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Mbs GBY, Wasek B, Bottiglieri T, Malysheva O, Caudill MA, Jadavji NM. Dietary vitamin B12 deficiency impairs motor function and changes neuronal survival and choline metabolism after ischemic stroke in middle-aged male and female mice. Nutr Neurosci 2024; 27:300-309. [PMID: 36932327 DOI: 10.1080/1028415x.2023.2188639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Nutrition is a modifiable risk factor for ischemic stroke. As people age their ability to absorb some nutrients decreases, a primary example is vitamin B12. Older individuals with a vitamin B12 deficiency are at a higher risk for ischemic stroke and have worse stroke outcome. However, the mechanisms through which these occur remain unknown. The aim of the study was to investigate the role of vitamin B12 deficiency in ischemic stroke outcome and mechanistic changes in a mouse model. Ten-month-old male and female mice were put on control or vitamin B12 deficient diets for 4 weeks prior to and after ischemic stroke to the sensorimotor cortex. Motor function was measured, and tissues were collected to assess potential mechanisms. All deficient mice had increased levels of total homocysteine in plasma and liver tissues. After ischemic stroke, deficient mice had impaired motor function compared to control mice. There was no difference between groups in ischemic damage volume. However, within the ischemic damage region, there was an increase in total apoptosis of male deficient mice compared to controls. Furthermore, there was an increase in neuronal survival in ischemic brain tissue of the vitamin B12 deficient mice compared to controls. Additionally, there were changes in choline metabolites in ischemic brain tissue because of a vitamin B12 deficiency. The data presented in this study confirms that a vitamin B12 deficiency worsens stroke outcome in male and female mice. The mechanisms driving this change may be a result of neuronal survival and compensation in choline metabolism within the damaged brain tissue.
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Affiliation(s)
- Gyllian B Yahn Mbs
- Department of Biomedical Sciences, Midwestern University, Glendale, AZ, USA
| | - Brandi Wasek
- Center of Metabolomics, Institute of Metabolic Disease, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Teodoro Bottiglieri
- Center of Metabolomics, Institute of Metabolic Disease, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Olga Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Nafisa M Jadavji
- Department of Biomedical Sciences, Midwestern University, Glendale, AZ, USA
- College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA
- College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
- Department of Neuroscience, Carleton University, Ottawa, Canada
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Avnon T, Anbar R, Yogev Y. Reply to: "Letter to the Editor to: Does vegan diet influence umbilical cord vitamin B12, folate, and ferritin levels?". Arch Gynecol Obstet 2023; 308:1897-1898. [PMID: 34982176 DOI: 10.1007/s00404-021-06314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/25/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Tomer Avnon
- Department of Obstetrics and Gynecology, Lis Maternity & Women's Hospital, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Ronit Anbar
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- School of Nutritional Sciences, The Robert H Smith Faculty of Agriculture, Food and Environmental Quality Sciences, Hebrew University, Jerusalem, Israel
| | - Yariv Yogev
- Department of Obstetrics and Gynecology, Lis Maternity & Women's Hospital, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Yadav A, Jyoti S, Mehta RK, Parajuli SB. Vitamin B12 Deficiency among Metformin Treated Type 2 Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:861-863. [PMID: 38289733 PMCID: PMC10725234 DOI: 10.31729/jnma.8340] [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: 11/01/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction About 424.9 million people worldwide are affected by Diabetes mellitus. Prevalence among people 20-79 years old in Nepal was 4% in 2017. It is associated with microvascular and macrovascular complications such as peripheral neuropathy leading to risk of foot ulcers and amputation, and impaired sensation in their feet. The study aimed to find the prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients visiting the Department of Medicine of a tertiary care centre. Methods A descriptive cross-sectional study was conducted in a tertiary care centre between 24 May 2021 to 24 May 2022 after obtaining ethical approval from the Institutional Review Committee. Patients who visited the Department of Medicine and gave informed consent were included in the study. Patients with underlying comorbidities were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 330 patients, vitamin B12 deficiency was seen in 33 (10%) (6.76-13.24, 95% Confidence Interval). Among them, 27 (81.82%) were male and 6 (18.18%) were female. Conclusions The prevalence of vitamin B12 deficiency was found to be higher than other studies done in similar settings. Keywords diabetic neuropathy; metformin; type 2 diabetes; vitamin B12.
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Affiliation(s)
- Anil Yadav
- Department of Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
| | - Sabita Jyoti
- Department of Community Medicine, Nepalgunj Medical College, Nepalgunj, Banke
| | - Ram Kumar Mehta
- Department of Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
| | - Surya Bahadur Parajuli
- Department of Community Medicine, Birat Medical College Teaching Hospital, Biratnagar, Morang, Nepal
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Repić A, Vukelić D, Andjelković M, Buha Djordjević A, Lukić V, Savić O, Mandić-Rajčević S, Antonijević B, Bulat P, Bulat Z. Individual, sociodemographic, and lifestyle influence on blood chromium, cobalt, and nickel levels in healthy population living in Belgrade, Serbia. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:109546-109558. [PMID: 37924173 DOI: 10.1007/s11356-023-29950-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/14/2023] [Indexed: 11/06/2023]
Abstract
The rapid trend of industrialization and urbanization can lead to greater exposure of the general population to chromium, cobalt, and nickel. Their total body burden from all routes of recent exposure, as well as interindividual variability in exposure levels, metabolism, and excretion rates, are reflected in the blood metal concentrations. The main goals in this study were as follows: observing the reference levels of chromium, cobalt, and nickel in the blood of the population living in Belgrade, identification of individual and sociodemographic factors that most affect their blood levels, and comprehension of recent exposure to chromium, cobalt, and nickel. Blood was sampled from 984 participants, voluntary blood donors, who agreed to participate in this study. Individual and sociodemographic data were collected using questionnaire adapted for different subpopulations. Blood metal analyses were measured using ICP-MS method (7700×, Agilent, USA). Our study provided reference values of chromium, cobalt, and nickel in blood for adult population (18-65 years) and confirmed that blood cobalt and nickel levels were mostly influenced by age and gender, and age, respectively. Furthermore, weight status affected blood chromium and cobalt levels, while national origin affected blood chromium levels. The present study highlighted the importance of human biomonitoring studies to monitor exposure status and identify subpopulations with increased exposure to chromium, cobalt, and nickel.
