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Polis B, Samson AO. Enhancing cognitive function in older adults: dietary approaches and implications. Front Nutr 2024; 11:1286725. [PMID: 38356861 PMCID: PMC10864441 DOI: 10.3389/fnut.2024.1286725] [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: 08/31/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Natural aging encompasses physiological and psychological changes that impact overall health and quality of life. Mitigating these effects requires physical and mental exercise, coupled with proper nutrition. Notably, protein malnutrition emerges as a potential risk factor for senile dementia, with insufficient intake correlating with premature cognitive decline. Adequate protein intake in the elderly positively associates with memory function and lowers cognitive impairment risk. Considering diet as a modifiable risk factor for cognitive decline, extensive research has explored diverse dietary strategies to prevent dementia onset in older adults. However, conclusive results remain limited. This review aims to synthesize recent evidence on effective dietary approaches to enhance cognitive function and prognosis in older individuals. Specifically, the study evaluates complex multicomponent programs, protein-rich diets, and branched-chain amino acid supplementation. By addressing the nexus of nutrition and cognitive health, this review contributes to understanding viable interventions for promoting cognitive well-being in aging populations.
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Affiliation(s)
- Baruh Polis
- Laboratory of Computational Biology and Drug Discovery, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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Michels AJ, Butler JA, Uesugi SL, Lee K, Frei BB, Bobe G, Magnusson KR, Hagen TM. Multivitamin/Multimineral Supplementation Prevents or Reverses Decline in Vitamin Biomarkers and Cellular Energy Metabolism in Healthy Older Men: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients 2023; 15:2691. [PMID: 37375594 PMCID: PMC10301451 DOI: 10.3390/nu15122691] [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: 05/19/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the reported prevalence of micronutrient deficiencies in older adults, it is not yet established whether multivitamin/multimineral (MV/MM) supplements improve blood micronutrient status in individuals over the age of 65. Therefore, a cohort of 35 healthy men (>67 years) was recruited for an MV/MM supplementation trial. The primary endpoint was, as an indicator of micronutrient status, changes in blood micronutrient biomarkers from baseline to at least six months of supplementation with MV/MM or placebo. The secondary endpoint was basal O2 consumption in monocytes as an indicator of cellular metabolism. MV/MM supplementation improved blood concentrations of pyridoxal phosphate, calcifediol, α-tocopherol, and β-carotene concentrations throughout the cohort. By contrast, those in the placebo group generally showed declines in blood vitamin concentrations and an increased prevalence of suboptimal vitamin status during the study period. On the other hand, MV/MM supplementation did not significantly affect blood mineral concentrations, i.e., calcium, copper, iron, magnesium, and zinc. Interestingly, MV/MM supplementation prevented the decline in monocyte O2 consumption rate. Overall, MV/MM use improves or prevents declines in vitamin, but not mineral, status and limits declines in cellular O2 consumption, which may have important implications for metabolism and immune health in healthy older men.
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Affiliation(s)
- Alexander J. Michels
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
| | - Judy A. Butler
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
| | - Sandra L. Uesugi
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
| | - Ken Lee
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
| | - Balz B. Frei
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
- Department of Biochemistry and Biophysics, College of Science, Oregon State University, Corvallis, OR 97331, USA
| | - Gerd Bobe
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
- Department of Animal and Rangeland Sciences, College of Agriculture, Oregon State University, Corvallis, OR 97331, USA
| | - Kathy R. Magnusson
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
| | - Tory M. Hagen
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; (A.J.M.); (J.A.B.); (S.L.U.); (K.L.); (B.B.F.); (G.B.); (K.R.M.)
- Department of Biochemistry and Biophysics, College of Science, Oregon State University, Corvallis, OR 97331, USA
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Porter KM, Hoey L, Hughes CF, Ward M, Clements M, Strain J, Cunningham C, Casey MC, Tracey F, O'Kane M, Pentieva K, McAnena L, McCarroll K, Laird E, Molloy AM, McNulty H. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr 2021; 114:1286-1294. [PMID: 34134144 PMCID: PMC8488868 DOI: 10.1093/ajcn/nqab193] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Atrophic gastritis (AG) and use of proton pump inhibitors (PPIs) result in gastric acid suppression that can impair the absorption of vitamin B-12 from foods. The crystalline vitamin B-12 form, found in fortified foods, does not require gastric acid for its absorption and could thus be beneficial for older adults with hypochlorhydria, but evidence is lacking. OBJECTIVES To investigate associations of AG and PPI use with vitamin B-12 status, and the potential protective role of fortified foods, in older adults. METHODS Eligible participants (n = 3299) not using vitamin B-12 supplements were drawn from the Trinity-Ulster and Department of Agriculture cohort, a study of noninstitutionalized adults aged ≥60 y and recruited in 2008-2012. Vitamin B-12 status was measured using 4 biomarkers, and vitamin B-12 deficiency was defined as a combined indicator value < -0.5. A pepsinogen I:II ratio <3 was considered indicative of AG. RESULTS AG was identified in 15% of participants and associated with significantly lower serum total vitamin B-12 (P < 0.001) and plasma holotranscobalamin (holoTC; P < 0.001), and higher prevalence of vitamin B-12 deficiency (38%), compared with PPI users (21%) and controls (without AG and nonusers of PPIs; 15%; P < 0.001). PPI drugs were used (≥6 mo) by 37% of participants and were associated with lower holoTC concentrations, but only in participants taking higher doses (≥30 mg/d). Regular, compared with nonregular, consumption of fortified foods (i.e., ≥5 and 0-4 portions/wk, respectively) was associated with higher vitamin B-12 biomarkers in all participants, but inadequate to restore normal vitamin B-12 status in those with AG. CONCLUSIONS Older adults who have AG and/or use higher doses of PPIs are more likely to have indicators of vitamin B-12 deficiency. Fortified foods, if consumed regularly, were associated with enhanced vitamin B-12 status, but higher levels of added vitamin B-12 than currently provided could be warranted to optimize status in people with AG.
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Affiliation(s)
- Kirsty M Porter
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Jj Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Miriam C Casey
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
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Reversible dementia due to vitamin B12 deficiency in a lung cancer patient: Relevance of preoperative evaluation. Palliat Support Care 2021; 19:377-379. [PMID: 33947505 DOI: 10.1017/s1478951521000481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cognitive dysfunction has a negative effect on cancer treatment; however, in a cancer setting, specific treatments can restore cognitive function. Such conditions are known as reversible dementia, with one of these being vitamin B12 (VB12) deficiency. However, there have been no reports of VB12 deficiency identified by preoperative evaluation in cancer patients. METHOD We studied a patient who was referred to the Department of Psycho-oncology on suspicion of cognitive decline prior to lung cancer surgery. Preoperative evaluation revealed VB12 deficiency. RESULTS The patient was an 82-year-old woman diagnosed with lung cancer. She also presented with cognitive decline and, therefore, was referred to the Department of Psycho-oncology for preoperative evaluation. The patient scored 19 points on a Mini-Mental State Examination (MMSE), which is indicative of cognitive decline. As the onset of symptoms occurred several months previously and they were subacute, the possibility of reversible dementia was considered. Extensive examination revealed VB12 deficiency, and VB12 replacement therapy normalized the MMSE score to 25 points before surgery. SIGNIFICANCE OF THE RESULTS When cognitive decline is observed in cancer patients, it is necessary to actively evaluate the serum levels of some B vitamins, including VB12.
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Sobczyńska-Malefora A, Delvin E, McCaddon A, Ahmadi KR, Harrington DJ. Vitamin B 12 status in health and disease: a critical review. Diagnosis of deficiency and insufficiency - clinical and laboratory pitfalls. Crit Rev Clin Lab Sci 2021; 58:399-429. [PMID: 33881359 DOI: 10.1080/10408363.2021.1885339] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Vitamin B12 (cobalamin) is an essential cofactor for two metabolic pathways. It is obtained principally from food of animal origin. Cobalamin becomes bioavailable through a series of steps pertaining to its release from dietary protein, intrinsic factor-mediated absorption, haptocorrin or transcobalamin-mediated transport, cellular uptake, and two enzymatic conversions (via methionine synthase and methylmalonyl-CoA-mutase) into cofactor forms: methylcobalamin and adenosylcobalamin. Vitamin B12 deficiency can masquerade as a multitude of illnesses, presenting different perspectives from the point of view of the hematologist, neurologist, gastroenterologist, general physician, or dietician. Increased physician vigilance and heightened patient awareness often account for its early presentation, and testing sometimes occurs during a phase of vitamin B12 insufficiency before the main onset of the disease. The chosen test often depends on its availability rather than on the diagnostic performance and sensitivity to irrelevant factors interfering with vitamin B12 markers. Although serum B12 is still the most commonly used and widely available test, diagnostics by holotranscobalamin, serum methylmalonic acid, and plasma homocysteine measurements have grown in the last several years in routine practice. The lack of a robust absorption test, coupled with compromised sensitivity and specificity of other tests (intrinsic factor and gastric parietal cell antibodies), hinders determination of the cause for depleted B12 status. This can lead to incorrect supplementation regimes and uncertainty regarding later treatment. This review discusses currently available knowledge on vitamin B12, informs the reader about the pitfalls of tests for assessing its deficiency, reviews B12 status in various populations at different disease stages, and provides recommendations for interpretation, treatment, and associated risks. Future directions for diagnostics of B12 status and health interventions are also discussed.
