1
|
Tang Y, Zhou X, Cao J, Li Z, Yin W, Wan K, Huang C, Zhu W, Yin J, Zhang W, Zhu X, Sun Z. Synergistic effect of folate and MTHFR C677T on hippocampal subfields and perfusion in Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111071. [PMID: 38908503 DOI: 10.1016/j.pnpbp.2024.111071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/09/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Low folate intake and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism have been suggested to increase the risk of Alzheimer's disease (AD). However, the synergistic effects and their impact on brain structure and perfusion remain unclear. METHODS This study explored the effects of dietary and genetic deficiencies in folate metabolism on the volume of the hippocampal subregions, cerebral perfusion, and cognitive decline in 71 cognitively unimpaired (CU) individuals and 102 patients with mild cognitive impairment (MCI) due to AD or AD. All participants underwent magnetic resonance imaging, laboratory examinations, and neuropsychological assessments. The hippocampal subfields were segmented using Freesurfer, and arterial spin labeling was used to measure the cerebral blood flow. RESULTS We found a significant group-by-MTHFR interaction effect on folate. Patients with AD and the 677 T allele showed hypoperfusion in the left precuneus compared to patients without this mutation, which mediated the relationship between low folate level and cognitive decline in patients carrying the 677 T allele. Moreover, a synergistic effect was observed for the combination of decreased folate concentrations and the presence of the MTHFR 677 T allele on the atrophy of specific hippocampal subregions in patients with AD. CONCLUSIONS In addition to offering insights into the neuronal mechanism underlying gene-dependent folate-induced cognitive impairment in AD, these findings may have clinical significance for the allocation of auxiliary folate supplementation therapy in patients with AD with low folate levels and carrying the MTHFR 677 T allele and may eventually promote the selection of early individualized AD drug therapy.
Collapse
Affiliation(s)
- Yating Tang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xia Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Jing Cao
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Zhiwei Li
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wenwen Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Ke Wan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Chaojuan Huang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wenhao Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Jiabin Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wei Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xiaoqun Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Zhongwu Sun
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| |
Collapse
|
2
|
Zhao Q, Lv X, Liu Q, Hu Z, Zhan Y. Association between serum folate concentrations and all-cause mortality in U.S. adults: a cohort study based on National Health and Nutrition Examination Survey III. Front Nutr 2024; 11:1408023. [PMID: 39055385 PMCID: PMC11270589 DOI: 10.3389/fnut.2024.1408023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
The association between serum folate and all-cause mortality in general population remains unclear. The objective of this study was to investigate the potential association between serum folate concentrations and all-cause mortality in a large, prospective, long-term U.S. cohort. Our study included adults from the National Health and Nutrition Examination Survey (NHANES) III, and mortality data was obtained by linking with the National Death Index (NDI) until December 31, 2019. Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) to assess the association between serum folate concentrations and all-cause mortality. A total of 12,862 participants were included in this cohort study. After a median follow-up of 26.4 years [interquartile range (IQR), 15.4-28.7 years], a total of 5,299 deaths were recorded. The risk of death was lower by 12% per 1.0 g/L increase in log-transformed serum folate concentrations (HR, 0.88; 95% CI, 0.83-0.94). Compared with the lowest quartiles of serum folate level, the risk of death was lower in the second (HR, 0.84; 95% CI, 0.72-0.97), third (HR, 0.78; 95% CI, 0.68-0.91) and the highest quartiles (HR, 0.78; 95% CI, 0.69-0.88) in multivariable-adjusted model. In subgroup analyses, the inverse association between serum folate and all-cause mortality remained statistically significant for women, men and non-Hispanic White people. Higher serum folate levels were found to be significantly associated with reduced risk of all-cause mortality. However, further studies are needed to verify these findings and explore the underlying mechanism.