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Affiliation(s)
- Aleksandra Repić
- Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, 31a Deligradska Street, Belgrade, 11000, Serbia.
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia.
| | - Dragana Vukelić
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia
| | - Milena Andjelković
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia
| | - Aleksandra Buha Djordjević
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia
| | - Vera Lukić
- Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, 31a Deligradska Street, Belgrade, 11000, Serbia
| | - Olivera Savić
- Blood Transfusion Institute of Serbia, 39 Sveti Sava Street, Belgrade, 11000, Serbia
| | - Stefan Mandić-Rajčević
- Faculty of Medicine, University of Belgrade, 8 Dr Subotić stariji Street, Belgrade, 11000, Serbia
| | - Biljana Antonijević
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia
| | - Petar Bulat
- Faculty of Medicine, University of Belgrade, 8 Dr Subotić stariji Street, Belgrade, 11000, Serbia
- Serbian Institute of Occupational Health "Dr Dragomir Karajović", 29 Deligradska Street, Belgrade, 11000, Serbia
| | - Zorica Bulat
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, 11000, Serbia
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Sasaki Y, Kawagoe N, Imai T, Urita Y. Effects of ethanol and sex on propionate metabolism evaluated via a faster 13C-propionate breath test in rats. World J Gastroenterol 2023; 29:3269-3279. [PMID: 37377586 PMCID: PMC10292142 DOI: 10.3748/wjg.v29.i21.3269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/13/2023] [Accepted: 05/06/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Alcoholism is regarded as a risk factor for vitamin B12 (VB12) deficiency. Because VB12 serves as a coenzyme of methylmalonyl-CoA mutase, a key enzyme in propionate metabolism, the 13C-propionate breath test (PBT) has been studied as a non-invasive diagnostic modality for VB12 deficiency. However, the conventional PBT requires 2 h, which is inconvenient in clinical practice. We hypothesized that a faster PBT can be used to evaluate propionate metabolism and is more easily adaptable for clinical practice.
AIM To evaluate a faster PBT for assessing the effects of long-term ethanol consumption on propionate metabolism in ethanol-fed rats (ERs).
METHODS ERs were obtained by replacing standard drinking water (for control rats, CRs) with 16% ethanol solution in descendants of F344/DuCrj rats. Faster PBT was performed by administering 13C-propionate aqueous solution to male and female ERs and CRs by inserting a metal tubule from the mouth to the stomach; exhaled gas was collected in a bag to measure its 13CO2/12CO2 isotope ratio via infrared isotope spectrometry. Serum VB12 and alanine transaminase (ALT) levels were measured via chemiluminescence immunoassay and the lactate dehydrogenase-ultraviolet method, respectively. We evaluated statistical differences in mean body weight, change in 13CO2 (Δ13CO2‰), peak Δ13CO2‰, and serum VB12 and ALT, between males and females and between ERs and CRs using the t-test and Mann-Whitney U test for normally and non-normally distributed variables, respectively.
RESULTS Males weighed significantly more than females (P < 0.001); CRs weighed significantly more than ERs (P < 0.008). Δ13CO2 reached a peak (Cmax) at 20 min and 30 min in females and males, respectively, decreasing after 20-30 min without rebound in all groups. Males had significantly higher Cmax and Δ13CO2 at 15-45 min than females (P < 0.05; for all pairs). Propionate metabolism was enhanced in male ERs relative to male CRs, whereas metabolism did not differ markedly between ERs and CRs for females. Males had higher serum VB12 levels than females, without prominent differences between the ER and CR groups. Male CRs had notably higher ALT levels than male ERs. Thus, chronic ethanol consumption may trigger fatty acid production via intestinal bacteria and changes in gut microbiome composition.
CONCLUSION Faster PBT shows that 16% ethanol consumption promotes propionate metabolism without inducing liver injury. This PBT may be used clinically to evaluate gut flora status.
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Affiliation(s)
- Yosuke Sasaki
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo 143-8541, Japan
| | - Naoyuki Kawagoe
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo 143-8541, Japan
| | - Tsunehiko Imai
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo 143-8541, Japan
| | - Yoshihisa Urita
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo 143-8541, Japan
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Wang D, Pham VT, Steinert RE, Zhernakova A, Fu J. Microbial vitamin production mediates dietary effects on diabetic risk. Gut Microbes 2022; 14:2154550. [PMID: 36474346 PMCID: PMC9733697 DOI: 10.1080/19490976.2022.2154550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Adequate levels of essential vitamins are important for the prevention of diabetes. While the main efforts to address this are currently focused on the intake of vitamin supplements, improving and maintaining intrinsic vitamin production capacity, which is determined by gut microbes, has received insufficient attention. In this study, we systematically investigated the relationship between gut microbial vitamin production and factors related to diabetes and cardiometabolic health in a deeply phenotyped cohort, Lifelines-DEEP (N = 1,135). We found that blood glucose-related factors, lipids, circulating inflammation, and fecal short-chain fatty acids are associated with gut microbial vitamin production. Use of laxatives and metformin are associated with increased levels of vitamin B1/B6 biosynthesis pathways. We further reveal a mediatory role for microbial vitamin B1/B2 production on the influence of fruit intake on diabetes risk. This study provides preliminary evidence for microbiome-targeted vitamin metabolism interventions to promote health.