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Affiliation(s)
- Agata Sobczyńska-Malefora
- The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK.,Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Edgard Delvin
- Sainte-Justine UHC Research Centre, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, University of Montreal, Montreal, Canada
| | | | - Kourosh R Ahmadi
- Department of Nutrition & Metabolism, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Dominic J Harrington
- The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK.,Faculty of Life Sciences and Medicine, King's College London, London, UK
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Roberts SB, Silver RE, Das SK, Fielding RA, Gilhooly CH, Jacques PF, Kelly JM, Mason JB, McKeown NM, Reardon MA, Rowan S, Saltzman E, Shukitt-Hale B, Smith CE, Taylor AA, Wu D, Zhang FF, Panetta K, Booth S. Healthy Aging-Nutrition Matters: Start Early and Screen Often. Adv Nutr 2021; 12:1438-1448. [PMID: 33838032 PMCID: PMC8994693 DOI: 10.1093/advances/nmab032] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/11/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression-and in some cases effectively treat-many established aging-associated conditions. However, middle-aged and older adults are vulnerable to unhealthy dietary patterns, and typically consume diets with inadequate servings of healthy food groups and essential nutrients, along with an abundance of energy-dense but nutrient-weak foods that contribute to obesity. However, based on menu examples, diets that are nutrient-dense, plant-based, and with a moderately low glycemic load are better equipped to meet the nutritional needs of many older adults than current recommendations in US Dietary Guidelines. These summary findings indicate that healthy nutrition is more important for healthy aging than generally recognized. Improved public health messaging about nutrition and aging, combined with routine screening and medical referrals for age-related conditions that can be treated with a nutrition prescription, should form core components of a national nutrition roadmap to reduce the epidemic of unhealthy aging.
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Affiliation(s)
| | - Rachel E Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jennifer M Kelly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Joel B Mason
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Meaghan A Reardon
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sheldon Rowan
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Barbara Shukitt-Hale
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caren E Smith
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Allen A Taylor
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Dayong Wu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Karen Panetta
- School of Engineering, Tufts University, Medford, MA, USA
| | - Sarah Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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Agarwal V, Joshi I. Need for Nutritious Convenience Foods for the Elderly Population: A Review. CURRENT NUTRITION & FOOD SCIENCE 2021. [DOI: 10.2174/1573401316999201009144719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Worldwide, the population of elderly persons is rising at a very fast rate. Elderly people
have difficulties in performing day to day activities as the aging process deteriorates the normal
functioning of their body. There is risk of inadequate nutrition because of difficulties in shopping
for food, cooking a meal, chewing and putting food in mouth. Vision loss makes cooking, and even
eating, more difficult. Some elderly people live alone or with their spouses. Cooking for one or two
persons/s is not very stimulating. These changes have a great role to play in changing the eating
habits of the elderly which may affect their nutrient intake. All these factors may cause nutritional
deficiencies, malnutrition and other health problems among them. There are major opportunities to
develop convenience food products in order to meet the changing needs of aging population. In order
to get maximum product acceptance, it is important to combine the elements of convenience
and affordability. While designing products for elderly, it is desirable to modify the food consistency
to assist in swallowing, make it nutrient-dense and design it in a way that it can be easily handled
and eaten. The packaging can be easy to open, information written in large fonts and contrasting
colours to help in easy reading. The availability of nutritious ‘ready-meals’ can serve as an opportunity
for elderly people who do not want to cook or have low interest in cooking. This can provide
a variety of healthier food choices to them and help to reduce malnutrition. Access to nutritious
convenience food products can facilitate a positive intervention to the aging consumers.
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Affiliation(s)
- Vyoma Agarwal
- Department of Home Science, IIS (Deemed to be University), Jaipur 302020, India
| | - Ila Joshi
- Department of Home Science, IIS (Deemed to be University), Jaipur 302020, India
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Yahn GB, Abato JE, Jadavji NM. Role of vitamin B12 deficiency in ischemic stroke risk and outcome. Neural Regen Res 2021; 16:470-474. [PMID: 32985467 PMCID: PMC7996019 DOI: 10.4103/1673-5374.291381] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Currently, ischemic stroke is the most prevalent form of stroke compared to hemorrhagic and there is a high incidence in older adults. Nutrition is a modifiable risk factor for stroke. B-vitamins are part of a metabolic network that integrates nutritional signals with biosynthesis, redox homeostasis, and epigenetics. These vitamins play an essential role in the regulation of cell proliferation, stress resistance, and embryo development. A deficiency in vitamin B12 is common in older adults and has been reported to be implicated in ischemic stroke. The aim of this review was to investigate whether vitamin B12 deficiencies impact the risk and outcome of ischemic stroke. Clinical data from our literature review strongly suggest that a deficiency in vitamin B12 is a risk factor for ischemic stroke and possible outcome. Our survey of the literature has identified that there is a gap in the understanding of the mechanisms through which a vitamin B12 deficiency leads to an increased risk of stroke and outcome. A vitamin B12 deficiency can increase homocysteine levels, which are a well-established risk factor for ischemic stroke. Another potential mechanism through which vitamin B12 deficient may impact neurological function and increase risk of stroke, is changes in myelination, however this link requires further investigation. Further studies are required in model systems to understand how a vitamin B12 deficiency changes the brain.
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Affiliation(s)
- Gyllian B Yahn
- Department of Biomedical Sciences, Midwestern University, Glendale, AZ, USA
| | - Jamie E Abato
- Department of Biomedical Sciences, Midwestern University, Glendale, AZ, USA
| | - Nafisa M Jadavji
- Department of Biomedical Sciences, Midwestern University, Glendale, AZ, USA; Department of Neuroscience, Carleton University, Ottawa, ON, Canada
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Baroni L, Bonetto C, Rizzo G, Bertola C, Caberlotto L, Bazzerla G. Association Between Cognitive Impairment and Vitamin B12, Folate, and Homocysteine Status in Elderly Adults: A Retrospective Study. J Alzheimers Dis 2020; 70:443-453. [PMID: 31177227 DOI: 10.3233/jad-190249] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive disorders in old age have a serious impact on the health and social aspects of patients and their families. OBJECTIVE The scope of this paper is to explore the role of cobalamin and folate that has been linked to cognitive decline, not only as a deficiency state depending on malnutrition, but also a determinant in cognitive impairment. METHODS A 6-year observational, retrospective study was conducted by collecting the routine blood analyses and cognitive screening scores of patients aged 60 years or older, followed at our Centre for the Diagnosis and Treatment of Cognitive Disorders. RESULTS In a linear regression with a multi-vitamin model, higher folate concentrations were correlated with better cognitive performances through MMSE score, even after correction for sex, age, and years of education (beta = 0.144, p = 0.001). Estimated MMSE marginal means for folate versus homocysteine showed that folate deficiency was associated with worse cognitive performances, with a more severe cognitive impairment when hyperhomocysteinemia was present. CONCLUSION The assessment of B-vitamin status among elderly adults can contribute to an economic and practical approach to the prevention and management of cognitive decline. Future studies focused to define optimal vitamin status are warranted.
