Folsäure- und Vitamin-B12-Bestimmung in der Diagnostik kognitiver Störungen

Journal für Gynäkologische Endokrinologie/Schweiz - Tập 25 - Trang 193-201 - 2022
Robert Haußmann1,2, Cathrin Sauer1, Stefanie Neumann1, Anne Zweiniger1, Jan Lange1, Markus Donix1,2
1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
2Standort Dresden, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Dresden, Deutschland

Tóm tắt

Vitamin-B12- und Folsäuremangelzustände sind insbesondere im höheren Lebensalter häufig. Da derartige Mangelzustände relevant dyskognitive Faktoren darstellen, ist ihre Bestimmung in der diagnostischen Abklärung kognitiver Störung bedeutsam und unverzichtbarer Bestandteil der Routinediagnostik in einer Gedächtnisambulanz. Wir geben einen Überblick über den klinischen Stellenwert von Vitamin-B12- und Folsäuremangelzuständen im Kontext kognitiver Störungen und über diesbezüglich relevante diagnostische und therapeutische Aspekte. Die Literaturübersicht wird durch eine Datenanalyse einer Kohorte von 250 Patienten aus unserer Gedächtnisambulanz ergänzt.

Tài liệu tham khảo

Schrier S, Motil K, Tirnauer J (2017) Causes and pathophysiology of vitamin B12 and folate deficiency. www.uptodate.com. Zugegriffen: 9.11.2018 Schrier S, Mentzer W, Tirnauer J (2017) Clinical manifestation and diagnosis of vitamin B12 and folate deficiency. www.uptodate.com. Zugegriffen: 9.11.2018 Carmel R (2008) How I treat cobalamin (vitamin B12) deficiency. Blood 112:2214–2222 Reynolds E (2014) The neurology of folic acid deficiency. Handb Clin Neurol 120:927 Green R (2017) Vitamin B12 deficiency from the perspective of a practicing hematologist. Blood 129:2603–2611 Scaglione F, Panzavolta G (2014) Folate, folic acid and 5‑methyltetrahydrofolate are not the same thing. Xenobiotica 44:480–488 Lindenbaum J et al (1994) Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr 60:2–11 Allen R et al (1993) Metabolic abnormalities in cobalamin (vitamin B12) and folate deficiency. Faseb J 7:1344–1353 Wickramasinghe S (1995) Morphology, biology and biochemistry of cobalamin- and folate-deficient bone marrow cells. Baillieres Clin Haematol 8:441–459 Stabler S (2013) Clinical practice. Vitamin B12 deficiency. N Engl J Med 368:149–160 Hemmer B et al (1998) Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry 65:822–827 Pittock S, Payne T, Harper C (2002) Reversible myelopathy in a 34-year-old man with vitamin B12 deficiency. Mayo Clin Proc 77:291–294 Lindenbaum J et al (1988) Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med 318:1720–1728 Bottiglieri T (1996) Folate, vitamin B12, and neuropsychiatric disorders. Nutr Rev 54:382–390 Blasko I et al (2012) Conversion from mild cognitive impairment to dementia: influence of folic acid and vitamin B12 use in the VITA cohort. J Nutr Health Aging 16:687–694 Stoopler E, Kuperstein A (2013) Glossitis secondary to vitamin B12 deficiency anemia. CMAJ 185:E582 Zhu J et al (2013) Atrophic glossitis is attributed to cobalamin deficiency. Shanghai Kou Qiang Yi Xue 22:58–62 Garcia B et al (2009) A case report of pernicious anemia and recurrent aphthous stomatitis. J Contemp Dent Pract 10:83–89 Gulcan E et al (2008) Cyanocobalamin may be beneficial in the treatment of recurrent aphthous ulcers even when vitamin B12 levels are normal. Am J Med Sci 336:379–382 Jessen F, Deuschl G, Maier W (2016) S3-Leitline „Demenzen“. Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN). Deutsche Gesellschaft für Neurologie (DGN). https://www.awmf.org/uploads/tx_szleitlinien/038-013l_S3-Demenzen-2016-07.pdf Clarfield A (2003) The decreasing prevalence of reversible dementias: an updated meta-analysis. Arch Intern Med 163:2219–2229 Malouf R, Areosa Sastre A (2003) Vitamin B12 for cognition. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd004394 Gupta L et al (2016) Assessment of brain cognitive functions in patients with vitamin B12 deficiency using resting state functional MRI: a longitudinal study. Magn Reson Imaging 34:191–196 Akdal G, Yener G, Kurt P (2008) Treatment resonsive executive and behavioral dysfunction associated with vitamin B12 deficiency. Neurocase 14:147–150 Briani C et al (2013) Cobalamin deficiency: clinical picture and radiological findings. Nutrients 5:4521–4539 Stabler S et al (1990) Clinical spectrum and diagnosis of cobalamin deficiency. Blood 76:871–881 Whyte E et al (2002) Cognitive and behavioural correlates of low vitamin B12 levels in elderly patients with progressive dementia. Am J Geriatr Psychiatry 10:321–327 Moore E et al (2012) Cognitive impairment and vitamin B12: a review. Int Psychogeriatr 24:541–556 Zhang D et al (2017) Efficacy of vitamin B supplementation on cognition in elderly patients with cognitive-related diseases. J Geriatr Psychiatry Neurol 30:50–59 Silva D et al (2013) Do MCI patients with vitamin B12 deficiency have distinctive cognitive deficits? Bmc Res Notes 6:357 Soysal P, Turan Isik A (2018) Vitamin B12 deficiency can be a cause of acute reversible parkinsonism and cognitive impairment in older adults. Geriatr Gerontol Int 18:650–651 de Jager C et al (2012) Cognitive and clinical outcomes of homocysteine-lowering B‑vitamin treatemnt in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry 27:592–600 Malouf R, Evans JG (2008) Folic acis with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database Syst Rev 4. https://doi.org/10.1002/14651858.cd004514.pub2 Aisen P et al (2008) High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA 300:1774–1783 Spence J (2016) Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke. Nutr Res 36:109–116 Bizzaro N, Antico A (2014) Diagnosis and classification of pernicious anemia. Autoimmun Rev 13:565–568 Pawlak R, Lester S, Babatunde T (2014) The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature. Eur J Clin Nutr 68:541–548 Khan A, Shafiq I, Hassan Shah M (2017) Prevalence of vitamin B12 deficiency in patients with type II diabetes mellitus on metformin: a study from Khyber Pakhtunkhwa. Cureus e1577:18 Maes M, Fixen D, Linnebur S (2017) Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence. Ther Adv Drug Saf 8:273–297 Valente E et al (2011) Diagnostic accuracy of holotranscobalamin, methylmalonic acid, serum cobalamin, and other indicators of tissue vitamin B12 status in the elderly. Clin Chem 57:856–863 Herrmann W et al (2003) Functional vitamin B12 deficiency and determination of holotranscobalamin in populations at risk. Clin Chem Lab Med 41:1478–1488 Carmel R (2008) How I treat cobalamin (vitamin B12) deficiency. Blood 112:2214–2221 Schrier S (2017) Treatment of vitamin B12 and folate deficiencies. www.uptodate.com (p. 1–18). Zugegriffen: 9.11.2018 Kuzminski A et al (1998) Effective treatment of cobalamin deficiency with oral cobalamin. Blood 92:1191–1198 Wang H et al (2018) Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd004655.pub3 Mills J, Molloy A, Reynolds E (2018) Do the benefits of folic acis fortification outweigh the risk of msasking vitamin B12 deficiency. BMJ 360:1–3