Association Between Homocysteine and Vitamin Levels in Demented Patients

Background: Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed. Objective: An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer’s disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia. Results: Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin. Conclusion: Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.

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Serum Total Homocysteine Level in Association with Folate and Vitamin B12 Status Among Algerian Prostate Cancer Patients

Medical Technologies Journal ◽

10.26415/2572-004x-vol3iss2p420-420 ◽

2019 ◽

Vol 3 (2) ◽

pp. 420-420

Author(s):

Rima Mouhoub

Keyword(s):

Prostate Cancer ◽

Vitamin B12 ◽

Cancer Patients ◽

Homocysteine Level ◽

Total Homocysteine ◽

Folate And Vitamin B12

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Long-term Effect of Folic Acid and Vitamin B12 Supplementation on Fracture Risk and Cardiovascular Disease: Follow-up Study of B-PROOF Trial (P24-031-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p24-031-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Sadaf Oliai Araghi ◽

Jessica C Kiefte-de Jong ◽

Suzanne van Dijk ◽

Natasja van Schoor ◽

Lisette CPGM de Groot ◽

...

Keyword(s):

Cardiovascular Disease ◽

Folic Acid ◽

Fracture Risk ◽

Vitamin B12 ◽

Homocysteine Level ◽

Fracture Incidence ◽

Total Homocysteine ◽

The Hague ◽

Vitamin B12 Supplementation

Abstract Objectives To investigate the possible effects of the intervention with folic acid and vitamin B12 supplementation on fracture and cardiovascular disease risk: 5–7 years after the end of the intervention period of 2–3 years. Methods Extended follow-up of B-PROOF trial, a multi-center, double-blind randomized placebo-controlled trial designed to assess the effect of 2–3 years daily supplementation with folic acid (400 µg) and vitamin-B12 (500 µg) versus placebo on fracture incidence. Fracture and cardiovascular outcomes were assessed by follow-up questionnaire. Fracture incidence (and a part of cardiovascular disease incidence) was verified by general practitioners (GPs). Results A total of 1298 individuals participated in the second follow-up round. Median age at baseline was 71.0 years [68.0–76.0] for both groups (n = 662 in the treatment group and n = 636 in the placebo group). No effect of the intervention on first osteoporotic fracture and other fracture risk after a follow up of 5–7 years was observed (HR: 0.99, 95% CI: 0.62; 1.59 and HR: 0.77; 95% CI: 0.50; 1.19, respectively) and also not for cardiovascular- or cerebrovascular disease (OR: 1.14; 95%CI: 0.74–1.74 and OR: 1.01; 95%CI: 0.76–1.33, respectively). Significant interaction for total homocysteine level was observed for osteoporotic- and any fracture (P = 0.10 and 0.06 resp.), which indicated a significantly lower risk of fracture in the intervention group with higher total homocysteine level. Conclusions This study does not support a prolonged effect of supplementation of folic acid and vitamin B12 on fracture risk, or on cardiovascular disease in older individuals with elevated homocysteine concentration. However, B-vitamin supplementation may be beneficial in reducing fractures in individuals with higher total homocysteine levels. Funding Sources The initial B-PROOF study has received funding so far by The Netherlands Organization for Health Research and Development (ZonMw), the Hague; unrestricted grant from NZO (Dutch Dairy Association), Zoetermeer; Orthica, Almere; NCHA (Netherlands Consortium Healthy Ageing) Leiden/Rotterdam; Ministry of Economic Affairs, Agriculture and Innovationn, the Hague; Wageningen University, Wageningen; VUmc, Amsterdam; Erasmus Medical Center, Rotterdam. Supporting Tables, Images and/or Graphs

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PERBAIKAN KADAR ALBUMIN PASIEN POST AMPUTASI ET CAUSA LUKA BAKAR LISTRIK 25% DERAJAT III DAN STATUS GIZI KURANG DENGAN PEMBERIAN ASUPAN TINGGI PROTEIN

IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN) ◽

10.54773/ijcnp.v1i1.27 ◽

2018 ◽

Vol 1 (1) ◽

pp. 18-25

Author(s):

Diane Paparang ◽

Nurpudji A. Taslim ◽

Haerani Rasyid ◽

A. Yasmin Syauki

Keyword(s):