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Affiliation(s)
- Luciana Baroni
- Primary Care Unit, Local Health Unit 2 - Marca Trevigiana, Treviso, Italy
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gianluca Rizzo
- Scientific Society for Vegetarian Nutrition (SSVN), Mestre (VE), Italy
| | - Caterina Bertola
- Primary Care Unit, Local Health Unit 2 - Marca Trevigiana, Treviso, Italy
| | - Livio Caberlotto
- Central Laboratory Ca' Foncello Hospital, Local Health Unity 2 - Marca Trevigiana, Treviso, Italy
| | - Giorgio Bazzerla
- Primary Care Unit, Local Health Unit 2 - Marca Trevigiana, Treviso, Italy
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Schmid G. Einflussnahme auf das Bewegungssystem durch individuelle Anpassung der Makro- und Mikronährstoffzufuhr. MANUELLE MEDIZIN 2020. [DOI: 10.1007/s00337-020-00693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anaya-Loyola MA, Brito A, Vergara-Castañeda H, Sosa C, Rosado JL, Allen LH. Low Serum B12 Concentrations Are Associated with Low B12 Dietary Intake But Not with Helicobacter pylori Infection or Abnormal Gastric Function in Rural Mexican Women. Nutrients 2019; 11:nu11122922. [PMID: 31810343 PMCID: PMC6950710 DOI: 10.3390/nu11122922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Gastric function, Helicobacter pylori infection, and vitamin B12 (B12) dietary intake were assessed as predictors of serum B12. Methods: H. pylori antibodies, gastric function, B12 dietary intake, and biochemical/hematological parameters were measured in 191 adult women from two rural communities in Querétaro, Mexico. Results: The overall mean serum B12 concentration was 211 ± 117 pmol/L. The prevalences of low (≤ 148 pmol/L), marginal (148 to 221 pmol/L), and adequate (> 221 pmol/L) serum B12 were 28.4%, 31.1%, and 40.5%, respectively. Seventy-one percent of women tested positive for H. pylori antibodies. The prevalence of gastric function categories did not differ by serum B12 categories. The odds ratio for having low serum B12 was 2.7 (p = 0.01) for women with an intake below the estimated average requirement, 3.6 (p = 0.01) for those in the lowest tertile of total B12 intake, and 3.0 (p = 0.02) for those in the lowest tertile of B12 intake from animal source foods. Age and B12 intake were predictors of serum B12 concentrations [serum B12 (pmol/L) = 90.060 + 5.208 (B12 intake, µg/day) + 2.989 (age, years). Conclusions: Low serum B12 concentrations were associated with low B12 dietary intake but not with H. pylori infection or abnormal gastric function in rural Mexican women.
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Affiliation(s)
- Miriam A. Anaya-Loyola
- Escuela de Nutrición, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México, Av de las Ciencias S/N, Santiago de Querétaro, QT 76230, Mexico; (M.A.A.-L.); (C.S.); (J.L.R.)
| | - Alex Brito
- Laboratory of Pharmacokinetics and Metabolomic Analysis. Institute of Translational Medicine and Biotechnology. I.M. Sechenov First Moscow State Medical University, 2-4 Bolshaya Pirogovskaya St., 119991 Moscow, Russia;
- Luxembourg Institute of Health, Department of Population Health, NutriHealth Group, 1 A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg
| | - Haydé Vergara-Castañeda
- Facultad de Medicina, Universidad Autónoma de Querétaro, Querétaro, México, Clavel 200, Prados de La Capilla, Santiago de Querétaro, QT 76176, Mexico;
| | - Carina Sosa
- Escuela de Nutrición, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México, Av de las Ciencias S/N, Santiago de Querétaro, QT 76230, Mexico; (M.A.A.-L.); (C.S.); (J.L.R.)
| | - Jorge L. Rosado
- Escuela de Nutrición, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México, Av de las Ciencias S/N, Santiago de Querétaro, QT 76230, Mexico; (M.A.A.-L.); (C.S.); (J.L.R.)
| | - Lindsay H. Allen
- USDA, ARS Western Human Nutrition Research Center, 430 W. Health Sciences Drive, University of California, Davis, CA 95616, USA
- Correspondence:
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Brito A, Habeych E, Silva-Zolezzi I, Galaffu N, Allen LH. Methods to assess vitamin B12 bioavailability and technologies to enhance its absorption. Nutr Rev 2019; 76:778-792. [PMID: 29931214 DOI: 10.1093/nutrit/nuy026] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Vitamin B12 (B-12) deficiency is still relatively common in low-, medium-, and high-income countries, mainly because of dietary inadequacy and, to a lesser extent, malabsorption. This narrative review is based on a systematic search of evidence on methods to assess B-12 bioavailability and technologies to enhance its absorption. A total of 2523 scientific articles identified in PubMed and 1572 patents identified in Orbit Intelligence were prescreened. Among the reviewed methods, Schilling's test and/or its food-based version (using cobalamin-labeled egg yolk) were used for decades but have been discontinued, largely because they required radioactive cobalt. The qualitative CobaSorb test, based on changes in circulating holo-transcobalamin before and after B-12 administration, and the 14C-labeled B-12 test for quantitative measurement of absorption of a low-dose radioactive tracer are currently the best available methods. Various forms of B-12 co-formulated with chemical enhancers (ie, salcaprozate sodium, 8-amino caprylate) or supplied via biotechnological methods (ie, microbiological techniques, plant cells expressing cobalamin binding proteins), encapsulation techniques (ie, emulsions, use of chitosan particles), and alternative routes of administration (ie, intranasal, transdermal administration) were identified as potential technologies to enhance B-12 absorption in humans. However, in most cases the evidence of absorption enhancement is limited.
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Affiliation(s)
- Alex Brito
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | | | - Lindsay H Allen
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, California, USA
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[The geriatric syndrome of anemia-Summary of the symposium of the working group anemia during the annual meeting of the German Geriatric Society 2018 in Cologne, Germany]. Z Gerontol Geriatr 2019; 52:370-376. [PMID: 31016373 DOI: 10.1007/s00391-019-01545-z] [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: 01/21/2019] [Revised: 03/15/2019] [Accepted: 03/29/2019] [Indexed: 10/27/2022]
Abstract
This year's symposium of the working group anemia of the German Geriatric Society (DGG) aimed to underline the multicausality of anemia in the aged and to highlight definition parallels with geriatric syndromes. For these reasons, nutritional and malignant causes for anemia were discussed and the influence of oxidative stress on the development of anemia was underlined. The need for ongoing research in the field of anemia in the aged was emphasized by the lack of perioperative transfusion strategies in geriatric patients.
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Ströhle A, Richter M, González‐Gross M, Neuhäuser‐Berthold M, Wagner K, Leschik‐Bonnet E, Egert S. The Revised D-A-CH-Reference Values for the Intake of Vitamin B 12 : Prevention of Deficiency and Beyond. Mol Nutr Food Res 2019; 63:e1801178. [PMID: 30657638 PMCID: PMC6590120 DOI: 10.1002/mnfr.201801178] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/07/2019] [Indexed: 12/25/2022]
Abstract
SCOPE The nutrition societies of Germany, Austria, and Switzerland are the joint editors of the "D-A-CH reference values for nutrient intake", which are revised regularly. METHODS AND RESULTS By reviewing vitamin-B12 -related biomarker studies, the reference values for vitamin B12 were revised in 2018. For adults, the estimated intake is based on the adequate serum concentrations of holotranscobalamin and methylmalonic acid. The estimated values for children and adolescents are extrapolated from the adult reference value by considering differences in body mass, an allometric exponent, and growth factors. For infants below 4 months of age, an estimated value is set based on the vitamin B12 intake via breast milk. The reference values for pregnant and lactating women consider the requirements for the fetus and for loss via breast milk. The estimated values for vitamin B12 intake for infants, children, and adolescents range from 0.5 to 4.0 µg d-1 . For adults, the estimated values are set at 4.0 µg d-1 , and for pregnant and lactating women, they are set at 4.5 and 5.5 µg d-1 , respectively. CONCLUSION Based on the data of several vitamin B12 status biomarkers studies, the reference value for vitamin B12 intake for adults is raised from 3.0 to 4.0 µg d-1 .
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Affiliation(s)
- Alexander Ströhle
- Institute of Food Science and Human NutritionLeibniz University HannoverAm Kleinen Felde 3030167HannoverGermany
| | - Margrit Richter
- German Nutrition Society (DGE)Godesberger Allee 1853175BonnGermany
| | - Marcela González‐Gross
- ImFINE Research Group, Department of Health and Human PerformanceUniversidad Politécnica de Madridc/ Martín Fierro 728040MadridSpain
| | | | - Karl‐Heinz Wagner
- Department of Nutritional SciencesUniversity of ViennaAlthanstraße 141090ViennaAustria
| | | | - Sarah Egert
- German Nutrition Society (DGE)Godesberger Allee 1853175BonnGermany
- Institute of Nutritional MedicineUniversity of HohenheimFruwirthstr. 1270599StuttgartGermany
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Allen LH, Miller JW, de Groot L, Rosenberg IH, Smith AD, Refsum H, Raiten DJ. Biomarkers of Nutrition for Development (BOND): Vitamin B-12 Review. J Nutr 2018; 148:1995S-2027S. [PMID: 30500928 PMCID: PMC6297555 DOI: 10.1093/jn/nxy201] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/06/2017] [Accepted: 08/02/2018] [Indexed: 12/31/2022] Open
Abstract
This report on vitamin B-12 (B12) is part of the Biomarkers of Nutrition for Development (BOND) Project, which provides state-of-the art information and advice on the selection, use, and interpretation of biomarkers of nutrient exposure, status, and function. As with the other 5 reports in this series, which focused on iodine, folate, zinc, iron, and vitamin A, this B12 report was developed with the assistance of an expert panel (BOND B12 EP) and other experts who provided information during a consultation. The experts reviewed the existing literature in depth in order to consolidate existing relevant information on the biology of B12, including known and possible effects of insufficiency, and available and potential biomarkers of status. Unlike the situation for the other 5 nutrients reviewed during the BOND project, there has been relatively little previous attention paid to B12 status and its biomarkers, so this report is a landmark in terms of the consolidation and interpretation of the available information on B12 nutrition. Historically, most focus has been on diagnosis and treatment of clinical symptoms of B12 deficiency, which result primarily from pernicious anemia or strict vegetarianism. More recently, we have become aware of the high prevalence of B12 insufficiency in populations consuming low amounts of animal-source foods, which can be detected with ≥1 serum biomarker but presents the new challenge of identifying functional consequences that may require public health interventions.