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Affiliation(s)
- Daoming Wang
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands,Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands
| | - Van T. Pham
- Global R&D Center Human Nutrition and Care (HNC), DSM Nutritional Products Ltd, Basel, Switzerland
| | - Robert E. Steinert
- Global R&D Center Human Nutrition and Care (HNC), DSM Nutritional Products Ltd, Basel, Switzerland,Department of Surgery, Division of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alexandra Zhernakova
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands
| | - Jingyuan Fu
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands,Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands,CONTACT Jingyuan Fu Department of Genetics, University of Groningen, University Medical Center Groningen; Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen9713AV, the Netherlands
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Lerman TT, Cohen E, Sochat T, Goldberg E, Goldberg I, Krause I. Proton pump inhibitor use and its effect on vitamin B12 and homocysteine levels among men and women: A large cross-sectional study. Am J Med Sci 2022; 364:746-751. [PMID: 35896125 DOI: 10.1016/j.amjms.2022.07.006] [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: 10/10/2021] [Revised: 03/28/2022] [Accepted: 07/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Previous studies have demonstrated an association between proton pump inhibitors (PPI) use and vitamin B12 deficiency. However, data regarding PPI use and elevated serum homocysteine level, an important marker of vitamin B12 deficiency, are scant. METHODS Data were collected from medical records of subjects examined at a screening center in Israel. Cross sectional analysis was conducted on 25,953 subjects. Levels of vitamin B12 and homocysteine were compared between subjects who consumed PPI medications and those who did not. RESULTS The mean age of the study population was 45 years and 33% were females. Subjects who received PPI medications had a minor higher vitamin B12 levels (320 pmol/L vs 300 pmol/L, p=0.024). Levels of vitamin B12 remained higher in females receiving PPI medications after performing a stratified analysis according to subjects' gender. Homocysteine levels were higher in subjects receiving PPI medications as compared to those who did not (12.0 μmol/L vs 11.6 0 μmol/L, p<0.001). Levels remained higher in female subjects after performing a stratified analysis according to subjects' sex. There was no statistically significant difference in the prevalence of vitamin B12 deficiency (according to two cutoffs: vitamin B12≤200 or ≤140 pmol/L) as well as the prevalence of hyperhomocysteinemia (defined as homocysteine >15.0 μmol/L) between the two groups. CONCLUSIONS According to our study, no association was found between PPI medication use and vitamin B12 deficiency or hyperhomocysteinemia. Patients receiving PPI medications had slightly higher levels of vitamin B12 and homocysteine, however these differences were too small to have any clinical relevance.
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Affiliation(s)
- Tsahi T Lerman
- Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
| | - Eytan Cohen
- Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Tzippy Sochat
- Statistical Consulting Unit, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Elad Goldberg
- Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Idan Goldberg
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel; Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - Ilan Krause
- Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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Pozzi FE, Conti E, Appollonio I, Ferrarese C, Tremolizzo L. Predictors of response to acetylcholinesterase inhibitors in dementia: A systematic review. Front Neurosci 2022; 16:998224. [PMID: 36203811 PMCID: PMC9530658 DOI: 10.3389/fnins.2022.998224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background The mainstay of therapy for many neurodegenerative dementias still relies on acetylcholinesterase inhibitors (AChEI); however, there is debate on various aspects of such treatment. A huge body of literature exists on possible predictors of response, but a comprehensive review is lacking. Therefore, our aim is to perform a systematic review of the predictors of response to AChEI in neurodegenerative dementias, providing a categorization and interpretation of the results. Methods We conducted a systematic review of the literature up to December 31st, 2021, searching five different databases and registers, including studies on rivastigmine, donepezil, and galantamine, with clearly defined criteria for the diagnosis of dementia and the response to AChEI therapy. Records were identified through the string: predict * AND respon * AND (acetylcholinesterase inhibitors OR donepezil OR rivastigmine OR galantamine). The results were presented narratively. Results We identified 1,994 records in five different databases; after exclusion of duplicates, title and abstract screening, and full-text retrieval, 122 studies were finally included. Discussion The studies show high heterogeneity in duration, response definition, drug dosage, and diagnostic criteria. Response to AChEI seems associated with correlates of cholinergic deficit (hallucinations, fluctuating cognition, substantia innominate atrophy) and preserved cholinergic neurons (faster alpha on REM sleep EEG, increased anterior frontal and parietal lobe perfusion after donepezil); white matter hyperintensities in the cholinergic pathways have shown inconsistent results. The K-variant of butyrylcholinesterase may correlate with better response in late stages of disease, while the role of polymorphisms in other genes involved in the cholinergic system is controversial. Factors related to drug availability may influence response; in particular, low serum albumin (for donepezil), CYP2D6 variants associated with reduced enzymatic activity and higher drug doses are the most consistent predictors, while AChEI concentration influence on clinical outcomes is debatable. Other predictors of response include faster disease progression, lower serum cholesterol, preserved medial temporal lobes, apathy, absence of concomitant diseases, and absence of antipsychotics. Short-term response may predict subsequent cognitive response, while higher education might correlate with short-term good response (months), and long-term poor response (years). Age, gender, baseline cognitive and functional levels, and APOE relationship with treatment outcome is controversial.
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Affiliation(s)
| | - Elisa Conti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Carlo Ferrarese
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Lucio Tremolizzo
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
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Micronutrient Deficiencies Presenting with Optic Disc Swelling Associated with or without Intracranial Hypertension: A Systematic Review. Nutrients 2022; 14:nu14153068. [PMID: 35893919 PMCID: PMC9331791 DOI: 10.3390/nu14153068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterised by optic disc swelling secondary to raised intracranial pressure (ICP) of unknown cause. Obesity is the most established and prevalent risk factor in developed countries. As obesogenic diets are high in calories and nutrient-poor, there may be associated nutritional deficiencies that contribute to the clinical presentation of IIH. Yet none, aside from iron deficiency, are currently included in the inclusion or exclusion criteria for the diagnosis of IIH. Our primary aim was to determine which micronutrient deficiencies, aside from iron deficiency, could present with optic disc swelling associated with or without intracranial hypertension that could potentially meet current IIH diagnostic criteria. To this end, we conducted a systematic search of articles published between 1 January 1980 and 18 December 2020 reporting cases of optic disc swelling associated with micronutrient deficiencies. In total, 65 cases met the eligibility criteria from initial searches: all were case reports and case series with a high risk of bias. Our findings suggest that patients with IIH or unexplained optic disc swelling ought to be screened, investigated, and treated for associated micronutrient deficiencies in vitamin A, B1 and B12; and weight loss interventions in IIH patients ought to promote better nutrition in addition to overall calorie restriction.
