Abstract
BackgroundMalnutrition, metabolism stress, inflammation, peripheral organs dysfunction, and B vitamins deficiency significantly contribute to the progression and mortality of Alzheimer's disease (AD). However, it is unclear which blood biochemical indicators are most closely related to cognitive decline and B vitamins deficiency (thiamine, folate, vitamin B12) in patients with AD.MethodsThis was a cross-sectional study of 206 AD patients recruited from six hospitals in China. Thiamine diphosphate (TDP), the bioactive form of thiamine, was measured by high-performance liquid chromatography fluoroscopy (HPLC) at a single center. Levels of biochemical indicators (except TDP) were measured by regular and standard laboratory tests in each hospital. Pearson's rank correlation analysis was used to assess relationships between B vitamins and biochemical indicators. T-test was used to compare the difference between ApoE ε4 and non-ApoE ε4 groups. Differences were considered statistically significant as P < 0.05.ResultsAmong the biochemical results, in AD population, malnutrition indicators (erythrocyte, hemoglobin, serum albumin, and total protein) were most significantly associated with cognitive function, as was free triiodothyronine (FT3) levels which had been observed in previous study. Malnutrition and FT3 levels depend on age but not apolipoprotein E (ApoE) genotype. Meanwhile, Among the B vitamins, TDP was the most significantly associated with malnutrition indicators and FT3.ConclusionOur results indicated that TDP reduction could be a modifiable risk factor for malnutrition and FT3 that contributed to cognitive decline in AD patients. Correcting thiamine metabolism could serve as an optional therapy target for AD treatment.
Highlights
Alzheimer’s disease (AD) is a devastating neurodegenerative disease clinically characterized by cognitive impairment and eventual loss of self-care ability
The results showed that blood Thiamine diphosphate (TDP) level significantly associated with erythrocyte number (r = 0.32, P < 0.001), hemoglobin level (r = 0.33, P < 0.001), albumin level (r = 0.30, P < 0.001), and weakly associated with total protein level (r = 0.17, P < 0.05)
We found no significant differences in malnutrition indicators and FT3 between non-ApoE ε4 and ApoE ε4 carrier group (Figure 1)
Summary
Alzheimer’s disease (AD) is a devastating neurodegenerative disease clinically characterized by cognitive impairment and eventual loss of self-care ability. Several studies reported that anemia/abnormal hemoglobin and low serum albumin level is an independent risk factor of poor cognitive performance in the elderly and for dementia and rapid cognitive decline among the elderly [11, 12] These blood biochemical results contributing to cognitive decline were regular measured and can be collected in hospital daily. Malnutrition, metabolism stress, inflammation, peripheral organs dysfunction, and B vitamins deficiency significantly contribute to the progression and mortality of Alzheimer’s disease (AD). It is unclear which blood biochemical indicators are most closely related to cognitive decline and B vitamins deficiency (thiamine, folate, vitamin B12) in patients with AD
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