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Affiliation(s)
- Lindsay H Allen
- USDA, Agricultural Research Service Western Human Nutrition Research Center, University of California, Davis, CA
| | - Joshua W Miller
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ
| | - Lisette de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Irwin H Rosenberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, United Kingdom
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, Bethesda, MD
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Röhrig G, Gütgemann I, Kolb G, Leischker A. Klinisch-hämatologisches Bild des Vitamin-B12-Mangels im Alter. Z Gerontol Geriatr 2018; 51:446-452. [DOI: 10.1007/s00391-018-1410-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/25/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
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Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations. Nutr Res Rev 2018; 31:204-224. [DOI: 10.1017/s0954422418000045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractThe possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.
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Jannusch K, Jockwitz C, Bidmon HJ, Moebus S, Amunts K, Caspers S. A Complex Interplay of Vitamin B1 and B6 Metabolism with Cognition, Brain Structure, and Functional Connectivity in Older Adults. Front Neurosci 2017; 11:596. [PMID: 29163003 PMCID: PMC5663975 DOI: 10.3389/fnins.2017.00596] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/10/2017] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with brain atrophy, functional brain network reorganization and decline of cognitive performance, albeit characterized by high interindividual variability. Among environmental influencing factors accounting for this variability, nutrition and particularly vitamin supply is thought to play an important role. While evidence exists that supplementation of vitamins B6 and B1 might be beneficial for cognition and brain structure, at least in deficient states and neurodegenerative diseases, little is known about this relation during healthy aging and in relation to reorganization of functional brain networks. We thus assessed the relation between blood levels of vitamins B1 and B6 and cognitive performance, cortical folding, and functional resting-state connectivity in a large sample of older adults (N > 600; age: 55-85 years), drawn from the population-based 1000BRAINS study. In addition to blood sampling, subjects underwent structural and functional resting-state neuroimaging as well as extensive neuropsychological testing in the domains of executive functions, (working) memory, attention, and language. Brain regions showing changes in the local gyrification index as calculated using FreeSurfer in relation to vitamin levels were used for subsequent seed-based resting-state functional connectivity analysis. For B6, a positive correlation with local cortical folding was found throughout the brain, while only slight changes in functional connectivity were observed. Contrarily, for B1, a negative correlation with cortical folding as well as problem solving and visuo-spatial working memory performance was found, which was accompanied by pronounced increases of interhemispheric and decreases of intrahemispheric functional connectivity. While the effects for B6 expand previous knowledge on beneficial effects of B6 supplementation on brain structure, they also showed that additional effects on cognition might not be recognizable in healthy older subjects with normal B6 blood levels. The cortical atrophy and pronounced functional reorganization associated with B1, contrarily, was more in line with the theory of a disturbed B1 metabolism in older adults, leading to B1 utilization deficits, and thus, an effective B1 deficiency in the brain, despite normal to high-normal blood levels.
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Affiliation(s)
- Kai Jannusch
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
| | - Hans-Jürgen Bidmon
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Katrin Amunts
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
| | - Svenja Caspers
- C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- JARA–BRAIN, Jülich Aachen Research Alliance, Research Centre Jülich, Jülich, Germany
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Tucker KL. Nutrient intake, nutritional status, and cognitive function with aging. Ann N Y Acad Sci 2017; 1367:38-49. [PMID: 27116240 DOI: 10.1111/nyas.13062] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 12/13/2022]
Abstract
With the demographic aging of populations worldwide, diseases associated with aging are becoming more prevalent and costly to individuals, families, and healthcare systems. Among aging-related impairments, a decline in cognitive function is of particular concern, as it erodes memory and processing abilities and eventually leads to the need for institutionalized care. Accumulating evidence suggests that nutritional status is a key factor in the loss of cognitive abilities with aging. This is of tremendous importance, as dietary intake is a modifiable risk factor that can be improved to help reduce the burden of cognitive impairment. With respect to nutrients, there is evidence to support the critical role of several B vitamins in particular, but also of vitamin D, antioxidant vitamins (including vitamin E), and omega-3 fatty acids, which are preferentially taken up by brain tissue. On the other hand, high intakes of nutrients that contribute to hypertension, atherosclerosis, and poor glycemic control may have negative effects on cognition through these conditions. Collectively, the evidence suggests that considerable slowing and reduction of cognitive decline may be achieved by following a healthy dietary pattern, which limits intake of added sugars, while maximizing intakes of fish, fruits, vegetables, nuts, and seeds.
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Affiliation(s)
- Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
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Mardo K, Visnapuu T, Vija H, Aasamets A, Viigand K, Alamäe T. A Highly Active Endo-Levanase BT1760 of a Dominant Mammalian Gut Commensal Bacteroides thetaiotaomicron Cleaves Not Only Various Bacterial Levans, but Also Levan of Timothy Grass. PLoS One 2017; 12:e0169989. [PMID: 28103254 PMCID: PMC5245892 DOI: 10.1371/journal.pone.0169989] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/27/2016] [Indexed: 12/11/2022] Open
Abstract
Bacteroides thetaiotaomicron, an abundant commensal of the human gut, degrades numerous complex carbohydrates. Recently, it was reported to grow on a β-2,6-linked polyfructan levan produced by Zymomonas mobilis degrading the polymer into fructooligosaccharides (FOS) with a cell surface bound endo-levanase BT1760. The FOS are consumed by B. thetaiotaomicron, but also by other gut bacteria, including health-promoting bifidobacteria and lactobacilli. Here we characterize biochemical properties of BT1760, including the activity of BT1760 on six bacterial levans synthesized by the levansucrase Lsc3 of Pseudomonas syringae pv. tomato, its mutant Asp300Asn, levansucrases of Zymomonas mobilis, Erwinia herbicola, Halomonas smyrnensis as well as on levan isolated from timothy grass. For the first time a plant levan is shown as a perfect substrate for an endo-fructanase of a human gut bacterium. BT1760 degraded levans to FOS with degree of polymerization from 2 to 13. At optimal reaction conditions up to 1 g of FOS were produced per 1 mg of BT1760 protein. Low molecular weight (<60 kDa) levans, including timothy grass levan and levan synthesized from sucrose by the Lsc3Asp300Asn, were degraded most rapidly whilst levan produced by Lsc3 from raffinose least rapidly. BT1760 catalyzed finely at human body temperature (37°C) and in moderately acidic environment (pH 5–6) that is typical for the gut lumen. According to differential scanning fluorimetry, the Tm of the endo-levanase was 51.5°C. All tested levans were sufficiently stable in acidic conditions (pH 2.0) simulating the gastric environment. Therefore, levans of both bacterial and plant origin may serve as a prebiotic fiber for B. thetaiotaomicron and contribute to short-chain fatty acids synthesis by gut microbiota. In the genome of Bacteroides xylanisolvens of human origin a putative levan degradation locus was disclosed.
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Affiliation(s)
- Karin Mardo
- Department of Genetics, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Triinu Visnapuu
- Department of Genetics, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Heiki Vija
- Laboratory of Environmental Toxicology, National Institute of Chemical Physics and Biophysics, Tallinn, Estonia
| | - Anneli Aasamets
- Department of Genetics, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Katrin Viigand
- Department of Genetics, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Tiina Alamäe
- Department of Genetics, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
- * E-mail:
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Yu TY, Wei JN, Kuo CH, Liou JM, Lin MS, Shih SR, Hua CH, Hsein YC, Hsu YW, Chuang LM, Lee MK, Hsiao CH, Wu MS, Li HY. The Impact of Gastric Atrophy on the Incidence of Diabetes. Sci Rep 2017; 7:39777. [PMID: 28045079 PMCID: PMC5206635 DOI: 10.1038/srep39777] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/28/2016] [Indexed: 01/08/2023] Open
Abstract
Gastric atrophy results in lower plasma ghrelin, higher gastrin secretion, a change in gut microbiota, and altered dietary nutrient absorption, which may be associated with the incidence of diabetes. Helicobacter pylori (H. pylori) infection is a major cause of gastric atrophy and is associated with diabetes in some reports. Since there is no study which investigates the impact of gastric atrophy on diabetes, we conduct a prospective cohort study to examine the relationship between H. pylori infection, gastric atrophy, and incident diabetes. In this study, subjects with gastric atrophy had a lower risk of incident diabetes, compared to those without gastric atrophy. The extent of gastric atrophy, measured by serum pepsinogen (PG) I/II ratio, was correlated with age, H. pylori IgG titer, HOMA2-IR, and HOMA2%B. When gastric atrophy is more extensive, presented as a lower serum PG I/II ratio, the risk of incident diabetes is lower. On the other hand, there was no significant association between H. pylori infection and the incidence of diabetes. In conclusion, the presence and the extent of gastric atrophy, but not H. pylori infection, are associated with incident diabetes. Further studies are needed to investigate the detailed mechanisms and the potential applications of the findings to guide diabetes screening and treatment strategies.