Vitamin A ◽

Vitamin C ◽

Vitamin B12 ◽

Vitamin B6 ◽

Vitamin B1

Pendahuluan Proses penyembuhan luka post amputasi dan luka bakar dengan luas 25% dan kedalaman derajat III serta hipoalbuminemia sedang (albumin 2,6g/dL) dan status gizi kurang memerlukan terapi gizi spesifik tinggi protein. Laporan Kasus Tn.I, laki-laki, 28 tahun dikonsul oleh bagian bedah dengan luka post amputasi dan luka bakar listrik derajat III luas 25%. Keluhan utama asupan makan kurang sejak 16 hari terakhir karena nafsu makan kurang akibat nyeri pada luka post amputasi dan luka bakar. Ada nyeri ulu hati dan demam menggigil. Asupan 24 jam 1000kkal. Pasien didiagnosis dengan status gizi kurang (LLA=80,7%), status metabolik anemia normositik normokrom (Hb 9.7 g/dl), deplesi sedang sistem imun (TLC 940/µL), hipoalbuminemia (albumin 2,6g/dL) dan status gastrointestinal fungsional. Terapi nutrisi dengan energi 2500 kkal, protein 2 gr/kgBBI/hari (23%), karbohidrat 57% dan lemak 20 %, melalui oral berupa makanan biasa 1250 kkal, ONS glutamine 2.5g/hari, suplementasi 6 butir putih telur (protein 31,5g/hari), vitamin C 1g/24jam, vitamin A 6.000IU/12jam, vitamin B1-100mg, vitamin B6-200mg, vitamin B12-200mg, Zinc 50mg/24jam, selenium 55µg, Curcuma 400mg/8jam dan ekstrak ikan gabus 2 kapsul/8 jam. Setelah perawatan 30 hari, terjadi perbaikan dalam penyembuhan luka, peningkatan LLA menjadi 23,5cm, peningkatan hemoglobin 9.3g/dl, peningkatan sistem imun (TLC 2064/µL), peningkatan albumin 3.9g/dL. Kesimpulan Terapi nutrisi spesifik dengan protein 2 gr/kgBBI dapat meningkatkan kadar albumin dan mempercepat penyembuhan luka pada pasien luka bakar.

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B-Vitamine in der Geriatrie – was bestimmen, was ersetzen?

Aktuelle Ernährungsmedizin ◽

10.1055/a-1449-1786 ◽

2021 ◽

Vol 46 (05) ◽

pp. 312-316

Author(s):

Marija Djukic ◽

Christine A. F. von Arnim

Keyword(s):

Vitamin B12 ◽

Barthel Index ◽

Vitamin B6 ◽

Vitamin B1 ◽

Geriatrische Patienten ◽

Klinische Diagnose ◽

Neurologische Symptome ◽

Diagnostische Zuverlässigkeit

ZusammenfassungEin Vitamin-B1-Mangel kann sich als Wernicke-Enzephalopathie oder als Beriberi manifestieren. Geriatrische Patienten mit den Diagnosen Demenz oder Delir haben niedrigere Vitamin-B1-Spiegel als solche ohne diese Diagnosen. Ebenso zeigen sich bei geriatrischen Patienten mit höherem Vitamin-B1-Spiegel bessere Ergebnisse in der Funktionalität (Barthel-Index) bei Entlassung. Vitamin B6 ist an über 100 Reaktionen als Koenzym beteiligt und ein Mangel kann daher mit vielen Symptomen einhergehen. Klinische Manifestationen des Vitamin-B12-Mangels reichen von frühen neuropsychiatrischen bis zu hämatologischen Symptomen, wobei die makrozytäre Anämie als später Indikator eines Vitamin-B12-Mangels gilt. Neurologische Symptome treten sehr häufig schon vor oder ohne hämatologische Manifestationen auf. Die Bestimmung des Vitamin-B1-Spiegels im Blut ist wenig aussagekräftig. Die Wernicke-Enzephalopathie ist eine klinische Diagnose. Zur Diagnose eines Vitamin-B6-Mangels wird die Bestimmung von Pyridoxin (Pyridoxal-5′-Phosphat) im Plasma empfohlen. Ein erniedrigter Holo-TC-Spiegel im Serum gilt als frühester Marker eines Vitamin-B12-Mangels. Eine kombinierte Bestimmung von Vitamin B12, Holo-TC, MMA und Homozystein scheint die diagnostische Zuverlässigkeit bei Vitamin-B12-Mangel zu erhöhen. Für Empfehlungen zur Substitutionstherapie bei allen B-Vitaminen liegen kaum bzw. keine evidenzbasierten Daten vor. Durch die Substitution von 0,8 mg Folsäure, 0,5 mg Vitamin B12 und 20 mg Vitamin B6 konnte in einer randomisierten kontrollierten Studie bei Patienten mit einer leichten kognitiven Störung eine Verlangsamung der Hirnatrophie bewirkt werden.

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