The impact of homocysteine, B12, and D vitamins levels on functional neurocognitive performance in HIV-positive subjects

Abstract

BackgroundThe correlation among high levels of total homocysteine, low levels of B12vitamin, and neurocognitive impairment in HIV negative patients has been the main research topic in some of the latest reviews. The aim of this study was to examine if the alteration of homocysteine, B12 vitamin, and D vitamins plasma levels was present in HIV-positive, and their relationship with cognitive function.Methods57 HIV infected were enrolled and underwent the serum measurement of homocysteine, B12, and D vitamins. The neurocognitive evaluation investigated 5 cognitive domains, through a neuropsychological battery testResultsHomocysteine was found to be elevated in 70.2% of cases, B12 vitamin mean levels were low in 8 participants (14.0%), and 8 patients had D hypovitaminosis (14.0%). Abnormal homocysteine levels were associated with worse performance of verbal fluency (p = 0.003) and worse executive function (Stroop E test p = 0.040). The 25-OH D hypovitaminosis was associated with worse performances in executive functions in three different tests: Stroop E (p = 0.049), Trail B (p = 0.035), and Wais Digit Span (p = 0.042). Pathological levels of B12 Vitamin were also associated to worse performances in executive functions (Trail B Test and Wais Digit Span respectively p = 0.002 and 0.029) and with a lower speed in psychomotor processing (Peg Board Test on dominant hand, p = 0.014).ConclusionsIn this study serum homocysteine, B12, and D vitamin levels are associated with neurocognitive performances; in fact low performance neurocognitive was correlated with hyperhomocysteine and low B12vitamin, and D vitamin levels. Evidence of the alteration of these parameters could facilitate the early identification of a neurocognitive impairment.

Association between neuropathy and B‐vitamins: A systematic review and meta‐analysis

“…Hyperhomocysteinaemia and vitamin B12 deficiency are often detected in patients affected with diseases associated with neuropathy such as diabetes, 66 alcoholism, 67 Parkinson’s disease (treated with L‐dopa), 68 or HIV infection 69 . Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients.…”

Gender- and age-related differences in homocysteine concentration: a cross-sectional study of the general population of China

“…folate or vitamin B12 deficiency) 17 . It has been reported that vitamin B12 or folate 8 deficiency was the cause in two thirds of patients with hyperhomocysteinemia studied. The vitamin B12-dependent enzyme methionine synthase catalyzes the transfer of the methyl group from N-5-methyl-tetrahydrofolate to Hcy to form methionine.…”

“…Homocysteine (Hcy), which has caught the attention of researchers and clinicians in recent years, is a recognized biomarker and an established independent risk factor for various diseases 1 , including cardiovascular disease (CVD) [2][3][4][5][6] , neurocognitive disorders 7,8 and osteoporotic fracture 9,10 .…”

Neuroimaging and Cognitive Evidence for Combined HIV‐Alcohol Effects on the Central Nervous System: A Review

“…Thiamine deficiency is associated with episodic memory deficit and ataxia (Fama et al, 2019; Mulholland, 2006) and underlies Wernicke’s encephalopathy in both AUD and PLWH (Le Berre et al, 2019; Martin et al, 2003). The pattern of nutritional deficiencies in PLWH is wider, and in particular, B12 and D vitamin deficiencies have been linked to worse executive function and psychomotor speed among PLWH (Falasca et al, 2019). Specific profiles of deficiency associated with HIV/AUD are not yet established.…”