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Affiliation(s)
- Tse-Ya Yu
- Health Management Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jung-Nan Wei
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chun-Heng Kuo
- Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan
| | - Jyh-Ming Liou
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Mao-Shin Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shyang-Rong Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cyue-Huei Hua
- Division of Clinical Pathology' National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Yenh-Chen Hsein
- Division of Clinical Pathology' National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Ya-Wen Hsu
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Kuei Lee
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | | | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Iron Isotope Signature in Red Blood Cell Samples from Japanese Female Donors of Various Ages. Metallomics 2017. [DOI: 10.1007/978-4-431-56463-8_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sechi G, Sechi E, Fois C, Kumar N. Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutr Rev 2016; 74:281-300. [PMID: 27034475 DOI: 10.1093/nutrit/nuv107] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
B vitamin deficiency is a leading cause of neurological impairment and disability throughout the world. Multiple B vitamin deficiencies often coexist, and thus an understanding of the complex relationships between the different biochemical pathways regulated in the brain by these vitamins may facilitate prompter diagnosis and improved treatment. Particular populations at risk for multiple B vitamin deficiencies include the elderly, people with alcoholism, patients with heart failure, patients with recent obesity surgery, and vegetarians/vegans. Recently, new clinical settings that predispose individuals to B vitamin deficiency have been highlighted. Moreover, other data indicate a possible pathogenetic role of subclinical chronic B vitamin deficiency in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. In light of these findings, this review examines the clinical manifestations of B vitamin deficiency and the effect of B vitamin deficiency on the adult nervous system. The interrelationships of multiple B vitamin deficiencies are emphasized, along with the clinical phenotypes related to B vitamin deficiencies. Recent advances in the clinical determinants and diagnostic clues of B vitamin deficiency, as well as the suggested therapies for B vitamin disorders, are described.
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Affiliation(s)
- GianPietro Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
| | - Elia Sechi
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Chiara Fois
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
| | - Neeraj Kumar
- G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA
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Daulatzai MA. “Boomerang Neuropathology” of Late-Onset Alzheimer’s Disease is Shrouded in Harmful “BDDS”: Breathing, Diet, Drinking, and Sleep During Aging. Neurotox Res 2015; 28:55-93. [DOI: 10.1007/s12640-015-9528-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/03/2015] [Accepted: 04/03/2015] [Indexed: 12/12/2022]
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Abstract
Alzheimer's disease (AD), the most common form of dementia, is a chronic, progressive neurodegenerative disease that manifests clinically as a slow global decline in cognitive function, including deterioration of memory, reasoning, abstraction, language and emotional stability, culminating in a patient with end-stage disease, totally dependent on custodial care. With a global ageing population, it is predicted that there will be a marked increase in the number of people diagnosed with AD in the coming decades, making this a significant challenge to socio-economic policy and aged care. Global estimates put a direct cost for treating and caring for people with dementia at $US604 billion, an estimate that is expected to increase markedly. According to recent global statistics, there are 35.6 million dementia sufferers, the number of which is predicted to double every 20 years, unless strategies are implemented to reduce this burden. Currently, there is no cure for AD; while current therapies may temporarily ameliorate symptoms, death usually occurs approximately 8 years after diagnosis. A greater understanding of AD pathophysiology is paramount, and attention is now being directed to the discovery of biomarkers that may not only facilitate pre-symptomatic diagnosis, but also provide an insight into aberrant biochemical pathways that may reveal potential therapeutic targets, including nutritional ones. AD pathogenesis develops over many years before clinical symptoms appear, providing the opportunity to develop therapy that could slow or stop disease progression well before any clinical manifestation develops.
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Inadequate supply of vitamins and DHA in the elderly: Implications for brain aging and Alzheimer-type dementia. Nutrition 2015; 31:261-75. [DOI: 10.1016/j.nut.2014.06.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/27/2014] [Accepted: 06/04/2014] [Indexed: 12/28/2022]
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Keser A, Yabanci Ayhan N, Bilgiç P, Tayfur M, ŞImşek I. Determination of Dietary Status as a Risk Factor of Cardiovascular Heart Disease in Turkish Elderly People. Ecol Food Nutr 2015; 54:328-41. [DOI: 10.1080/03670244.2014.992520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
The prevalence of vitamin B12 deficiency increases with age. Patients with dementia and spouses of patients with dementia are at special risk for the development of vitamin B12 deficiency. In a normal diet this vitamin is present only in animal source foods; therefore, vegans frequently develop vitamin B12 deficiency if not using supplements or foods fortified with cobalamin. Apart from dementia, most of these manifestations are completely reversible under correct therapy; therefore it is crucial to identify and to treat even atypical presentations of vitamin B12 deficiency as early as possible. This article deals with the physiology and pathophysiology of vitamin B12 metabolism. A practice-oriented algorithm which also considers health economic aspects for a rational laboratory diagnosis of vitamin B12 deficiency is presented. In cases with severe neurological symptoms, therapy should be parenteral, especially initially. For parenteral treatment, hydroxocobalamin is the drug of choice.
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Affiliation(s)
- A H Leischker
- Klinik für Allgemeine Innere Medizin und Altersmedizin, Alexianer Krefeld GmbH, Dießemer Bruch 81, 47805, Krefeld, Deutschland,
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Mandal U, Ali KM, Chatterjee K, De D, Biswas A, Ghosh D. Management of experimental hypochlorhydria with iron deficiency by the composite extract of Fumaria vaillantii L. and Benincasa hispida T. in rat. J Nat Sci Biol Med 2014; 5:397-403. [PMID: 25097423 PMCID: PMC4121923 DOI: 10.4103/0976-9668.136202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The aim of the present study was to search the effective ratio of whole plant of Fumaria vaillantii Loisel (Fumaria vaillantii L.) and fruit of Benincasa hispida Thunb. (Benincasa hispida T.) in composite form, namely “FVBH” for the management of hypochlorhydria along with iron deficiency in male albino rats. Hypochlorhydria refers to suppression of hydrochloric acid secretion by the stomach. Hypochlorhydria was induced by ranitidine in this study. We used four composite extracts of the mentioned plant and fruit with different ratios (1:1, 1:2, 2:1, and 3:2) for searching the most effective composite extract for the correction of hypochlorhydria. Gastric acidity is an important factor for iron absorption. Thus, hypochlorhydria causes iron deficiency in rat and it was prevented significantly by the extract treatment at the ratio of 1:1 of the said plant and fruit. The correction of iron deficiency by the composite extract was compared with iron supplementation to hypochlorhydric rat. It was found that preadministration followed by coadministration of FVBH-1 (1:1) able to prevent the ranitidine-induced hypochlorhydria and iron deficiency. The composite extract, FVBH-1 (1:1) significantly (P<0.05) increased the pepsin concentration, chloride level in gastric juice, iron levels in serum and liver along with blood hemoglobin level than other ratios used here. Hence, it can be concluded that FVBH-1 (1:1) is an effective herbal formulation for the management of hypochlorhydria and related iron deficiency.
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Affiliation(s)
- Upanandan Mandal
- Andrology, Endocrinology and Molecular Medicine Laboratory, Department of Bio-Medical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, India
| | - Kazi Monjur Ali
- Andrology, Endocrinology and Molecular Medicine Laboratory, Department of Bio-Medical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, India
| | - Kausik Chatterjee
- Andrology, Endocrinology and Molecular Medicine Laboratory, Department of Bio-Medical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, India
| | - Debasis De
- Andrology, Endocrinology and Molecular Medicine Laboratory, Department of Bio-Medical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, India
| | - Anjan Biswas
- Department of Physiology, Presidency University, Kolkata, West Bengal, India
| | - Debidas Ghosh
- Andrology, Endocrinology and Molecular Medicine Laboratory, Department of Bio-Medical Laboratory Science and Management (UGC Innovative Department), Vidyasagar University, Midnapore, West Bengal, India
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Abstract
INTRODUCTION Given the high prevalence of dementia and its devastating consequences, identifying risk factors for dementia is a public health priority. The present study aims to assess whether gastritis increases the odds of dementia. METHODOLOGY The data for this study, consisting of 2926 community-dwelling older adults, were obtained from the National survey entitled "Mental Health and Quality of Life of Older Malaysians." Dementia was diagnosed using the Geriatric Mental State-Automated Geriatric Examination for Computer-Assisted Taxonomy. RESULTS Prevalence of dementia was considerably higher among older adults with gastritis (29.5%) compared to those without gastritis (13.2%). After adjusting for age, gender, marital status, educational attainment, hypertension, stroke, and diabetes, gastritis was significantly associated with more than twice odds of dementia (adjusted odds ratio = 2.42, P < .001, 95% confidence interval = 1.68-3.49). CONCLUSIONS The findings from this population-based observational study showing evidence that gastritis may increase the risk of dementia provide avenue for further inquiries into dementia.