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Ischemic Stroke and Dietary Vitamin B12 Deficiency in Old-Aged Females: Impaired Motor Function, Increased Ischemic Damage Size, and Changed Metabolite Profiles in Brain and Cecum Tissue. Nutrients 2022; 14:nu14142960. [PMID: 35889916 PMCID: PMC9318046 DOI: 10.3390/nu14142960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023] Open
Abstract
A vitamin B12 deficiency (vit. B12 def.) is common in the elderly, because of changes in metabolism. Clinical studies have reported that a vit. B12 def. results in worse outcome after stroke, and the mechanisms through which a vit. B12 def. changes the brain requires further investigation. This study investigated the role of vit. B12 def. on stroke outcome and mechanisms using aged female mice. Eighteen-month-old females were put on a control or vit. B12 def. diet for 4 weeks, after which an ischemic stroke was induced in the sensorimotor cortex. After damage, motor function was measured, the animals were euthanized, and tissues were collected for analysis. Vit. B12 def. animals had increased levels of total homocysteine in plasma and liver, and choline levels were also increased in the liver. Vit. B12 def. animals had larger damage volume in brain tissue and more apoptosis. The cecum tissue pathway analysis showed dysfunction in B12 transport. The analysis of mitochondrial metabolomics in brain tissue showed reduced levels of metabolites involved in the TCA cycle in vit. B12 def. animals. Motor function after stroke was impaired in vit. B12 def. animals. A dietary vit. B12 def. impairs motor function through increased apoptosis and changes in mitochondrial metabolism in brain tissue.
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11
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Is There An Association Between Vitamin B12 Level and Vitamin D Status in Children? J Pediatr Hematol Oncol 2022; 44:e677-e681. [PMID: 35319507 DOI: 10.1097/mph.0000000000002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
Vitamin B12 (vit B12) or cobalamin is a water-soluble vitamin that acts as a coenzyme and is effective in the formation of a healthy nervous system and erythrocytes. In its deficiency, except fatigue and weakness, may cause serious signs and symptoms such as macrocytic anemia, cognitive-developmental delay, irreversible neurological damage. In this study, hemoglobin, leukocyte, thrombocyte, iron, iron-binding, ferritin, and vit B12 levels were evaluated retrospectively during the routine controls of 689 children 5 to 18 years old without any complaints. In addition, the relationship between serum 25-Hydroxyvitamin D (vit D) levels and vit B12 levels, which were evaluated in 487 of the cases, was investigated. Vit B12 deficiency was diagnosed in a total of 160 (23.2%) cases, 99 (24.4%) girls and 61 (21.4%) boys. Vit B12 level was significantly lower in children over 12 years old. Vitamin D deficiency was found to be 49.3% in 487 cases and was significantly higher in the group under 12 years and girls. The frequency of anemia was 7.2% in this group. There was a significant relationship between vit D deficiency and vit B12 deficiency. In conclusion, vit B12 deficiency is common in school-age children, especially in the adolescent age group. It should be known that vit D deficiency may also be present in vit B12 deficiency cases. More comprehensive studies are needed to reveal the relationship between B12 and vit D deficiency.
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12
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Ilias I, Rizzo M, Zabuliene L. Metformin: Sex/Gender Differences in Its Uses and Effects—Narrative Review. Medicina (B Aires) 2022; 58:medicina58030430. [PMID: 35334606 PMCID: PMC8952223 DOI: 10.3390/medicina58030430] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
Metformin (MTF) occupies a major and fundamental position in the therapeutic management of type 2 diabetes mellitus (T2DM). Gender differences in some effects and actions of MTF have been reported. Women are usually prescribed lower MTF doses compared to men and report more gastrointestinal side effects. The incidence of cardiovascular events in women on MTF has been found to be lower to that of men on MTF. Despite some promising results with MTF regarding pregnancy rates in women with PCOS, the management of gestational diabetes, cancer prevention or adjunctive cancer treatment and COVID-19, most robust meta-analyses have yet to confirm such beneficial effects.
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Affiliation(s)
- Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, GR-11521 Athens, Greece
- Correspondence: e-mail:
| | - Manfredi Rizzo
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), School of Medicine, University of Palermo, Via del Vespro, 141, 90127 Palermo, Italy;
| | - Lina Zabuliene
- Faculty of Medicine, Vilnius University, M. K. Čiurlionio St. 21/27, LT-03101 Vilnius, Lithuania;
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13
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Channer-Wallen T, Dawson P, Thomas-Brown PG, Gossell-Williams M. Lack of association between serum vitamin B12 and nocturnal sleep parameters following cyanocobalamin supplementation in healthy adults. Heliyon 2022; 8:e08831. [PMID: 35146159 PMCID: PMC8816676 DOI: 10.1016/j.heliyon.2022.e08831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background This study examined the effect of vitamin B12 supplementation on sleep parameters of latency, total sleep time, wake-after-sleep onset, total time in bed and sleep efficiency in healthy adults. Methods This quasi-experimental pre-test, post-test design recruited adults 25–50 years old, with normal vitamin B12 levels. Sleep parameters were assessed using Phillips Respironics Actiwatch-2® on non-dominant wrist from Monday to Thursday for four weeks. Pre-supplementation data was collected for the first two weeks; then participants started 3mg pre-packaged cyanocobalamin supplements daily for 14 days. Post-supplementation data was collected for weeks three and four. Serum was collected by venipuncture at the beginning and end of the study for vitamin B12 assay. Descriptive statistics involved median and interquartile range [IQR]. A comparison of the sleep parameters before and after cyanocobalamin supplementation was done using non-parametric inferential analysis. Results Fourteen healthy adult participants completed the study; nine females and five males with median age of 37[17] years and a normal range of serum vitamin B12 level (169–695 pmol/L). Median serum vitamin B12 level was significantly elevated following supplementation (355[217] to 961[679]) pmol/L; p = 0.020); but there was no change in any of the sleep parameters measured. Spearman's rho correlation analysis showed no correlation between serum vitamin B12 levels and the sleep parameters for pre-supplementation and post-supplementation weeks. Conclusion Two weeks of cyanocobalamin supplementation (3mg/day) resulted in the expected increase in serum vitamin B12 levels in healthy adults but did not influence their sleep wake activity.