Collapse
Affiliation(s)
- Qingya Zhao
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xiaogang Lv
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Qi Liu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
3
|
Fallah M, Karim Dehnavi M, Lotfi K, Aminianfar A, Azadbakht L, Esmaillzadeh A. Folate Biomarkers, Folate Intake, and Risk of Death From All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Nutr Rev 2024:nuae077. [PMID: 38950416 DOI: 10.1093/nutrit/nuae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
CONTEXT Existing evidence on the relation between folate intake and biomarkers with mortality risk is controversial. OBJECTIVE Previous cohort studies were examined regarding folate intake and biomarkers in relation to risk of all-cause, cardiovascular disease- (CVD), and cancer-related mortality through a systematic review and meta-analysis. DATA SOURCES A systematic search was performed of the PubMed, Scopus, and ISI Web of Science databases up to July 2023. DATA EXTRACTION Prospective cohort studies examining the association of folate biomarkers (in serum, plasma, red blood cells) and intake with risk of all-cause, CVD-, and cancer-related mortality were considered. A random-effects model was applied to combine study-specific risk estimates. Dose-response relations were assessed by 1-stage weighted mixed-effects meta-analysis. DATA ANALYSIS A total of 25 cohorts with 423 304 participants, 36 558 all-cause, 12 662 CVD-, and 2426 cancer-related deaths were included. No significant association was observed between the highest levels of folate biomarkers and all-cause mortality risk (hazard ratio [HR], 0.91; 95% CI, 0.77-1.06; n = 17; I2 = 89.4%; P < .001), CVD-related mortality risk (HR, 0.97; 95% CI, 0.87-1.06; n = 11; I2 = 0.0%; P = .57), and cancer-related mortality risk (HR, 0.85; 95% CI, 0.69-1.05; n = 6; I2 = 57.8%; P = .04) compared with the lowest. Furthermore, each 10 nmol/L increase was marginally related to a 12% reduced all-cause mortality risk but not to CVD- and cancer-related mortality risk. A significant inverse association was found between highest intake of dietary folate and the lowest, and risk of all-cause (HR, 0.87; 95% CI, 0.78-0.96; n = 3; I2 = 63.6%; P = .06) and CVD (HR, 0.77; 95% CI, 0.57-0.93; n = 4; I2 = 80.2%; P = .002) mortality. CONCLUSIONS This meta-analysis revealed a significant inverse relation between dietary folate intake and risk of all-cause and CVD mortality. Such an association was not found in the case of folate biomarkers. Further prospective studies are warranted to confirm these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42023401700.
Collapse
Affiliation(s)
- Melika Fallah
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Maryam Karim Dehnavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Azadeh Aminianfar
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Diabetes Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, 81745, Iran
| |
Collapse
|
4
|
Pu S, Xu Y, Tong X, Zhang Y, Sun X, Gao X. Correlation of dietary inflammation index and dietary pattern with mild cognitive impairment in patients with type 2 diabetes. ENDOCRINOL DIAB NUTR 2024; 71:152-162. [PMID: 38735677 DOI: 10.1016/j.endien.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE We aimed to determine the dietary patterns associated with mild cognitive impairment (MCI) in type 2 diabetes (T2DM) and the correlation of dietary inflammatory index (DII) with MCI. METHODS The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. A semi-quantitative food frequency questionnaire was used to collect dietary data and calculate DII. Dietary patterns were determined by reduced-rank regression (RRR), grouping dietary pattern scores and DII into quartiles, with logistic regression for correlation analysis. Dose-response relationships between dietary pattern scores, DII and diabetic MCI were explored using restricted cubic splines (RCS). A mediation analysis was performed to investigate whether DII mediates the association between dietary patterns and MCI. RESULTS In the "Mediterranean-style dietary pattern", the multivariable-adjusted odds ratio of having MCI was 0.37 (95% CI: 0.20-0.68; p for trend=0.002) in the highest versus lowest quartiles of the dietary score. In the "high-meat and low-vegetable pattern", the multivariable-adjusted odds ratio of having MCI was 6.84 (95% CI: 3.58-13.10; p for trend<0.001) in the highest versus lowest quartiles of the dietary score. In the "Western-style dietary pattern", the multivariable-adjusted odds ratio of having MCI was 2.48 (95% CI: 1.38-4.46; p for trend=0.001). The multivariable-adjusted odds ratio of having MCI was 3.99 (95% CI: 2.14-7.42; p for trend<0.001) in the highest versus lowest quartiles of DII. There is a non-linear dose-response relationship between the "high-meat and low-vegetable pattern" score and the prevalence of MCI, as well as the DII and the prevalence of MCI. The DII partially mediated the impact of the "Mediterranean-style dietary pattern" and the "high-meat and low-vegetable pattern" on MCI. CONCLUSION In T2DM patients, greater adherence to the "Mediterranean-style dietary pattern" is associated with a lower probability of having MCI. However, excessive consumption of meat, especially red meat and processed meat, combined with a lack of vegetable intake, is associated with a higher probability of having MCI. Greater adherence to the "Western-style dietary pattern" is associated with a higher probability of having MCI. In addition, a pro-inflammatory diet is associated with a higher probability of having MCI, and DII partially mediates the impact of dietary patterns on MCI.
