阿尔茨海默病与维生素D水平的关系

Relationship between serum 25 （OH）D level and cognitive function in patients with Alzheimer＇s disease

目的,了解阿尔茨海默病（AD）患者体内维生素D营养状况，分析其血清25羟维生素D[25（OH）D ]水平与认知功能的关系，为临床补充维生素D制剂的干预研究提供依据。方法 回顾性分析本院113例住院AD患者血清总25（OH）D浓度与认知功能的关系。采用液相色谱-串联质谱法（LC-MS／MS），定量测定AD患者血清25（OH）D2、25（OH）D3 和总25（OH）D浓度。按2011年美国医学科学院（IOM）的维生素D营养状况分级标准分组：维生素D充足组［25（OH）D≥75 nmol/L］、维生素D不足组［25（OH）D 50～75 nmol/L］、维生素D缺乏组［25（OH）D 25～50 nmol/L］和维生素D严重缺乏组［25（OH）D≤25 nmol/L］。结果 （1）113例AD患者血清总25（OH）D为（27.08±15.33）nmol/L，其中血清25（OH）D2为（1.23±0.93）nmol/L和25（OH）D3为（24.50±13.04）nmol/L；（2）60.18 %（68/113）患者维生素D严重缺乏、30.97 %（35/113）患者维生素D缺乏、7.97%（9/113）患者维生素D不足和0.88%（1/113）患者维生素D充足；（3）AD患者血清总25（OH）D浓度与MMSE总分的Spearman秩和相关分析呈正相关关系（r=0.202，P=0.032）。结论 住院AD患者严重缺乏维生素D，需要补充维生素D；血清总25（OH）D浓度与认知功能有正相关关系；补充维生素D制剂是否能提高认知功能，需要进一步进行随机双盲、安慰剂对照临床研究证实。

Objective To explore the relationship between serum 25（OH）D level and cognitive function in patients with Alzheimer′s disease （AD）. Methods Totally 113 AD impatients were enrolled in this study. Their serum 25（OH）D2, 25（OH）D3, and total 25（OH）D levels were determined by liquid chromatography-tandem mass spectrometry （LC-MS/MS）. Patients were divided into Vitamin D severe deficiency group [25（OH）D level≤25 nmol/L], deficiency group[25（OH）D levels： 25-50 nmol/L], insufficiency group[25（OH）D level： 50-75 nmol/L], and sufficiency group[25（OH）D level ≥75 nmol/L] according to the criteria proposed by US Institute of Medicine. The cognitive function was assessed by MMSE score. The association between serum 25（OH）D level and cognitive function was systematically analyzed. Results The serum levels of 25（OH）D, 25（OH）D2, and 25（OH）D3 were（27.08±15.33）nmol/L, （1.23±0.93） nmol/L and （24.50±13.04） nmol/L in AD patients. The proportions of severe deficiency, deficiency, insufficiency, and sufficiency were 60.18%（68/113）, 30.97%（35/113）,7.97%（9/113）,and 0.88%（1/113）, respectively, among these AD patients. A positive correlation was found between serum 25（OH） D concentration and MMSE score in AD patients. Conclusions Impatients with AD often have severe vitamin D deficiency and need vitamin D supplementation. Serum 25（OH）D concentration is associated with cognitive function, and therefore vitamin D supplementation may improve cognitive function.