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Affiliation(s)
| | - Tengku Aizan Hamid
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rahimah Ibrahim
- Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Korkushko OV, Shatilo VB, Gavalko YV, Grib ON, Bagrii AS, Ostapchenko LI, Strotskaya EA. The relationship between enzyme activity of gastric mucosa with microcirculation and acid output. ADVANCES IN GERONTOLOGY 2013. [DOI: 10.1134/s2079057013020094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bito T, Ohishi N, Hatanaka Y, Takenaka S, Nishihara E, Yabuta Y, Watanabe F. Production and characterization of cyanocobalamin-enriched lettuce (Lactuca sativa L.) grown using hydroponics. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2013; 61:3852-8. [PMID: 23578327 DOI: 10.1021/jf305033s] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
When lettuces (Lactuca sativa L.) grown for 30 days in hydroponic culture were treated with various concentrations of cyanocobalamin for 24 h, its content in their leaves increased significantly from nondetectable to 164.6 ± 74.7 ng/g fresh weight. This finding indicated that consumption of only two or three of these fresh leaves is sufficient to meet the Recommended Dietary Allowance for adults of 2.4 μg/day. Analyses using a cobalamin-dependent Escherichia coli 215 bioautogram and LC/ESI-MS/MS demonstrated that the cyanocobalamin absorbed from the nutrient solutions by the leaves did not alter any other compounds such as coenzymes and inactive corrinoids. Gel filtration indicated that most (86%) of the cyanocobalamin in the leaves was recovered in the free cyanocobalamin fractions. These results indicated that cyanocobalamin-enriched lettuce leaves would be an excellent source of free cyanocobalamin, particularly for strict vegetarians or elderly people with food-bound cobalamin malabsorption.
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Affiliation(s)
- Tomohiro Bito
- Division of Applied Bioresources Chemistry, The United Graduate School of Agricultural Sciences, and ‡School of Agricultural, Biological and Environmental Sciences, Tottori University , Tottori 680-8553, Japan
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Bossenmeyer‐Pourié C, Pourié G, Koziel V, Helle D, Jeannesson E, Guéant J, Beck B. Early methyl donor deficiency produces severe gastritis in mothers and offspring through
N
‐homocysteinylation of cytoskeleton proteins, cellular stress, and inflammation. FASEB J 2013; 27:2185-97. [DOI: 10.1096/fj.12-224642] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Carine Bossenmeyer‐Pourié
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Grégory Pourié
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Violette Koziel
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Deborah Helle
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Elise Jeannesson
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Jean‐Louis Guéant
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
| | - Bernard Beck
- Institut National de la Santé et de la Recherche Médicale (INSERM)U954, Nutrition, Génétique et Exposition aux Risques EnvironnementauxVandœuvreFrance
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McCaddon A. Vitamin B12 in neurology and ageing; clinical and genetic aspects. Biochimie 2012; 95:1066-76. [PMID: 23228515 DOI: 10.1016/j.biochi.2012.11.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 11/27/2012] [Indexed: 01/13/2023]
Abstract
The classic neurological and psychiatric features associated with vitamin B12 deficiency have been well described and are the subject of many excellent review articles. The advent of sensitive diagnostic tests, including homocysteine and methylmalonic acid assays, has revealed a surprisingly high prevalence of a more subtle 'subclinical' form of B12 deficiency, particularly within the elderly. This is often associated with cognitive impairment and dementia, including Alzheimer's disease. Metabolic evidence of B12 deficiency is also reported in association with other neurodegenerative disorders including vascular dementia, Parkinson's disease and multiple sclerosis. These conditions are all associated with chronic neuro-inflammation and oxidative stress. It is possible that these clinical associations reflect compromised vitamin B12 metabolism due to such stress. Physicians are also increasingly aware of considerable inter-individual variation in the clinical response to B12 replacement therapy. Further research is needed to determine to what extent this is attributable to genetic determinants of vitamin B12 absorption, distribution and cellular uptake.
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Affiliation(s)
- Andrew McCaddon
- School of Medicine, Cardiff University, Gwenfro Units 6/7, Wrexham Technology Park, Wrexham LL17 7YP, Wales, United Kingdom.
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Troesch B, Eggersdorfer M, Weber P. 100 years of vitamins: adequate intake in the elderly is still a matter of concern. J Nutr 2012; 142:979-80. [PMID: 22535756 DOI: 10.3945/jn.112.157826] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Demographic changes lead to an ever greater number of elderly people and mounting evidence suggests an association between vitamin status and the development of noncommunicable diseases. However, even in affluent Western countries, data from dietary intake surveys indicate that vitamin inadequacy is widespread even in healthy elderly. Changes inherent to the aging process lead to the need for increased nutrient density, which is difficult to achieve from diet alone. Where this is not sufficient to close the gap between actual vitamin intakes and recommendations, fortified foods and dietary supplements specifically targeted at the growing segment of healthy elderly can be a pragmatic solution.
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Tanaka M, Fukui M, Kuroda M, Yamazaki M, Hasegawa G, Oda Y, Naito Y, Toda H, Yoshikawa T, Nakamura N. Pepsinogen I/II ratio is related to glucose, triacylglycerol, and uric acid levels. Nutrition 2012; 28:418-21. [PMID: 22304859 DOI: 10.1016/j.nut.2011.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/14/2010] [Accepted: 09/08/2011] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Under- and overnutrition are associated with a worse prognosis and constitute independent risk factors for morbidity and mortality. It is increasingly important to understand the factors that affect nutritional and metabolic statuses. The purpose of this study was to assess the relation between the pepsinogen I/II ratio and several biochemical markers. METHODS A cross-sectional study was performed in 1985 subjects who underwent a health screening test. Subjects had no medications for hyperuricemia, dyslipidemia, diabetes mellitus, or hypertension. All subjects were classified into two groups. Subjects with a pepsinogen I/II ratio below 3 were defined as having atrophic gastritis. The relations between the pepsinogen I/II ratio and several biochemical markers, including total cholesterol, triacylglycerol, uric acid, cholinesterase, and glucose levels, were evaluated. RESULTS The presence of atrophic gastritis was significantly associated with age, smoking status, alcohol consumption, body mass index, and triacylglycerol, uric acid, cholinesterase, and hemoglobin levels. Multiple linear regression analysis demonstrated that the pepsinogen I/II ratio was an independent determinant of glucose level (β = 0.104, P < 0.0001), triacylglycerol level (β = 0.072, P = 0.0014), uric acid level (β = 0.048, P = 0.0138), and hemoglobin (β = 0.037, P = 0.0429) after adjustments for age, sex, smoking status, alcohol consumption, and body mass index. CONCLUSION The pepsinogen I/II ratio was related to glucose, triacylglycerol, and uric acid levels. Such an association fosters the idea that a decreased pepsinogen I/II ratio seems favorable for the prevention of overnutrition.
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Affiliation(s)
- Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Abstract
Cobalamin (Cbl, vitamin B12) consists of a corrinoid structure with cobalt in the centre of the molecule. Neither humans nor animals are able to synthesize this vitamin. Foods of animal source are the only natural source of cobalamin in human diet. There are only two enzymatic reactions in mammalian cells that require cobalamin as cofactor. Methylcobolamin is a cofactor for methionine synthase. The enzyme methylmalonyl-CoA-mutase requires adenosylcobalamin as a cofactor. Therefore, serum concentrations of homocysteine (tHcy) and methylmalonic acid (MMA) will increase in cobalamin deficiency. The cobalamin absorption from diet is a complex process that involves different proteins: haptocorrin, intrinsic factor and transcobalamin (TC). Cobalamin that is bound to TC is called holotranscobalamin (holoTC) which is the metabolically active vitamin B12 fraction. HoloTC consists 6 and 20% of total cobalamin whereas 80% of total serum cobalamin is bound to another binding protein, haptocorrin. Cobalamin deficiency is common worldwide. Cobalamin malabsorption is common in elderly subjects which might explain low vitamin status. Subjects who ingest low amount of cobalamin like vegetarians develop vitamin deficiency. No single parameter can be used to diagnose cobalamin deficiency. Total serum cobalamin is neither sensitive nor it is specific for cobalamin deficiency. This might explain why many deficient subjects would be overlooked by utilizing total cobalamin as status marker. Concentration of holotranscobalamin (holoTC) in serum is an earlier marker that becomes decreased before total serum cobalamin. Concentrations of MMA and tHcy increase in blood of cobalamin deficient subjects. Despite limitations of these markers in patients with renal dysfunction, concentrations of MMA and tHcy are useful functional markers of cobalamin status. The combined use of holoTC and MMA assays may better indicate cobalamin status than either of them. Because Cbl deficiency is a risk factor for neurodegenerative diseases an early diagnosis of a low B12 status is required which should be followed by an effective treatment in order to prevent irreversible damages.
