Ne content with the AD group was higher than that of your cascular dementia group (Figure ).Discussion Homocysteine is an intermediate product of methionine metabolism.Numerous studies showed that homocysteine was an independent threat factor for coronary artery disease, cerebrovascular disease, peripheral vascular disease and other folks.Some research held that hyperhomocysteinemia played a role within the occurrence and improvement of AD.Studies have shown that high homocysteine brought on cognitive function and resulted in AD, which could be associated with biochemical harm triggered by oxidative strain .High levels of homocysteine can markedly enhance the content material of oxygen no cost radicals and promote the formation of nitric oxide.Higher levels of nitric oxide can develop into neurotoxic substances .Oxygen free radicals can market schizolysis of APP ( amyloid protein precursor) and formation of A amyloid protein, as a result rising the generation and deposition of A, which is the principle pathological modify in AD.Our study result showed that when the AD group was compared with the standard control group, the MMSE score was lower plus the homocysteine content higher, with a statistically important distinction amongst the two groups (P ).When the AD group was compared using the vascular dementia group, the MMSE scores were not substantially various among the two groups (P ); the homocysteine content on the AD group was lower than that from the vascular dementia group, with a statistically important distinction (P ).According to the comprehensive outcome in the above documents, it was usually deemed that the MMSE score and homocysteine content material could possibly be applied as one of the PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21593114 indicators to distinguish AD and regular elderly subjects, as well as the homocysteine content material as one with the indicators to distinguish AD and vascular dementia.The result of our metaanalysis was restricted in the following aspects firstly, despite the fact that our study DMNQ Cancer incorporated publications, we didn’t make stratified analysis on gender and various ages, so we could not see much more detailed outcome; secondly, there existed selection bias that could not be excluded plus the influence of confounding factors that couldn’t be determined; furthermore, there existed methodological defects in publications incorporated in our metaanalysis, such as not clearly explaining random technique, blinding technique and others, which impacted our analysis benefits.It really is held in evidencebased medicine that the evidence obtained from randomized controlled clinical trials has the strongest authenticity and reliability; and the complete conclusion is a lot more convincing from systematic evaluation on numerous RCT and metaanalysis, as compared with single RCT.Most studies integrated in our analysis are retrospective casecontrol studies and do not belong for the RCT category in the strict sense, which straight impacts the demonstration strength of our metaanalysis result.Inside the future, when creating systematic evaluation on multicenter RCT research among elderly men and women, we are hopeful to acquire conclusive evidence around the partnership in cognitive function involving homocysteine and AD, then offering directions to clinical practice and generating clinical intervention tactic additional rational.Disclosure of conflict of interest None.Address correspondence to Dr.Yuan Zhong, Department of Geriatrics, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Yishan Road, Shanghai , China.Tel ; Email [email protected]
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