Collapse
Affiliation(s)
- Shengdan Pu
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Yuxin Xu
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xuewei Tong
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Yitong Zhang
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xiaotong Sun
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xinyuan Gao
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
| |
Collapse
|
5
|
Mashayekhi F, Hadipour E, Shabani S, Salehi Z. Folate receptor alpha autoantibodies in the serum of patients with relapsing-remitting multiple sclerosis (RRMS). Clin Neurol Neurosurg 2024; 237:108161. [PMID: 38325038 DOI: 10.1016/j.clineuro.2024.108161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a potentially progressive, autoimmune neurologic disorder of the central nervous system (CNS), resulting from an autoimmune attack on central nervous system white matter. Folate deficiencies are linked to DNA instability and breakdown of phospholipid membranes and thus might affect myelin integrity. Folic acid exerts its effects through its receptors (FRs). Folate receptor alpha autoantibodies (FRAA) can block folate transport to the brain. Due to important role of folate in the pathogenesis of MS, in this project we aimed to study FRAA serum levels in patients with relapsing remitting multiple sclerosis (RRMS). METHODS Fifty-four patients with RRMS and 58 healthy individuals were enrolled in this study. Serum samples were collected from all participants and folate receptor alpha autoantibody (FRAA) serum concentration was measured by Enzyme-linked immunosorbent assay (ELISA). RESULTS The results showed that FRAA serum levels in patients with RRMS is 67.20 ± 19.79 ng/ml as compared to controls which was 37.32 ± 13.26 ng/ml. Significant increase in folate receptor autoantibody serum concentration was seen in patients with RRMS when compared to control group (P = 0.007). The results showed that a high concentration of folate receptor autoantibody is associated with RRMS. We have also found that 85.18% (46/54) of patients with RRMS were positive for serum FRAA, whereas the prevalence in controls was only 46.55% (27/58). CONCLUSIONS It is concluded that serum FRAA are more prevalent in RRMS patients than controls. The findings also suggest that FRAA might be involved in the pathophysiology of RRMS.
