervention (0.32, 0.02-0.62) were significantly better than the control group but not better than the single component group. Regarding acceptability, there was no significant difference among types of intervention. CONCLUSION Physical activity, cognitive, and multicomponent intervention could be provided regardless of their types and acceptability due to their effectiveness on improved cognitive function for people with MCI.
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Affiliation(s)
- Mingyue Hu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hengyu Hu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Zhanfang Shao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yinyan Gao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xianmei Zeng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xinhui Shu
- Kaifeng Central Hospital, Kaifeng, China
| | - Jundan Huang
- Xiangya Nursing School, Central South University, Changsha, China
| | | | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, Changsha, China.
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China; Oceanwide Health Management Institute, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Zhou H, Wu Y, Jiang B, Li B, Li M, Tian H, Shui G, Lam SM, Kwok T. Metabolic Basis of Cognitive Improvement Associated With Active B Vitamin Supplementation in Cognitively Impaired Elderly Subjects – A Metabolomics Study. Front Med (Lausanne) 2022; 9:864152. [PMID: 35572970 PMCID: PMC9091598 DOI: 10.3389/fmed.2022.864152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/05/2022] [Indexed: 01/09/2023] Open
Abstract
Intervention studies with active B vitamin supplementation in cognitively impaired individuals have yielded varying results in randomized controlled trials. In addition, a negative interaction of active B vitamin supplementation with aspirin usage on cognitive outcome was noted, but the molecular basis of the interaction has largely remained unknown. To investigate the metabolic basis of cognitive improvement brought about by active B vitamin supplementation, we conducted an extensive metabolomics analysis covering 302 identified metabolites on the baseline and 24-month serum samples from a cohort of 137 subjects randomly assigned to active supplementation or placebo. Pathway analysis uncovered enhanced gluconeogenesis and War-burg effects underlying cognitive improvement in non-aspirin users supplemented with active B vitamins. In addition, metabolomics revealed that aspirin usage may interact with B vitamin supplementation by altering gut microbial metabolism, particularly in terms of propionate production. Lastly, our omics data suggest that varying capacities to assimilate B vitamins at baseline, possibly mediated by differences in gut microbial composition, may underlie variations in inter-individual responses to active B vitamin supplementation.
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Affiliation(s)
- Haiming Zhou
- LipidALL Technologies Company Limited, Changzhou, China
| | - Yuanyuan Wu
- Health Management Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Binhua Jiang
- LipidALL Technologies Company Limited, Changzhou, China
| | - Bowen Li
- LipidALL Technologies Company Limited, Changzhou, China
| | - Martin Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - He Tian
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Beijing, China
| | - Guanghou Shui
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Beijing, China
| | - Sin Man Lam
- LipidALL Technologies Company Limited, Changzhou, China
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Beijing, China
- *Correspondence: Sin Man Lam,
| | - Timothy Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Timothy Kwok,
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Shao Z, Hu M, Zhang D, Zeng X, Shu X, Wu X, Kwok TCY, Feng H. Dose‐response relationship in non‐pharmacological interventions for individuals with mild cognitive impairment: A systematic review and meta‐analysis of randomised controlled trials. J Clin Nurs 2022; 31:3390-3401. [DOI: 10.1111/jocn.16240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/08/2022] [Accepted: 01/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Zhanfang Shao
- Xiangya School of Nursing Central South University Changsha China
| | - Mingyue Hu
- Xiangya School of Nursing Central South University Changsha China
| | - Dou Zhang
- Xiangya School of Nursing Central South University Changsha China
| | - Xianmei Zeng
- Xiangya School of Nursing Central South University Changsha China
| | - Xinhui Shu
- Department of Hematology Tumor Hospital of Henan ProvinceAffiliated Tumor Hospital of Zhengzhou University Zhengzhou China
| | - Xinyin Wu
- Department of Public Health XiangYa School of MedicineCentral South University Changsha China
| | - Timothy C. Y. Kwok
- JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China
| | - Hui Feng
- Xiangya School of Nursing Central South University Changsha China
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Maltais M, de Souto Barreto P, Bowman GL, Smith AD, Cantet C, Andrieu S, Rolland Y. Omega-3 Supplementation for the Prevention of Cognitive Decline in Older Adults: Does It Depend on Homocysteine Levels? J Nutr Health Aging 2022; 26:615-620. [PMID: 35718871 DOI: 10.1007/s12603-022-1809-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent evidence point towards an interaction between omega-3 (n-3) polyunsaturated fatty acids (PUFA) and plasma homocysteine (Hcy). OBJECTIVES This study tested the hypothesis that effects of red blood cell n-3 PUFA are modified according to baseline plasma Hcy in the large Mulit-domain Alzheimer Prevention Trial (MAPT) throughout the 3-years of treatment with an additional 2 years of observational follow-up. DESIGN Experimental study. PARTICIPANTS From the 1680 participants that were randomized in the four groups of the MAPT study (two of which received n-3 PUFA, the other two without n-3 PUFA), 782 were selected because they had baseline data on both Hcy and n-3 PUFA. MEASUREMENTS Cognitive performance was measured with a broad set of cognitive tests including free and total recall of the cued selective reminding test, digit symbol substitution test, category naming test and Trail-making tests (TMT-A and B) and Clinical dementia rating scale. RESULTS We found a significant association between TMT-A and red blood cell n-3 PUFA levels in participants with Hcy values ≤16.8 µMol/L after adjustments at baseline (Estimate: -1.3, 95% CI: -2.3; -0.3, p=0.01). Additionally, participants with high Hcy values had a significant worsening after adjustments in TMT-B after a 5-year n-3 PUFA supplementation, compared to low levels of Hcy (Mean difference: 34.8, 95% CI: 7.8;61.7). CONCLUSION This study shows that Hcy levels could modify the association between red blood cell n-3 PUFA and executive function. People with high Hcy may benefit less from a n-3 PUFA supplementation to prevent cognitive decline.
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Affiliation(s)
- M Maltais
- Mathieu Maltais, PhD, Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke QC, +1 873-662-2510 E-mail : , @mathieu_maltais
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