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Affiliation(s)
- Toshiba Channer-Wallen
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Kingston 7, Jamaica
- Corresponding author.
| | - Paula Dawson
- Department of Surgery, Radiology, Anaesthesia and Intensive Care & Emergency Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica
| | - Peta-Gaye Thomas-Brown
- Section of Pharmacology and Pharmacy, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica
- School of Pharmacy, College of Health Sciences, The University of Technology, 237 Old Hope Road, Kingston 6, Jamaica
| | - Maxine Gossell-Williams
- Section of Pharmacology and Pharmacy, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica
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14
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Fuchs HE, O’Connell K, Du M, Navarro SL, Brasky TM, Kantor ED. Vitamin B 12 Supplementation and Vitamin B 12 Blood Serum Levels: Evaluation of Effect Modification by Gender and Smoking Status. Nutr Cancer 2022; 74:2373-2383. [PMID: 34817305 PMCID: PMC9761981 DOI: 10.1080/01635581.2021.2007271] [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: 12/30/2022]
Abstract
Research suggests that high intake of supplemental vitamin B12 may be associated with increased risk of cancer, with some evidence that this association may vary by gender and smoking status. This investigation evaluates if similar patterns in association are observed for data for 11,757 adults from the National Health and Nutrition Examination Survey (1999-2006). Survey-weighted multivariable-adjusted linear regression was used to evaluate the association between regular B12 supplement use and log-transformed serum B12 levels. Persons taking vitamin B12 through a multivitamin/multimineral (MVMM) had a median supplemental intake of 12 mcg/day (Q1: 6, Q3: 25), compared to 100 mcg/day (Q1: 22, Q3: 500) for persons reporting supplemental B12 intake through a MVMM-exclusive source. MVMM users had a geometric mean serum B12 26% (95% CI: 23%-30%) higher than nonusers, whereas MVMM-exclusive users' geometric mean was 61% (95% CI: 53%-70%) higher than nonusers (p-trend < 0.001). Although a positive trend (p-trend < 0.001) was observed for both men and women, the association was stronger among women (p-interaction < 0.001). No interaction was observed for smoking status (p-interaction = 0.45). B12 supplementation is associated with higher levels of serum B12, with significant interaction by gender but not smoking. Further work is needed to better understand the interplay of B12 and gender.
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Affiliation(s)
- Hannah E. Fuchs
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kelli O’Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mengmeng Du
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sandi L. Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Theodore M. Brasky
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Elizabeth D. Kantor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Elizabeth D. Kantor, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017, Phone: 646.888.8247,
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15
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Travica N, Ried K, Hudson I, Scholey A, Pipingas A, Sali A. The effects of cardiovascular and orthopaedic surgery on vitamin concentrations: a narrative review of the literature and mechanisms of action. Crit Rev Food Sci Nutr 2021:1-31. [PMID: 34619992 DOI: 10.1080/10408398.2021.1983762] [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: 10/20/2022]
Abstract
Given the rise in worldwide chronic diseases, supplemented by an aging population, the volume of global major surgeries, encompassing cardiac and orthopedic procedures is anticipated to surge significantly. Surgical trauma can be accompanied by numerous postoperative complications and metabolic changes. The present review summarized the results from studies assessing the effects of orthopedic and cardiovascular surgery on vitamin concentrations, in addition to exploring the possible mechanisms associated with changes in concentrations. Studies have revealed a potentially severe depletion in plasma/serum concentrations of numerous vitamins following these surgeries acutely. Vitamins C, D and B1 appear particularly vulnerable to significant depletions, with vitamin C and D depletions consistently transpiring into inadequate and deficient concentrations, respectively. The possible multifactorial mechanisms impacting postoperative vitamin concentrations include changes in hemodilution and vitamin utilization, redistribution, circulatory transport and absorption. For a majority of vitamins, there has been a lack of investigation into the effects of both, cardiac and orthopedic surgery. Additionally, studies were predominantly restricted to short-term postoperative investigations, primarily performed within the first postoperative week of surgery. Overall, results indicated that further examination is necessary to determine the severity and clinical significance of the possible depletions in vitamin concentrations that ensue cardiovascular and orthopedic surgery.
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Affiliation(s)
- Nikolaj Travica
- Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), Geelong, Australia.,Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia.,The National Institute of Integrative Medicine, Melbourne, Australia
| | - Karin Ried
- The National Institute of Integrative Medicine, Melbourne, Australia.,Honorary Associate Professor, Discipline of General Practice, University of Adelaide, South Australia, Australia.,Torrens University, Melbourne, Australia
| | - Irene Hudson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia.,Digital Health, CRC, College of STEM, Mathematical Sciences, Royal Melbourne Institute of Technology (RMIT), Melbourne, Australia.,School of Mathematical and Physical Science, University of Newcastle, Newcastle, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Avni Sali
- The National Institute of Integrative Medicine, Melbourne, Australia
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16
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Shai A, Koffler S, Hashiloni-Dolev Y. Feminism, gender medicine and beyond: a feminist analysis of "gender medicine". Int J Equity Health 2021; 20:177. [PMID: 34344374 PMCID: PMC8330093 DOI: 10.1186/s12939-021-01511-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
The feminist women's health movement empowered women's knowledge regarding their health and battled against paternalistic and oppressive practices within healthcare systems. Gender Medicine (GM) is a new discipline that studies the effect of sex/gender on general health. The international society for gender medicine (IGM) was embraced by the FDA and granted funds by the European Union to formulate policies for medical practice and research.We conducted a review of IGM publications and policy statements in scientific journals and popular media. We found that while biological differences between men and women are emphasized, the impact of society on women is under- represented. The effect of gender-related violence, race, ethnic conflicts, poverty, immigration and discrimination on women's health is seldom recognized. Contrary to feminist practice, GM is practiced by physicians and scientists, neglecting voices of other disciplines and of women themselves.In this article we show that while GM may promote some aspects of women's health, at the same time it reaffirms conservative positions on sex and gender that can serve to justify discrimination and disregard the impact of society on women's lives and health. An alternative approach, that integrates feminist thinking and practices into medical science, practice and policies is likely to result in a deep and beneficiary change in women's health worldwide.