Collapse
Affiliation(s)
- Farhad Mashayekhi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
| | - Elham Hadipour
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Somayeh Shabani
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Zivar Salehi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| |
Collapse
|
6
|
Novo-Veleiro I, Mateos-Díaz AM, Rosón-Hernández B, Medina-García JA, Muga R, Fernández-Solá J, Martín-González MC, Seco-Hernández E, Suárez-Cuervo C, Monte-Secades R, Machado-Prieto B, Puerta-Louro R, Prada-González C, Fernández-Rial Á, Sabio-Repiso P, Vázquez-Vigo R, Antolí-Royo AC, Gomila-Grange A, Felipe-Pérez NC, Sanvisens-Bergé A, Antúnez-Jorge E, Fernández-Rodríguez CM, Alvela-Suárez L, Fidalgo-Navarro A, Castro J, Polvorosa-Gómez MA, Valle-Sánchez MD, López-Castro J, Chamorro AJ, Marcos M. Treatment variability and its relationships to outcomes among patients with Wernicke's encephalopathy: A multicenter retrospective study. Drug Alcohol Depend 2023; 252:110961. [PMID: 37748425 DOI: 10.1016/j.drugalcdep.2023.110961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/09/2023] [Accepted: 09/01/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Despite guidelines and recommendations, Wernicke's encephalopathy (WE) treatment lacks evidence, leading to clinical practice variability. AIMS Given the overall lack of information on thiamine use for WE treatment, we analyzed data from a large, well-characterized multicenter sample of patients with WE, examining thiamine dosages; factors associated with the use of different doses, frequencies, and routes; and the influence of differences in thiamine treatment on the outcome. METHODS This retrospective study was conducted with data from 443 patients from 21 centers obtained from a nationwide registry of the Spanish Society of Internal Medicine (from 2000 to 2012). Discharge codes and Caine criteria were applied for WE diagnosis, and treatment-related (thiamine dosage, frequency, and route of administration) demographic, clinical, and outcome variables were analyzed. RESULTS We found marked variability in WE treatment and a low rate of high-dose intravenous thiamine administration. Seventy-eight patients out of 373 (20.9%) received > 300mg/day of thiamine as initial dose. Patients fulfilling the Caine criteria or presenting with the classic WE triad more frequently received parenteral treatment. Delayed diagnosis (after 24h hospitalization), the fulfillment of more than two Caine criteria at diagnosis, mental status alterations, and folic acid deficiency were associated significantly with the lack of complete recovery. Malnutrition, reduced consciousness, folic acid deficiency, and the lack of timely thiamine treatment were risk factors for mortality. CONCLUSIONS Our results clearly show extreme variability in thiamine dosages and routes used in the management of WE. Measures should be implemented to ensure adherence to current guidelines and to correct potential nutritional deficits in patients with alcohol use disorders or other risk factors for WE.
Collapse
Affiliation(s)
- Ignacio Novo-Veleiro
- Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
| | - Ana-M Mateos-Díaz
- Department of Internal Medicine, Hospital Universitario de Salamanca-IBSAL, University of Salamanca, Salamanca, Spain; Department of Internal Medicine, Hospital Virgen del Puerto, Plasencia, Cáceres, Spain.
| | | | | | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona. Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | | | - Elena Seco-Hernández
- Department of Internal Medicine, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
| | | | - Rafael Monte-Secades
- Department of Internal Medicine, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Begoña Machado-Prieto
- Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
| | | | | | | | | | - Rocío Vázquez-Vigo
- Department of Internal Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - Ana-C Antolí-Royo
- Department of Internal Medicine, Complejo Asistencial de Ávila, Ávila, Spain.
| | | | | | - Arantza Sanvisens-Bergé
- Epidemiology Unit and Girona Cancer Registry, Institut Català d'Oncologia, Pla Director d'Oncologia, Girona, Spain.
| | | | | | - Lucia Alvela-Suárez
- Department of Internal Medicine, HM Rosaleda Hospital, Santiago de Compostela, A Coruña, Spain.
| | | | | | | | | | | | - Antonio-J Chamorro
- Department of Internal Medicine, Hospital Universitario de Salamanca-IBSAL, University of Salamanca, Salamanca, Spain.
| | - Miguel Marcos
- Department of Internal Medicine, Hospital Universitario de Salamanca-IBSAL, University of Salamanca, Salamanca, Spain.
