Relation of Serum Homocysteine Level to Oxidative Stress in Patients with Alzheimer's Dementia / 신경정신의학

ABSTRACT

OBJECTIVES: The goal of this study was to find an association between elevated blood homocysteine level in Korean patients with dementia of the Alzheimer's type (DAT), to analyze affecting factors, and to identify the role of oxidative stress which was known to be an underlying mechanism of hyperhomocysteinemia in DAT. METHODS: The subjected were consisted of 54 patients with dementia of the Alzheimer's type and 54 normal controls with age over 60. The clinical data was obtained by structured interview and medical records. Serum homocysteine, plasma total antioxidant capacity (TAC) and serum apolipoprotein E (apo E) levels were measured, and the cognitive function (Mini-Mental State Examination, MMSE), severity of dementia (Clinical Dementia Rating, CDR/Global Deterioration Scale, GDS), activities of daily living (Activities of Daily Living, ADL/Instrumental Activities of Daily Living, IADL) and severity of depression (Geriatric Depression Scale) were also evaluated using various rating scales. RESULTS: 1) The mean (+/-S.D.) serum homocysteine level in patients with dementia of the Alzheimer's type (21.69+/-8.24 micromol/L) was significantly (p<0.05) higher than the mean (+/-S.D.) serum homocysteine level in the control group (16.60+/-4.85 micromol/L) 2) The mean age and IADL scores of DAT patients with elevated serum homocysteine level were significantly higher than those of DAT patients with normal serum homocysteine level (p<0.05). However, there were no difference between groups in the MMSE, GDS, CDR, ADL, Geriatric Depression Scale, plasma TAC and serum apo E level. 3) The serum homocysteine level in patients with Alzheimer's dementia had no correlation with age, cognitive function, severity of dementia, activities of daily living, severity of depresseion nor plasma TAC and serum apo E level. CONCLUSION: This study does not support the association between elevated serum homocysteine level and oxidative stress.