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Affiliation(s)
- Wolfgang Herrmann
- Department of Clinical Chemistry and Laboratory Medicine, University of Saarland, 66421, Homburg, Germany,
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Bowman GL, Silbert LC, Howieson D, Dodge HH, Traber MG, Frei B, Kaye JA, Shannon J, Quinn JF. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 2011; 78:241-9. [PMID: 22205763 DOI: 10.1212/wnl.0b013e3182436598] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To examine the cross-sectional relationship between nutrient status and psychometric and imaging indices of brain health in dementia-free elders. METHODS Thirty plasma biomarkers of diet were assayed in the Oregon Brain Aging Study cohort (n = 104). Principal component analysis constructed nutrient biomarker patterns (NBPs) and regression models assessed the relationship of these with cognitive and MRI outcomes. RESULTS Mean age was 87 ± 10 years and 62% of subjects were female. Two NBPs associated with more favorable cognitive and MRI measures: one high in plasma vitamins B (B1, B2, B6, folate, and B12), C, D, and E, and another high in plasma marine ω-3 fatty acids. A third pattern characterized by high trans fat was associated with less favorable cognitive function and less total cerebral brain volume. Depression attenuated the relationship between the marine ω-3 pattern and white matter hyperintensity volume. CONCLUSION Distinct nutrient biomarker patterns detected in plasma are interpretable and account for a significant degree of variance in both cognitive function and brain volume. Objective and multivariate approaches to the study of nutrition in brain health warrant further study. These findings should be confirmed in a separate population.
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Affiliation(s)
- G L Bowman
- Department of Neurology, Oregon Health & Science University, Portland, USA.
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Quesada Gómez JM, Blanch Rubió J, Díaz Curiel M, Díez Pérez A. Calcium citrate and vitamin D in the treatment of osteoporosis. Clin Drug Investig 2011; 31:285-98. [PMID: 21405146 DOI: 10.1007/bf03256927] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The combination of calcium with vitamin D (vitamin D(3) [colecalciferol]) forms the basis of preventive and therapeutic regimens for osteoporosis. A number of studies have suggested that the combination of calcium and vitamin D is effective when administered at respective dosages of at least 1200 mg and 800 IU per day, although efficacy is, as expected, affected by patient compliance. Overall, treatment with this combination appears to be effective in reducing the incidence of non-vertebral and hip fractures. Also, in all drug studies (of antiresorptive and anabolic agents and strontium ranelate) that demonstrated a reduction in risk of osteoporotic fractures, patients also took calcium and vitamin D supplements. An important finding in this regard is that vitamin D levels have been demonstrated to be inadequate in more than half of women treated for osteoporosis in the US and Europe. The capacity of the small intestine to absorb calcium salts depends on the solubility and ionization of the salts. These properties vary for different salts, with fasting calcium citrate absorption being greater than that of calcium lactogluconate and calcium carbonate. Calcium citrate formulations taken between meals may help to prevent abdominal distension and flatulence, as well as minimize the risk of renal calculus formation, thus helping to optimize patient compliance. Therefore, calcium citrate combined with vitamin D is the combination of choice for the prevention or treatment of osteoporosis.
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Quesada Gómez JM, Rubió JB, Curiel MD, Pérez AD. Calcium Citrate and Vitamin D in the Treatment of Osteoporosis. Clin Drug Investig 2011. [DOI: 10.2165/11584940-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Singh B, Arora S. Acute presentation of dizziness in vitamin B12 deficient old patient of cardiac disease: a case report. Clin Chim Acta 2010; 411:2104-6. [PMID: 20736002 DOI: 10.1016/j.cca.2010.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 08/14/2010] [Accepted: 08/16/2010] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neuropsychiatric and hematological manifestations of vitamin B12 deficiency are well known. The present report highlights the biochemical basis for the impaired synthesis of DNA and neurological disorders associated with vitamin B12 deficiency. METHODS We present a case of an old patient who developed acute ataxia, dizziness and imbalance 2 days after pacemaker implantation in a cardiac care unit. RESULTS On evaluation, the patient was found to have low vitamin B12 levels (121 pmol/l) with raised plasma homocysteine levels (28 μmol/l) and methylmalonic acid levels (17 μmol/l). Neurological examination revealed signs and symptoms of peripheral neuropathy. CT scan of the brain was found to be normal. The usual hematological presentation was absent in this case. The patient responded dramatically to parenteral vitamin B12 supplementation. CONCLUSION Though frequent, the vitamin B12 deficiency often goes unnoticed in elderly population. So, with this report we emphasize that deficiency of serum vitamin B12 levels should be suspected and evaluated in elderly patients presenting with neuropsychiatric symptoms.
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Affiliation(s)
- Bhawna Singh
- GB Pant Hospital, Room 418, Dept of Biochemistry, Academic Block, Jawahar Lal Nehru Marg, New Delhi, India.
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Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 2010; 5:207-16. [PMID: 20711440 PMCID: PMC2920201 DOI: 10.2147/cia.s9664] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Indexed: 12/21/2022] Open
Abstract
Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.
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Affiliation(s)
- Tanvir Ahmed
- Adult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UK
| | - Nadim Haboubi
- Adult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UK
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Circulating unmetabolized folic acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, and cognitive test performance in American seniors. Am J Clin Nutr 2010; 91:1733-44. [PMID: 20357042 DOI: 10.3945/ajcn.2009.28671] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Folate deficiency has serious consequences for the fetus. Folic acid fortification of food addresses this problem. However, clinical consequences of vitamin B-12 deficiency may be worsened by high folic acid intakes, perhaps as a direct result of unmetabolized folic acid, which does not occur naturally in body tissues. OBJECTIVE We attempted to attribute associations that we previously found between higher folate status and anemia and cognitive test performance to circulating unmetabolized folic acid or 5-methyltetrahydrofolate (5MeTHF). DESIGN The subjects (n = 1858) were senior participants in the US National Health and Nutrition Examination Survey (1999-2002) who had normal renal function and reported no history of stroke, recent anemia therapy, or diseases of the liver, thyroid, or coronary arteries. Subjects had undergone a phlebotomy, a complete blood count, and cognitive and dietary assessments. RESULTS Circulating unmetabolized folic acid was detected in approximately 33% of the subjects and was related to an increased odds of anemia in alcohol users. In seniors with a serum vitamin B-12 concentration <148 pmol/L or a plasma methylmalonic acid concentration > or =210 nmol/L, the presence compared with the absence of detectable circulating unmetabolized folic acid was related to lower cognitive test scores and lower mean cell volume. In the same subgroup, higher serum 5MeTHF was related to an increased odds of anemia and a marginally significantly decreased odds of macrocytosis. In seniors with a normal vitamin B-12 status, a higher serum 5MeTHF concentration was related to higher cognitive test scores. CONCLUSION Results of this epidemiologic study were somewhat consistent with reports on the folic acid treatment of patients with pernicious anemia, but some findings were unexpected.
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Miller GD. Improved nutrient intake in older obese adults undergoing a structured diet and exercise intentional weight loss program. J Nutr Health Aging 2010; 14:461-6. [PMID: 20617289 DOI: 10.1007/s12603-010-0100-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Physicians are often reluctant to advise older obese patients to lose weight for fear of compromised nutrition and excessive loss of muscle mass and strength, all of which may lead to a loss of independence and accelerate disability. Therefore, the purpose of this study was to examine nutrient intake in older obese adults undergoing a weight loss intervention. SETTING The study setting was at a university research facility. PARTICIPANTS A total of 71 participants (age, 69.5 (SD = 5.8) yrs; 62% female; BMI, 34.6 (4.4) kg/m2) were recruited. DESIGN Individuals were randomized into either a weight stable (WS) control group or an intensive weight loss (WL) group. INTERVENTION The WL intervention was for 6 months and utilized partial meal replacements (PMR) and a facility-based 3 d/wk, 60 min/session exercise training program encompassing both aerobic and strength exercises. Weight loss goal for WL was 10% from baseline at 6-months. MEASUREMENTS Variables were obtained at baseline and 6-months and included 3 day dietary records along with daily step counts for 7 days. Total energy, macronutrients (g and % of energy), micronutrients (vitamins and minerals), as well as use of PMR were assessed from the diet records. Body mass and body fat (g and % of body mass) were determined at the 2 time points. RESULTS Estimated marginal means (SEM) for weight loss at 6-months was -8.8 (0.7)% for WL and -0.1 (0.7)% for WS. Daily energy intake at 6-months was lower for WL (1396 (64) kcals) compared to WS (1817 (71) kcals). Additionally, those in the WL group (compared to WS) had lower intakes of total fat (27.5 (1.2)%, WL vs. 36.1 (4.6)%, WS) and saturated fatty acids (8.5 (0.4)% vs. 10.8 (0.5)%), and had higher levels of carbohydrates (57.6 (1.5)% vs. 49.0 (1.7)%), protein (18.4 (0.5% vs. 16.2 (0.6)%), and dietary fiber (21.0 (0.9) g vs. 17.4 (1.0) g) at 6-months. Even with reduced total calorie intake, key micronutrients (calcium, iron, vitamin D, vitamin E, vitamin C) were higher for WL vs. WS at 6-months. Total daily step counts were higher for WL vs. WS at 6-months. CONCLUSION A nutrition intervention to promote weight loss in older obese adults was achieved using PMR as a primary strategy. Diet quality was improved for WL vs. WS in using the nutrient fortified product, even with a reduction in total energy intake.