| |
Collapse
|
7
|
Plascencia-Villa G, Perry G. Roles of Oxidative Stress in Synaptic Dysfunction and Neuronal Cell Death in Alzheimer's Disease. Antioxidants (Basel) 2023; 12:1628. [PMID: 37627623 PMCID: PMC10451948 DOI: 10.3390/antiox12081628] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Alzheimer's disease (AD) is a brain disorder that progressively undermines memory and thinking skills by affecting the hippocampus and entorhinal cortex. The main histopathological hallmarks of AD are the presence of abnormal protein aggregates (Aβ and tau), synaptic dysfunction, aberrant proteostasis, cytoskeletal abnormalities, altered energy homeostasis, DNA and RNA defects, inflammation, and neuronal cell death. However, oxidative stress or oxidative damage is also evident and commonly overlooked or considered a consequence of the advancement of dementia symptoms. The control or onset of oxidative stress is linked to the activity of the amyloid-β peptide, which may serve as both antioxidant and pro-oxidant molecules. Furthermore, oxidative stress is correlated with oxidative damage to proteins, nucleic acids, and lipids in vulnerable cell populations, which ultimately lead to neuronal death through different molecular mechanisms. By recognizing oxidative stress as an integral feature of AD, alternative therapeutic or preventive interventions are developed and tested as potential or complementary therapies for this devastating neurodegenerative disease.
Collapse
Affiliation(s)
- Germán Plascencia-Villa
- Department of Neuroscience, Developmental and Regenerative Biology, The University of Texas at San Antonio (UTSA), San Antonio, TX 78249, USA;
| | | |
Collapse
|
8
|
Kaya A, Alkan A, Toluk O, Ipar O, Polat YB, Celik Yabul F, Balsak S, Soysal P. Evaluation of white matter integrity by diffusion tensor imaging in the deficiencies of vitamin B12 and folate in older patients. Br J Radiol 2023; 96:20220415. [PMID: 37335177 PMCID: PMC10392645 DOI: 10.1259/bjr.20220415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/03/2022] [Accepted: 01/10/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES The aim of this study is to investigate whether white matter (WM) integrity is impaired in vitamin B12 and folate deficiency with Diffusion Tensor Imaging (DTI) in older patients. METHODS All the patients aged ≥65 years admitted to the geriatric clinic and performed DTI-MRI were included in the study. DTI parameters (fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity) were calculated by ROI-based method in white matter tracts. Deficiency threshold for vitamin B12 were defined as <200 pg ml-1 and <400 pg ml-1 separately; and for folate as <3 ng ml-1 and <6 ng ml-1, separately. RESULTS DTI was performed to older patients having serum vitamin B12 level (n = 106, mean age = 80.7±7.7, 66% female) and folate level (n = 101, mean age = 80.7±7.5, 67.3% female). Significantly lower FA and higher MD and RD levels were observed in multiple WM areas including superior and middle cerebellar peduncles, cingulum and genu of corpus callosum in patients with vitamin B12 <400 pg ml-1 (p < 0.05). DTI indices also showed significant changes in the genu of corpus callosum, and right and left superior longitudinal fasciculus in patients with folate <6 ng ml-1 (p < 0.05). CONCLUSIONS Deficiencies of vitamin B12 and folate may be associated with impaired white matter integrity in elderly even at high laboratory levels, and DTI is a useful method to detect it. ADVANCES IN KNOWLEDGE Early detection of impaired WM integrity caused by micronutrient deficiencies poses a great significance in terms of prevention and intervention, and DTI is an effective non-invasive method to be used for this purpose.
Collapse
Affiliation(s)
- Ahmet Kaya
- Department of Radiology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
| | - Alpay Alkan
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozlem Toluk
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozlem Ipar
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Yagmur Basak Polat
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Fatma Celik Yabul
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Serdar Balsak
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
9
|
Myers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs. Nutrients 2023; 15:2657. [PMID: 37375561 DOI: 10.3390/nu15122657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.
