Alzheimer hastalarının D vitamini düzeylerinin diğer nöroloji hastaları ile karşılaştırılması. Bir vaka kontrol çalışması

Year 2021, , 540 - 545, 10.09.2021

Özgül Ocak , Erkan Melih Şahin

https://doi.org/10.21763/tjfmpc.890372

Abstract

Amaç: Alzheimer hastalığı, kognitif fonksiyon bozukluğu yapan ilerleyici nörodejeneratif bir hastalıktır ve hastalığın göstergesi olan kognitif bozulmanın yaşlanma ile belirgin hale gelen D vitamini eksikliği ile ilişkili olabileceği ile ilgili çalışmalar yapılmıştır. Bu çalışmada Alzheimer hastalarında D vitamini düzeylerini belirlemek, eksiklik durum sıklığını saptamak ve benzer yaş grubu hastalarla karşılaştırmak amaçlanmıştır. Yöntem: Bu çalışmaya 01/01/2018 ve 31/12/2020 tarihleri arasında Nöroloji kliniğinde görülen ve 25(OH) Vitamin D3 düzeyleri ölçülmüş hasta kayıtları dahil edilmiştir. Alzheimer hastalarına ek olarak kontrol grubu, nöroloji polikliniğinde görülen, kognisyon bozukluğu olmayan hastalara ait kayıtlardan yaş ve cinsiyet olarak benzer özellikte, rastgele seçilmiştir. Bulgular: Çalışmaya 156 Alzheimer ve 442 kontrol grubunda hasta kayıt dahil edildi. Alzheimer grubunda 95 kadın (%60,9), 61 erkek (%39,1) kontrol grubunda 271 kadın (%61,3), 171 erkek (%38,7) bulunmaktaydı. Alzheimer grubu yaş ortalaması (75,9) ile kontrol grubu yaş ortalaması (75,4) arasında anlamlı fark yoktu. Vitamin D düzeyi ortalama değeri Alzheimer hastalarında 21,5±12,4 ng/ml ve kontrol grubunda 20,1±13,1 ng/ml olup anlamlı fark yoktu. Cinsiyetler arasında anlamlı fark yoktu. 85 yaş ve üzeri” Vitamin D düzeyleri “75-79 yaş”, “70-74 yaş” ve “65-69 yaş” gruplarından anlamlı düşüktü. Sonuç: D vitaminin AH üzerindeki etki mekanizmaları tam olarak açıklığa kavuşturulamamıştır. Çalışma sonuçlarımıza göre Alzheimer hastaları ile kontroller arasında D vitamin düzeyleri anlamlı farklı değildir. D vitamini düşüklüğü Alzheimer hastalık gelişiminde etkili bir etmen olabilir ancak hastalık ortaya çıktıktan sonra D vitamini düzeyleri benzer yaş ve cinsiyette diğer hastalardan farklılık göstermemektedir.

Keywords

25(OH) Vitamin D, Alzheimer Hastalığı, Kognisyon

Supporting Institution

yok

Thanks

yok

Vitamin D levels of Alzheimer's patients compared to other neurology clinic aplicants. A case-control study

Abstract

Introduction: Alzheimer's disease is a progressive neurodegenerative disease that causes cognitive dysfunction. Cognitive impairment may be associated with vitamin D deficiency. This study aims to determine vitamin D levels and frequency of deficiency in Alzheimer's patients and to compare it with other patients of similar age group applied to the neurology clinic.
Methods: The hospital records of patients who were seen in the neurology clinic between 01/01/2018 and 31/12/2020 and of whom 25 (OH) Vitamin D3 levels were measured were included. In addition to Alzheimer's patients, the control group was randomly selected from the records of patients with no cognitive disorder with similar age and gender.
Results: Of patients, 156 records were included in the Alzheimer group and 442 in the control group. There were 95 women (60.9%) 61 men (39.1%) in the Alzheimer group, 271 women (61.3%) 171 men (38.7%) in the control group. There was no significant difference between the mean age of the Alzheimer group (75.9) and control group (75.4). No significant difference was detected between the mean vitamin D levels of Alzheimer's patients (21.5±12.4 ng/ml) and control group (20.1±13.1 ng/ml). There was no significant difference between the genders. Vitamin D levels of “85 years and above” were significantly lower than those of the "75-79 years old", "70-74 years" and "65-69 years old" groups.
Conclusion: The mechanisms of vitamin D on the pathophysiologic pathways of Alzheimer disease have not been fully elucidated. According to our results, vitamin D levels are not significantly different between Alzheimer's patients and controls. Low vitamin D may be an effective factor in the development of Alzheimer's disease, but after the disease occurs, vitamin D levels do not differ from other patients of similar age and gender.