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Affiliation(s)
- G D Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109-7868, USA.
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Ueta K, Nishioka M, Yabuta Y, Watanabe F. TLC-BIOAUTOGRAPHY ANALYSIS OF VITAMIN B12 COMPOUND FROM THE SHORT-NECKED CLAM (RUDITAPES PHILIPPINARUM) EXTRACT USED AS A FLAVORING. J LIQ CHROMATOGR R T 2010. [DOI: 10.1080/10826071003769512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kazumi Ueta
- a Department of Food and Nutrition , Shikoku University Junior College , Tokushima, Japan
- b The United Graduate School of Agricultural Sciences, Tottori University , Tottori, Japan
| | - Michiko Nishioka
- b The United Graduate School of Agricultural Sciences, Tottori University , Tottori, Japan
- c Department of Health Science , Kochi Women's University , Kochi, Japan
| | - Yukinori Yabuta
- b The United Graduate School of Agricultural Sciences, Tottori University , Tottori, Japan
| | - Fumio Watanabe
- b The United Graduate School of Agricultural Sciences, Tottori University , Tottori, Japan
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Abstract
Reasons to fortify flour with vitamin B12 are considered, including the high prevalence of depletion and deficiency of this vitamin that occurs in persons of all ages in resource-poor countries and in the elderly in wealthier countries, and the adverse functional consequences of poor vitamin B12 status. From a global perspective, the main cause of inadequate intake and status is a low intake of animal-source foods; even lacto-ovo vegetarians have lower serum vitamin B12 concentrations than omnivores, and for various reasons many populations have limited consumption of animal-source foods. Infants are vitamin B12-depleted from early infancy if their mothers' vitamin B12 status and intake are poor during pregnancy and lactation. Even in the United States, more than 20% of the elderly have serum vitamin B12 concentrations that indicate depletion, and an additional 6% have deficiency, primarily due to gastric atrophy, which impairs the absorption of the vitamin from food but usually not from supplements or fortified foods. Although the evidence is limited, it shows that fortified flour, consumed as bread, can improve vitamin B12 status. Where vitamin B12 fortification is implemented, the recommendation is to add 20 μg/kg flour, assuming consumption of 75 to 100 g flour per day, to provide 75% to 100% of the Estimated Average Requirement; the amount of the vitamin that can be added is limited by its cost. The effectiveness of this level of addition for improving vitamin B12 status in programs needs to be determined and monitored. In addition, further research should evaluate the bioavailability of the vitamin from fortified flour by elderly people with food cobalamin malabsorption and gastric atrophy.
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Gao L, Weck MN, Stegmaier C, Rothenbacher D, Brenner H. Alcohol consumption and chronic atrophic gastritis: population-based study among 9,444 older adults from Germany. Int J Cancer 2009; 125:2918-22. [PMID: 19637315 DOI: 10.1002/ijc.24618] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Moderate alcohol consumption has been suggested to facilitate elimination of Helicobacter pylori infection which is a key risk factor for chronic atrophic gastritis (CAG) and gastric cancer. The aim of our study was to assess the association of alcohol consumption with CAG among older adults from Germany. In the baseline examination of ESTHER, a population-based study conducted in Saarland, serological measurements of pepsinogen I and II (for CAG definition) and H. pylori antibodies were taken in 9,444 subjects aged 50-74 years. Moderate current (<60 g/week) and lifetime (<or=51,376 g, lowest quartile) alcohol consumption were found to be associated with significantly reduced CAG risk compared to alcohol abstinence with adjusted odds ratios of 0.71 (0.55-0.90) and 0.73 (0.55-0.96), respectively. Inverse associations with CAG were observed for moderate alcohol consumption from both beer and wine, and were slightly attenuated after additional adjustment for H. pylori infection. Our results are consistent with the hypothesis that moderate alcohol consumption may be inversely related to CAG, partly through facilitating the elimination of H. pylori. However, the observed patterns suggest that other mechanisms are likely to contribute to the association as well.
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Affiliation(s)
- Lei Gao
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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Bossenmeyer-Pourié C, Blaise S, Pourié G, Tomasetto C, Audonnet S, Ortiou S, Koziel V, Rio MC, Daval JL, Guéant JL, Beck B. Methyl donor deficiency affects fetal programming of gastric ghrelin cell organization and function in the rat. THE AMERICAN JOURNAL OF PATHOLOGY 2009; 176:270-7. [PMID: 19948829 DOI: 10.2353/ajpath.2010.090153] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Methyl donor deficiency (MDD) during pregnancy influences intrauterine development. Ghrelin is expressed in the stomach of fetuses and influences fetal growth, but MDD influence on gastric ghrelin is unknown. We examined the gastric ghrelin system in MDD-induced intrauterine growth retardation. By using specific markers and approaches (such as periodic acid-Schiff, bromodeoxyuridine, homocysteine, terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling, immunostaining, reverse transcription-polymerase chain reaction), we studied the gastric oxyntic mucosa cellular organization and ghrelin gene expression in the mucosa in 20-day-old fetuses and weanling pups, and plasma ghrelin concentration in weanling rat pups of dams either normally fed or deprived of choline, folate, vitamin B6, and vitamin B12 during gestation and suckling periods. MDD fetuses weighed less than controls; the weight deficit reached 57% at weaning (P < 0.001). Both at the end of gestation and at weaning, they presented with an aberrant gastric oxyntic mucosa formation with loss of cell polarity, anarchic cell migration, abnormal progenitor differentiation, apoptosis, and signs of surface layer erosion. Ghrelin cells were abnormally located in the pit region of oxyntic glands. At weaning, plasma ghrelin levels were decreased (-28%; P < 0.001) despite unchanged mRNA expression in the stomach. This decrease was associated with lower body weight. Taken together, these data indicate that one mechanism through which MDD influences fetal programming is the remodeling of gastric cellular organization, leading to dysfunction of the ghrelin system and dramatic effects on growth.
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Affiliation(s)
- Carine Bossenmeyer-Pourié
- INSERM U954, Nutrition, Génétique et Expositions aux Risques Environnementaux, 54505 Vandoeuvre Cedex, France
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Influence of the MTHFR C677T polymorphism on magnetic resonance imaging hyperintensity volume and cognition in geriatric depression. Am J Geriatr Psychiatry 2009; 17:847-55. [PMID: 19910873 PMCID: PMC2805265 DOI: 10.1097/jgp.0b013e3181aad5b2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The 5,10-methylenetetrahydrofolate reductase gene (MTHFR) has been linked to unipolar major depressive disorder (MDD) and magnetic resonance imaging (MRI) hyperintensities. The authors examined the relationship between the MTHFR C677T polymorphism (C677T) and a) geriatric depression, b) MRI hyperintense lesion volume, and c) neurocognitive test performance. DESIGN Cross-sectional. SETTING Duke University Medical Center. PARTICIPANTS Depressed (N = 178) and comparison (N = 85) elderly subjects. MEASUREMENTS Subjects had blood drawn to assess MTHFR genotype, were imaged by MRI to determine their white matter hyperintense lesion (WML) and gray matter hyperintense lesion (GML) volume, and assessed using a comprehensive neurocognitive battery evaluating multiple domains of function. Linear regression models were fit to test the effect of genotype, a depression by genotype interaction, and an age by genotype interaction on both hyperintense lesion volume measures and neurocognitive task performance. RESULTS The MTHFR C677T genotype by age interaction term was significantly associated with MRI WML volume (p = 0.0175); however, this relationship was no longer statistically significant when WML volumes underwent a log transformation to produce a more normal distribution. The 677T allele was neither more frequent in depressed subjects nor associated with either gray matter hyperintensity volume or neurocognitive test performance. CONCLUSIONS MTHFR genotype affects the relationship between age and WML volume where individuals who carry the 677T allele exhibit greater WML volume by age, although this relationship should be verified given the failure to replicate the finding using transformed WML volumes. Genotype was not related to GML volume, cognitive function, or presence of depression, although demographic differences could account for this negative finding.
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