Collapse
|
10
|
Xu J, Zhu X, Guan G, Zhang Y, Hui R, Xing Y, Wang J, Zhu L. Non-linear associations of serum and red blood cell folate with risk of cardiovascular and all-cause mortality in hypertensive adults. Hypertens Res 2023:10.1038/s41440-023-01249-3. [PMID: 36899181 DOI: 10.1038/s41440-023-01249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/12/2023]
Abstract
This study aims to assess the associations of serum and red blood cell (RBC) folate with cardiovascular and all-cause mortality in hypertensive adults. Data on serum and RBC folate from the 1999-2014 National Health and Nutrition Examination Survey were included. Through December 31, 2015, cardiovascular and all-cause mortality were identified from the National Death Index. Multiple Cox regression and restricted cubic spline analyses were used to determine the relationship between folate concentrations and outcomes. A total of 13,986 hypertensive adults were included in the analysis (mean age, 58.5 ± 16.1 years; 6898 [49.3%] men). At a median of 7.0 years of follow-up, 548 cardiovascular deaths and 2726 all-cause deaths were identified. After multivariable adjustment, the fourth quartile of serum folate was associated with cardiovascular (HR = 1.32 [1.02-1.70]) and all-cause (HR = 1.20 [1.07-1.35]) mortality compared to the second quartile, whereas the first quartile was only linked with increased all-cause (HR = 1.29 [1.15-1.46]) mortality. The inflection points for the non-linear associations of serum folate with cardiovascular and all-cause mortality were 12.3 ng/mL and 20.5 ng/mL, respectively. In addition, the highest quartile of RBC folate was associated with cardiovascular (HR = 1.68 [1.30-2.16]) and all-cause (HR = 1.30 [1.16-1.46]) mortality compared to the second quartile, but the lowest quartile was not associated with either outcome. The inflection points for the non-linear associations of RBC folate with cardiovascular and all-cause mortality were 819.7 and 760.1 ng/mL, respectively. The findings suggest non-linear associations between serum and RBC folate levels and the risk of cardiovascular and all-cause mortality in hypertensive adults.
Collapse
Affiliation(s)
- Jing Xu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China
| | - Xu Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Gongchang Guan
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China
| | - Yong Zhang
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China
| | - Rutai Hui
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Yujie Xing
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China.
| | - Junkui Wang
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China.
| | - Ling Zhu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710000, China. .,Department of Cardiology, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710000, China.
| |
Collapse
|
11
|
Song S, Song BM, Park HY. Associations of Serum Folate and Homocysteine Concentrations with All-Cause, Cardiovascular Disease, and Cancer Mortality in Men and Women in Korea: the Cardiovascular Disease Association Study. J Nutr 2023; 153:760-770. [PMID: 36792392 DOI: 10.1016/j.tjnut.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/11/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Evidence on the association of serum folate and homocysteine concentrations with risk of mortality in the general population is unclear. OBJECTIVES This study aimed to examine the associations of serum folate and homocysteine concentrations with all-cause, CVD, and cancer mortality risk in Korean men and women aged ≥40 y. METHODS In this population-based prospective cohort study, serum folate and homocysteine concentrations were measured in a subset of participants enrolled between 2005 and 2012. A total of 21,260 participants were linked to mortality data from the survey date to 31 December 2019. Cox proportional hazards models and restricted cubic splines were used to identify the associations of serum folate and homocysteine concentrations with mortality. RESULTS During a median follow-up of 12.3 y, 2501, 549, and 842 deaths were attributed to all-cause, CVD, and cancer, respectively. The prevalence of folate deficiency and hyperhomocysteinemia were higher in men than in women. In men, a nonlinear inverse association was observed between serum folate concentrations and all-cause mortality. Men in the third quartile of serum folate concentrations exhibited a lower risk of all-cause mortality (HR: 0.85; 95% CI: 0.73, 0.99) than those in the lowest quartile. Serum homocysteine concentration was positively associated with all-cause and CVD mortality. Men and women in the highest compared with those in the lowest serum homocysteine quartile showed a higher risk of CVD mortality (HR: 1.60; 95% CI: 1.07, 2.39; and HR: 1.79; 95% CI: 1.11, 2.89, respectively). Hyperhomocysteinemia combined with folate deficiency was associated with increased all-cause, CVD, and cancer-related mortality rates. CONCLUSIONS Higher serum homocysteine and lower serum folate concentrations were associated with an increased risk of all-cause, CVD, and cancer-related mortality in Korean adults. The finding of a nonlinear inverse relationship between serum folate concentration and mortality in men warrants further investigation.