Keywords

25(OH) Vitamin D, Alzheimer Disease, cognition

References

• 1. Gurvit H, Emre M, Tinaz S, Bilgic B, Hanagasi H, Sahin H, et al. The prevalence of dementia in an urban Turkish population. Am J Alzheimers Dis Other Demen. 2008;23(1):67-76.
• 2. Soni M, Kos K, Lang IA, Jones K, Melzer D, Llewellyn DJ. Vitamin D and cognitive function. Scand J Clin Lab Invest Suppl. 2012;243:79- 82.
• 3. Annweiler C, Llewellyn DJ, Beauchet O. Low serum vitamin D concentrations in Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2013;33:659-74.
• 4. Qiao DL, Zhang SQ, Giunta B. Is vitamin D beneficial to Alzheimer disease? a surprising dilemma. CNS Neurosci Ther. 2012;18:601-3.
• 5. Annweiler C, Herrmann FR, Fantino B, Brugg B, Beauchet O. Effectiveness of the combination of memantine plus vitamin D on cognition in patients with Alzheimer disease: a pre-post pilot study. Cogn Behav Neurol.2012;25:121-7.
• 6. Annweiler C, Allali G, Allain P, Bridenbaugh S, Schott AM, Kressig RW, et al. Vitamin D and cognitive performance in adults: a systematic review. Eur J Neurol. 2009;16:1083-9.
• 7. Goedert M, Spillantini MG. A century of Alzheimer's disease. Science. 2006;314:777-81.
• 8. Prince MJ, Wimo A, Guerchet M, Ali GC, Wu YT, Prina M. World Alzheimer report 2015: the global impact of dementia: an analysis of prevalence, incidence, cost and trends. London: Alzheimer’s Disease International; 2015.
• 9. Hamelin L, Lagarde J, Dorothee G, Leroy C, Labit M, Comley RA, et al. Early and protective microglial activation in Alzheimer's disease: a prospective study using 18F-DPA-714 PET imaging. Brain J Neurol. 2016;139(Pt 4):1252–64.
• 10. Sperling R, Mormino E, Johnson K. The evolution of preclinical Alzheimer’s disease: implications for prevention trials. Neuron. 2014;84(3):608–22.
• 11. Annweiler C, Beauchet O. Vitamin D-mentia: randomized clinical trials should be the next step. Neuroepidemiology. 2011;37(3-4):249-58.
• 12. Buell JS, Scott TM, Dawson-Hughes B, Dallal GE, Rosenberg IH, Folstein MF, et al. Vitamin D is associated with cognitive function in elders receiving home health services. J Gerontol A Biol Sci Med Sci. 2009;64(8):888-95.
• 13. Goudarzvand M, Javan M, Mirnajafi-Zadeh J, Mozafari S, Tiraihi T. Vitamins E and D3 attenuate demyelination and potentiate remyelination processes of hippocampal formation of rats following local injection of ethidium bromide. Cell Mol Neurobiol. 2010;30(2):289-99.
• 14. Huang Y, Christakos S. Modulation of rat calbindin-D28 gene expression by 1,25-dihydroxy vitamin D3 and dietary alteration. Mol Endocrinol. 1988;2(10):928-35.
• 15. Gezen-Ak D, Yılmazer S, Dursun E. Why vitamin D in Alzheimer’s disease? The hypothesis. J Alzheimers Dis.2014;40:257–69. 16. Balion C, Griffith LE, Strifler L, Henderson M, Patterson C, Heckman G, et al. Vitamin D, cognition, and dementia: a systematic review and meta-analysis. Neurology. 2012;79:1397–405.
• 17. Wilkins CH, Sheline YI, Roe CM, Birge SJ, Morris JC. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry. 2006;14(12):1032-40.
• 18. McGrath J, Scragg R, Chant D, Eyles D, Burne T, Obradovic D. No association between serum 25-hydroxy vitamin D3 level and performance on psychometric tests in NHANES III. Neuroepidemiology. 2007;29(1-2):49-54
• 19. Karakis I, Pase MP, Beiser A, Booth SL, Jacques PF, Rogers G, et al. Association of serum vitamin D with the risk of incident dementia and subclinical indices of brain aging: The Framingham Heart Study. J Alzheimers Dis.2016;51:451–61
• 20. Littlejohns TJ, Henley WE, Lang IA, Annweiler C, Beauchet O, Chaves PH, et al. Vitamin D and the risk of dementia and Alzheimer disease. Neurology. 2014;83:920–8.
• 21. Afzal S, Bojesen SE, Nordestgaard BG. Reduced 25-hydroxy vitamin D and risk of Alzheimer’s disease and vascular dementia. Alzheimers Dement. 2014;10:296–302.
• 22. Slinin Y, Paudel M, Taylor BC, Ishani A, Rossom R, Yaffe K, et al. Association between serum 25(OH) vitamin D and the risk of cognitive decline in older women. J Gerontol. 2012;67:1092–8.