Introduction

To determine whether vitamin B12 level at Parkinson's disease (PD) diagnosis predicts time to develop dementia.

Methods

We utilized a population-based cohort of Parkinsonism patients to examine the relationship between serum vitamin B12 at the time of PD diagnosis and dementia risk. Receiver operating curves were calculated for vitamin B12 cutoffs maximizing sensitivity and specificity for determining who developed dementia. Time from Parkinsonism diagnosis to dementia, death, or censoring was calculated utilizing Kaplan-Meier analysis and Cox-proportional hazard models.

Results

PD patients who did not develop dementia had higher baseline levels of vitamin B12 at PD diagnosis (648.5 ng/L vs 452 ng/L, p < 0.05) than those who developed dementia. Dementia risk was significantly lower in the 3rd tertile compared with 2nd tertile and trended towards significance compared to the 1st tertile. Each 100 unit increase in vitamin B12 level had a hazard ratio of 0.31 (95% CI 0.44–0.95) for future dementia (p < 0.05). Vitamin B12 cutoff of <587 ng/L was 87% sensitive and 70% specific (AUC 0.79, 95% CI 0.60–0.98) distinguishing patients with dementia. PD patients with vitamin B12 levels <587 ng/L were 5.4 times more likely to develop dementia, with 50% having dementia within 5 years of PD diagnosis compared with 11% in those with a vitamin B12 level of ≥587 ng/L (p < 0.05).

Conclusion

Higher levels of serum vitamin B12 at PD diagnosis correlate with lower risk of future dementia. The role of vitamin B12 in the development of dementia among PD patients deserves further evaluation.

中文翻译：

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帕金森氏病诊断中较高的维生素B12水平与未来痴呆症的较低风险相关。

介绍

为了确定帕金森氏病（PD）诊断中的维生素B12水平是否可预测痴呆的发生时间。

方法

我们利用人群为基础的帕金森病患者队列研究了PD诊断时血清维生素B12与痴呆风险之间的关系。计算维生素B12临界值的受试者工作曲线，从而最大程度地提高灵敏度和特异性，从而确定谁患了痴呆症。使用Kaplan-Meier分析和Cox比例风险模型计算了从帕金森氏病诊断到痴呆，死亡或检查的时间。

结果

与痴呆症患者相比，未患痴呆症的PD患者在PD诊断时具有较高的维生素B12基线水平（648.5 ng / L对452 ng / L，p <0.05）。与第二三分位数相比，第三三分位数的痴呆风险显着降低，并且与第一三分位数相比，痴呆风险呈显着趋势。维生素B12水平每升高100单位，对未来痴呆的危险比为0.31（95％CI 0.44–0.95）（p <0.05）。<587 ng / L的维生素B12临界值敏感度为87％，特异性为70％（AUC 0.79，95％CI 0.60-0.98），可以区分痴呆症患者。维生素B12水平<587 ng / L的PD患者发生痴呆的可能性增加5.4倍，其中50％的PD诊断后5年内患有痴呆，而维生素B12水平≥587ng / L的患者则为11％（p <0.05）。

结论

PD诊断时血清维生素B12含量较高与未来痴呆症的风险较低相关。维生素B12在PD患者痴呆症发展中的作用值得进一步评估。