Collapse
Affiliation(s)
- Sihan Song
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Bo Mi Song
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Cheongju, Republic of Korea.
| |
Collapse
|
12
|
Zheng J, Wu F, Wang F, Cheng J, Zou H, Li Y, Du J, Kan J. Biomarkers of Micronutrients and Phytonutrients and Their Application in Epidemiological Studies. Nutrients 2023; 15:nu15040970. [PMID: 36839326 PMCID: PMC9959711 DOI: 10.3390/nu15040970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/21/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Nutritional biomarkers can be used as important indicators of nutritional status and play crucial roles in the prevention as well as prognosis optimization of various metabolism-related diseases. Measuring dietary with the deployment of biomarker assessments provides quantitative nutritional information that can better predict the health outcomes. With the increased availability of nutritional biomarkers and the development of assessment tools, the specificity and sensitivity of nutritional biomarkers have been greatly improved. This enables efficient disease surveillance in nutrition research. A wide range of biomarkers have been used in different types of studies, including clinical trials, observational studies, and qualitative studies, to reflect the relationship between diet and health. Through a comprehensive literature search, we reviewed the well-established nutritional biomarkers of vitamins, minerals, and phytonutrients, and their association with epidemiological studies, to better understand the role of nutrition in health and disease.
Collapse
Affiliation(s)
- Jianheng Zheng
- Nutrilite Health Institute, 720 Cailun Road, Shanghai 201203, China
| | - Feng Wu
- Sequanta Technologies Co., Ltd., 240 Hedan Road, Shanghai 200131, China
| | - Feijie Wang
- Nutrilite Health Institute, 720 Cailun Road, Shanghai 201203, China
| | - Junrui Cheng
- Department of Molecular and Structural Biochemistry, North Carolina State University, Raleigh, NC 27695, USA
| | - Hong Zou
- Sequanta Technologies Co., Ltd., 240 Hedan Road, Shanghai 200131, China
| | - Yuan Li
- Sequanta Technologies Co., Ltd., 240 Hedan Road, Shanghai 200131, China
| | - Jun Du
- Nutrilite Health Institute, 720 Cailun Road, Shanghai 201203, China
| | - Juntao Kan
- Nutrilite Health Institute, 720 Cailun Road, Shanghai 201203, China
- Correspondence: ; Tel.: +86-21-2305-6982
| |
Collapse
|
13
|
Martínez-Iglesias O, Naidoo V, Carrera I, Corzo L, Cacabelos R. Natural Bioactive Products as Epigenetic Modulators for Treating Neurodegenerative Disorders. Pharmaceuticals (Basel) 2023; 16:216. [PMID: 37259364 PMCID: PMC9967112 DOI: 10.3390/ph16020216] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 08/27/2023] Open
Abstract
Neurodegenerative disorders (NDDs) are major health issues in Western countries. Despite significant efforts, no effective therapeutics for NDDs exist. Several drugs that target epigenetic mechanisms (epidrugs) have been recently developed for the treatment of NDDs, and several of these are currently being tested in clinical trials. Furthermore, various bioproducts have shown important biological effects for the potential prevention and treatment of these disorders. Here, we review the use of natural products as epidrugs to treat NDDs in order to explore the epigenetic effects and benefits of functional foods and natural bioproducts on neurodegeneration.
Collapse
Affiliation(s)
- Olaia Martínez-Iglesias
- EuroEspes Biomedical Research Center, International Center of Neuroscience and Genomic Medicine, 15165 Bergondo, Corunna, Spain
| | | | | | | | | |
Collapse
|