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Affiliation(s)
- Ayelet Shai
- Oncology Department, Gailee Medical Center, 89 Meona rd, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Shahar Koffler
- Pediatrics Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Yael Hashiloni-Dolev
- Sociology and Anthropology Department, Ben-Gurion University of the Negev, Ben- Gurion Blvd 1, Be’er-Sheva, Israel
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17
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O'Logbon J, Crook M, Steed D, Harrington DJ, Sobczyńska-Malefora A. Ethnicity influences total serum vitamin B 12 concentration: a study of Black, Asian and White patients in a primary care setting. J Clin Pathol 2021; 75:598-604. [PMID: 33952588 DOI: 10.1136/jclinpath-2021-207519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/21/2021] [Accepted: 04/06/2021] [Indexed: 11/03/2022]
Abstract
AIMS A growing body of evidence suggests that ethnicity and race influence vitamin B12 metabolism and status yet clinical awareness of this is poor, causing doubts regarding diagnosis and treatment. Moreover, deficiency and insufficiency cut-offs are universally applied for this test in most diagnostic settings. The objective of this study was to assess serum vitamin B12 concentrations in Black, Asian and White primary care patients in London, UK, particularly in patients of Black or Black British ethnic origin and establish if there is a need for specific reference ranges. METHODS Serum B12 results from 49 414 patients were processed between January 2018 and November 2019 using the Architect assay (Abbott Diagnostics) at St. Thomas' Hospital, London, UK. Age, sex and ethnicity data were collected from the laboratory Health Informatics Team. RESULTS Black patients (n=13 806) were found to have significantly higher serum vitamin B12 concentration across all age groups and both sexes, especially Nigerian patients (median B12 505 pmol/L,IQR: 362-727, n=891), compared with Asian and White ethnic groups (p<0.001). Binary logistic regression analysis revealed that the Black or Black British ethnic group had the strongest association with elevated serum B12 (>652 pmol/L) (adjusted OR 3.38, 95% CI 3.17 to 3.61, p<0.0001). CONCLUSIONS It is likely that a combination of genetic and acquired/environmental factors are responsible for the ethnic differences in serum B12. This suggests that there is a need for ethnic-specific reference ranges with indications for the incorporation of age and sex too.
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Affiliation(s)
- Jessica O'Logbon
- GKT School of Medicine, King's College London Faculty of Life Sciences and Medicine, London, UK jessica.o'
| | - Martin Crook
- Clinical Biochemistry and Metabolic Medicine, Guy's, St Thomas' Trust, London, UK.,Clinical Biochemistry and Metabolic Medicine, Lewisham and Greenwich Trust, London, UK.,Hon Professor in Biochemical Medicine, King's College London, London, UK
| | - David Steed
- Viapath Informatics, Viapath, Francis House, St Thomas' Hospital, London, UK
| | - Dominic Jon Harrington
- Faculty of Life Sciences and Medicine, King's College London, London, UK.,The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK
| | - Agata Sobczyńska-Malefora
- Faculty of Life Sciences and Medicine, King's College London, London, UK.,The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK
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18
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Bajaj SR, Singhal RS. Fortification of wheat flour and oil with vitamins B12 and D3: Effect of processing and storage. J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2020.103703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Serra MC, Kancherla V, Khakharia A, Allen LL, Phillips LS, Rhee MK, Wilson PWF, Vaughan CP. Long-term metformin treatment and risk of peripheral neuropathy in older Veterans. Diabetes Res Clin Pract 2020; 170:108486. [PMID: 33035597 PMCID: PMC8015419 DOI: 10.1016/j.diabres.2020.108486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/09/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022]
Abstract
AIM Our objective was to assess whether increased duration of metformin therapy is associated with incident peripheral neuropathy (PN) in older Veterans with diabetes. METHODS Using national Veterans Affairs registry data from 2002 to 2015, we examined Veterans (50 + years) with diabetes. Long-term metformin therapy was defined as prescription ≥ 500 mg/day, filled for ≥ 6 consecutive months. Metformin therapy duration was examined both as continuous and categorical measures. Incident PN was defined by medical chart review. We estimated unadjusted and adjusted (variables selecteda priori)odds ratios (OR) and 95% confidence intervals (CI) using logistic regression. RESULTS The study included n = 210,004 individuals (mean ± SD: age: 66.2 ± 8.4 yrs, 96% male) prescribed metformin for 47.0 ± 34.0 months. Nineteen percent developed PN during follow-up. After adjusting for age, body mass index, duration of time receiving health care within the VA, smoking status, alcohol abuse, and vitamin B12 testing and treatment, the number of months of metformin treatment was associated with elevated odds for incident PN (aOR (metformin treatment - continuous) = 1.009 (95% CI = 1.009, 1.010); aOR (metformin treatment - categorical (ref: 6-<18 months): 18-<44.1 months = 1.57 (1.51-1.63), 44.1-<61 months = 2.05 (1.97-2.14), 61 + months = 2.69 (2.58-2.79), all p-values < 0.0001). CONCLUSION Our study suggests that Veterans treated for at least 18 months with metformin are approximately 2-3 times more likely to develop PN than those treated at least six, but<18 months. Future studies are needed to determine whether the association we found may be due to a decline in vitamin B12 status following metformin initiation.
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Affiliation(s)
- Monica C Serra
- Division of Geriatrics, Gerontology & Palliative Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, UT Health San Antonio, San Antonio, TX, USA; Department of Veterans Affairs, San Antonio Geriatric Research Education and Clinical Center, South Texas VA Health Care System, San Antonio, TX, USA.
