阿尔兹海默病和帕金森病患者中维生素D浓度及其相关因素的研究

发布时间：2018-07-04 13:36

本文选题：阿尔兹海默病 + 帕金森病　；参考：《山东理工大学》2013年硕士论文

【摘要】：维生素D是人体内必不可少的重要的维生素之一,已有报道称维生素D的缺乏与糖尿病、高血压、多发性硬化和认知功能障碍等疾病的形成密切相关,所以社会对于维生素D的研究越来越关注。进来,维生素D与神经退行性疾病,特别是对阿尔兹海默病(AD)和帕金森病(PD)的研究引起了人们的注意。我们对阿尔兹海默病和帕金森病患者中维生素D浓度以及其相关因素的影响进行了研究,得到的研究成果主要有以下三个部分：(一)很多研究结果显示了AD和PD患者中维生素D浓度与对照组中的比较关系。我们的研究目的是对现有的信息和资料进行总结,进而得到AD和PD患者中维生素D浓度与对照组中的比较关系。首先通过对相关数据库的资料的检索和筛选,然后得到6篇关于AD包括319个病例和573个对照的文献以及5篇关于PD包括434个病例和3451个对照的文献,共10篇并将它们纳入我们的meta分析中。利用相关软件进行meta分析,得到的结果是对于AD的合并的标准化均数差SMD(95% CI)为-1.39(-2.79-0.01),对于PD的合并的标准化均数差SMD(95% CI)为-1.33(-2.44--0.21)。表明在AD和PD的病人中维生素D的含量比对照组健康人中的含量低。(二)已有证据说明维生素D的含量是骨骼正常的一个重要的因素,而且低浓度的25(OH)D可导致肌无力并增加患骨折与骨质疏松症的发病率。加上上面我们得到的在AD和PD的病人中25(OH)D的含量低,因此我们做了关于骨折和AD以及骨质疏松症和PD的meta分析。鉴于骨折与骨质疏松症的鉴定都与骨密度BMD有关,我们进一步做了一个关于骨密度和AD以及PD的meta分析。对于AD最后纳入了9篇文献。利用比值比OR(95% CI)固定模型得到的结果是合并效应量ES(95% CI)为2.58(2.03—3.14),利用二分量得到的结果是合并OR(95%CI)为1.8(1.54—2.11)。表明AD病人更容易患骨折。进一步meta分析的结果发现AD病人中BMD的含量比对照组健康人中的含量低(SMD=-1.12,95% CI=-1.34--0.90)。对于PD最后纳入了15篇文献。结果表明PD病人更容易患骨质疏松症(OR=1.18,95% CI=1.09-1.27),而且男病人比女病人更容易患病(男OR=2.44,95%CI=1.37-4.34;女OR=1.16,95%CI=1.07—1.26)。进一步meta分析的结果发现PD病人中髋部、腰椎及股骨颈处BMD的含量比对照组健康人中的含量低。(三)维生素D的一些生物学功能是通过维生素D受体(VDR)介导维生素D活性分子1,25(OH)2D来发挥作用的。因此我们猜测VDR与AD和PD之间也有一定的关系,故我们做了VDR多态性和AD的meta分析。最后有4篇文献纳入了meta分析中。结果显示AD患者中VDR多态性基因ApaI的A等位基因出现的频率低(OR=0.79,95% CI=0.65-0.96), TaqI的T等位基因出现的频率低(OR=0.79,95% CI=0.65-0.96),而FokI得F等位基因对AD的发病率没有影响(OR=1.04,95% CI=0.89-1.23)。这些研究结果对于AD的预防和治疗有一定的理论指导意义。
[Abstract]:Vitamin D is one of the most important vitamins in human body. It has been reported that vitamin D deficiency is closely related to the development of diabetes mellitus, hypertension, multiple sclerosis and cognitive impairment. So society is paying more and more attention to the study of vitamin D. Vitamin D and neurodegenerative diseases, especially Alzheimer's disease (AD) and Parkinson's disease (PD), have attracted attention. We studied the effects of vitamin D concentrations and related factors in patients with Alzheimer's disease and Parkinson's disease. The main results are as follows: (1) the results of many studies show the relationship between vitamin D concentration in AD and PD patients and control group. The aim of our study was to summarize the available information and to obtain the comparative relationship between vitamin D concentrations in AD and PD patients and controls. By searching and screening the relevant databases, we obtained 6 articles on AD, including 319 cases and 573 controls, and 5 articles on PD, including 434 cases and 3 451 controls. A total of 10 articles were included in our meta analysis. The results obtained by meta analysis are as follows: for AD, the standardized mean difference (95% CI) is -1.39 (-2.79-0.01), and for PD, the normalized mean difference (SMD) is -1.33 (-2.44-0.21). The results showed that the level of vitamin D in AD and PD patients was lower than that in healthy controls. (II) there is evidence that vitamin D levels are an important factor in normal bones and that low concentrations of 25 (OH) D can lead to myasthenia and increase the incidence of fractures and osteoporosis. Plus, we found that 25 (OH) D levels were low in AD and PD patients above, so we did meta analysis of fractures and AD and osteoporosis and PD. Since the identification of fractures and osteoporosis is related to BMD, we further performed a meta analysis of BMD and AD and PD. For AD, 9 articles were included. The results obtained by the fixed ratio OR (95% CI) model are as follows: es (95% CI) is 2.58 (2.03-3.14), and the combined OR (95% CI) is 1.8 (1.54-2.11) by using two-component. This suggests that AD patients are more likely to suffer from fractures. The results of further meta analysis showed that the content of BMD in AD patients was lower than that in healthy controls (SMD-1.1295% CI -1.34--0.90). For PD, 15 articles were included. The results showed that PD patients were more likely to suffer from osteoporosis (ORL 1.1895% CI 1.09-1.27), and male patients were more likely to suffer from osteoporosis than female patients (male OR2.495 CI 1.37-4.34; female OR1.1695CII 1.07-1.26). Further meta analysis showed that the levels of meta in the hip, lumbar and femoral neck of PD patients were lower than those in healthy controls. (3) some biological functions of vitamin D are mediated by vitamin D receptor (VDR) -mediated vitamin D active molecule 1o 25 (OH) 2D. Therefore, we speculated that there was a certain relationship between VDR and AD and PD, so we did the meta analysis of VDR polymorphism and AD. Finally, four articles were included in the meta analysis. The results showed that the frequency of A allele of VDR polymorphic gene ApaI was low (OR0.79% 95% CI 0.65-0.96), the frequency of T allele of TaqI was low (OR0.79% 95% CI 0.65-0.96), and the F allele of FokI had no effect on the incidence of AD (ORX 1.0495% CI 0.89-1.23). These results have a certain theoretical significance for the prevention and treatment of AD.
【学位授予单位】：山东理工大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.16;R742.5

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