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Anjali Khakharia
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Latricia L Allen
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Decatur, GA, USA
| | - Lawrence S Phillips
- Atlanta VA Health Care System, Decatur, GA, USA; Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Mary K Rhee
- Atlanta VA Health Care System, Decatur, GA, USA; Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter W F Wilson
- Atlanta VA Health Care System, Decatur, GA, USA; Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Camille P Vaughan
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Decatur, GA, USA
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20
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Circulatory and Urinary B-Vitamin Responses to Multivitamin Supplement Ingestion Differ between Older and Younger Adults. Nutrients 2020; 12:nu12113529. [PMID: 33212933 PMCID: PMC7698360 DOI: 10.3390/nu12113529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 11/23/2022] Open
Abstract
Multivitamin and mineral (MVM) supplements are frequently used amongst older populations to improve adequacy of micronutrients, including B-vitamins, but evidence for improved health outcomes are limited and deficiencies remain prevalent. Although this may indicate poor efficacy of supplements, this could also suggest the possibility for altered B-vitamin bioavailability and metabolism in older people. This open-label, single-arm acute parallel study, conducted at the Liggins Institute Clinical Research Unit in Auckland, compared circulatory and urinary B-vitamer responses to MVM supplementation in older (70.1 ± 2.7 y, n = 10 male, n = 10 female) compared to younger (24.2 ± 2.8 y, n = 10 male, n = 10 female) participants for 4 h after the ingestion of a single dose of a commercial MVM supplement and standardized breakfast. Older adults had a lower area under the curve (AUC) of postprandial plasma pyridoxine (p = 0.02) and pyridoxal-5′phosphate (p = 0.03) forms of vitamin B6 but greater 4-pyridoxic acid AUC (p = 0.009). Urinary pyridoxine and pyridoxal excretion were higher in younger females than in older females (time × age × sex interaction, p < 0.05). Older adults had a greater AUC increase in plasma thiamine (p = 0.01), riboflavin (p = 0.009), and pantothenic acid (p = 0.027). In older adults, there was decreased plasma responsiveness of the ingested (pyridoxine) and active (pyridoxal-5′phosphate) forms of vitamin B6, which indicated a previously undescribed alteration in either absorption or subsequent metabolic interconversion. While these findings cannot determine whether acute B6 responsiveness is adequate, this difference may have potential implications for B6 function in older adults. Although this may imply higher B vitamin substrate requirements for older people, further work is required to understand the implications of postprandial differences in availability.
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21
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Xu R, Huang F, Wang Y, Liu Q, Lv Y, Zhang Q. Gender- and age-related differences in homocysteine concentration: a cross-sectional study of the general population of China. Sci Rep 2020; 10:17401. [PMID: 33060744 PMCID: PMC7566483 DOI: 10.1038/s41598-020-74596-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023] Open
Abstract
The primary goals of this study were to evaluate the gender- and age-related differences in homocysteine concentration in the general population of China and possible influencing factors. A total of 7872 subjects, divided into male and female groups, participated in this retrospective study. The average homocysteine level, prevalence of hyperhomocysteinemia, and independent factors affecting homocysteine concentration were analyzed. The homocysteine level was significantly higher in males than in females in each age range (aged 20–30, aged 30–40, aged 40–50, aged 50–60, aged 60–80, aged over 80) (P < 0.0001), and the trend did not abate with age. The homocysteine concentration first decreased and then increased, being lowest at 30–50 years of age and significantly increased after 50 years of age. Factors associated with homocysteine concentration in males were smoking status (current smokers versus ex-smokers: β: 0.112), estimated glomerular filtration rate (β = − 0.192), blood urea nitrogen (β = − 0.14), diastolic blood pressure (β = − 0.113), free triiodothyronine (β = − 0.091), serum potassium (β = − 0.107) and cystatin C (β = 0.173). In females, independent factors associated with homocysteine concentration were cystatin C (β = 0.319), albumin (β = 0.227), free thyroxine (β = 0.179), age (β = 0.148), free triiodothyronine (β = − 0.217) and serum potassium (β = − 0.153). The homocysteine level was significantly higher in males than in females and increased markedly after 50 years of age in both groups. The independent factors associated with increased homocysteine concentration differed between males and females.
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Affiliation(s)
- Ranran Xu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China
| | - Fei Huang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China
| | - Yiru Wang
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China
| | - Qingquan Liu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China
| | - Yongman Lv
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China. .,Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China.
| | - Qian Zhang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Hankou, Wuhan, 430030, People's Republic of China.
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22
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Liu L, Huang X, Wang B, Song Y, Lin T, Zhou Z, Wang Z, Wei Y, Guo H, Chen P, Yang Y, Ling W, Li Y, Qin X, Tang G, Liu C, Li J, Zhang Y, Zalloua PA, Wang X, Huo Y, Zhang H, Xu X. Vitamin B 12 and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT). BMJ Open Diabetes Res Care 2020; 8:8/1/e001423. [PMID: 33023897 PMCID: PMC7539576 DOI: 10.1136/bmjdrc-2020-001423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Previous studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12 with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12-diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses. RESEARCH DESIGN AND METHODS This report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit. RESULTS At baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12 deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12 levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12 and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12 measurements, we found a positive association between an increase in vitamin B12 and an increase in FBG. CONCLUSIONS In this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12 and its longitudinal trajectory in order to better elucidate the role of vitamin B12 in the development of diabetes. Such findings would have important clinical and public health implications.
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Affiliation(s)
- Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiao Huang
- Department of Cardiology, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ziyi Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Zhuo Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Yaping Wei
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Huiyuan Guo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, Guangdong, China
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, China
| | - Wenhua Ling
- Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, China
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Youbao Li
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
| | - Genfu Tang
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
| | | | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Pierre A Zalloua
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Hao Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
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KOR D, BULUT FD, ŞEKER B, KILAVUZ S, ÖNENLİ MUNGAN HN. Mukopolisakkaridozlu hastalarda vitamin B12 düzeyleri. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.687569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Effects of a 3-month dietary intervention with a lacto-ovo-vegetarian diet on vitamin B 12 levels in a group of omnivores: results from the CARDIVEG (Cardiovascular Prevention with Vegetarian Diet) study. Br J Nutr 2019; 121:756-762. [DOI: 10.1017/s0007114518003835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPrevious studies have suggested that vegetarianism can result in a reduction of vitamin B12 circulating levels. The aim of the present study was to investigate the effects of a 3-month dietary intervention with a lacto-ovo-vegetarian diet (VD) on the levels of circulating vitamin B12 in a group of omnivores. We analysed fifty-four omnivorous subjects who followed a VD as a first dietary intervention within the CARDIVEG (Cardiovascular Prevention with Vegetarian Diet) study, a dietary intervention study. VD resulted in a significant reduction (P<0·001) of 51·2 % of vitamin B12 intake and in a significant reduction (P=0·005) of 6·2 % of the circulating levels of vitamin B12 (–24·5 pg/ml). Changes in vitamin B12 intake were significantly correlated with changes in circulating levels of vitamin B12 (R 0·61, P<0·001). Subgroup analyses showed that reduction in circulating vitamin B12 levels was more evident in participants who were younger, overweight, non-smokers and had hypercholesterolaemia. A logistic regression analysis showed that a reduction in vitamin B12 intake greater than the first quartile of the delta changes obtained in the study population (–28·5 %) conferred a significantly higher risk of experiencing a decrease in circulating vitamin B12 levels (OR 10·1; 95 % CI 1·3, 76·1). In conclusion, a 3-month VD period determined a significant reduction in circulating levels of vitamin B12, being significantly correlated with the reduction in vitamin B12 intake. Although a well-planned VD can provide adequate nutrition across all life stages, special care must be taken to ensure adequate vitamin B12 intake and to help prevent deficiency.
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Cohen E, Margalit I, Shochat T, Goldberg E, Krause I. Gender differences in homocysteine concentrations, a population-based cross-sectional study. Nutr Metab Cardiovasc Dis 2019; 29:9-14. [PMID: 30459075 DOI: 10.1016/j.numecd.2018.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS High concentrations of homocysteine are considered a risk factor for atherosclerosis and coronary artery disease. The aim of this study was to assess whether or not there are gender differences in the plasma concentrations of homocysteine. METHODS AND RESULTS Data were collected from medical records of individuals examined at a screening center in Israel between the years 2000-2014. Cross sectional analysis was carried out on 9237 men and 4353 women. Mean (SD) age of the study sample was 48.4 (9.7) and 47.7 (9.7) years for men and women respectively. Average homocysteine concentrations were 12.6 (5.9) and 9.6 (3.2) μmol/L in men and women respectively (p < 0.001). Prevalence of homocysteine concentrations above 15 μmol/L was found to be significantly higher in men than in women; 15.5% vs 3.9% respectively (p < 0.001). Low concentrations of vitamin (B12 < 200 pmol/L) and low concentrations of folate (<12 nmol/L) were found to be significantly higher in men than in women 20.4% vs. 16.0% and 18.5% vs. 10.8% respectively. Compared to women, men had a significantly higher odds ratio (95% CI) of having homocysteine concentrations above 15 μmol/L: non adjusted model, 4.47 (3.80-5.26); adjusted model for age, smoking status, body mass index, diabetes mellitus, kidney function and low serum concentrations of vitamin B12 and folate, 3.44 (2.89-4.09). CONCLUSION Plasma homocysteine concentrations are higher in men than in women. This may be a contributing factor to gender differences for developing atherosclerosis and coronary artery disease.
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Affiliation(s)
- E Cohen
- Department of Medicine F - Recanati, Rabin Medical Center -Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
| | - I Margalit
- Department of Medicine F - Recanati, Rabin Medical Center -Beilinson Hospital, Petach Tikva, Israel
| | - T Shochat
- Statistical Counselling Unit, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - E Goldberg
- Department of Medicine F - Recanati, Rabin Medical Center -Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - I Krause
- Department of Medicine F - Recanati, Rabin Medical Center -Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
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26
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Braun DJ, Abner E, Bakshi V, Goulding DS, Grau EM, Lin AL, Norris CM, Sudduth TL, Webster SJ, Wilcock DM, Van Eldik LJ. Blood Flow Deficits and Cerebrovascular Changes in a Dietary Model of Hyperhomocysteinemia. ASN Neuro 2019; 11:1759091419865788. [PMID: 31362539 PMCID: PMC6668175 DOI: 10.1177/1759091419865788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/19/2022] Open
Abstract
Elevated homocysteine in the blood, or hyperhomocysteinemia, is a recognized risk factor for multiple causes of dementia including Alzheimer’s disease. While reduction of homocysteine levels can generally be accomplished in a straightforward manner, the evidence regarding the cognitive benefits of this approach is less clear. To identify adjunct therapeutic targets that might more effectively restore cognition, the present series of experiments characterizes early and later cerebrovascular changes in a model of hyperhomocysteinemia. Sex-balanced groups of adult C57BL/6J mice were administered a diet deficient in vitamins B6, B12, and B9 (folate) and supplemented with excess methionine. They were subsequently assessed for changes in cerebral blood flow, memory, blood–brain barrier permeability, and selected vascular-associated genes. Blood flow deficits and barrier permeability changes occurred alongside changes in memory and in genes associated with metabolism, endothelial nitric oxide signaling, barrier integrity, and extracellular matrix remodeling. Significant sexually dimorphic responses to the diet were also detected. Taken together, these data deepen our understanding of a major contributor to dementia burden.
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Affiliation(s)
- David J. Braun
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
| | - Erin Abner
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
- Department of Epidemiology, University of Kentucky, Lexington KY, USA
| | - Vikas Bakshi
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
| | | | - Elizabeth M. Grau
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
| | - Ai-Ling Lin
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
- Department of Pharmacology & Nutritional Sciences, University of Kentucky, Lexington KY, USA
| | - Christopher M. Norris
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
- Department of Pharmacology & Nutritional Sciences, University of Kentucky, Lexington KY, USA
| | - Tiffany L. Sudduth
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
| | - Scott J. Webster
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
| | - Donna M. Wilcock
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
- Department of Physiology, University of Kentucky, Lexington KY, USA
| | - Linda J. Van Eldik
- Sanders-Brown Center on Aging, University of Kentucky, Lexington KY, USA
- Department of Neuroscience, University of Kentucky, Lexington KY, USA
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington KY, USA
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