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Clinical Trial
. 2019 Oct 11;11(1):139.
doi: 10.1186/s13148-019-0741-y.

Dietary intakes and biomarker patterns of folate, vitamin B6, and vitamin B12 can be associated with cognitive impairment by hypermethylation of redox-related genes NUDT15 and TXNRD1

Yu An  1 , Lingli Feng  1   2 , Xiaona Zhang  1 , Ying Wang  1 , Yushan Wang  1 , Lingwei Tao  1 , Zhongsheng Qin  3 , Rong Xiao  4
Affiliations
Clinical Trial

Dietary intakes and biomarker patterns of folate, vitamin B6, and vitamin B12 can be associated with cognitive impairment by hypermethylation of redox-related genes NUDT15 and TXNRD1

Yu An et al. Clin Epigenetics. .

Abstract

Background: B vitamins in the one-carbon metabolism pathway (folate, vitamin B6, and vitamin B12) have been implicated in DNA methylation, and their deficiency may contribute to cognitive decline through increased homocysteine (Hcy) levels and subsequent oxidative damage. The aim of this study was to investigate whether B vitamin deficiency and increased Hcy could interact with DNA methylation of oxidative-related genes and exacerbate cognitive impairment.

Methods: Participants were selected from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study. We included 2533 participants who completed a selection of comprehensive cognitive tests and a semiquantitative food frequency questionnaire (FFQ) and were followed for an average of 2.3 years. The longitudinal effects of B vitamin intake on cognitive decline were examined using linear mixed-effect models. Seven mild cognitive impairment (MCI) patients, in the predementia stage of Alzheimer's disease (AD), and fivev healthy controls were selected for the discovery of genome-wide differentially methylated CpG sites. Candidate oxidative stress-related genes significantly correlated with serum levels of B vitamins were selected for validation in 102 MCI patients and 68 controls. The correlations between DNA methylation levels and serum concentrations of B vitamins and oxidative biomarkers were analyzed with Spearman's correlation. The interactive effects of DNA methylation and B vitamins on cognitive performance were further evaluated by multiple linear regression.

Results: In the prospective analysis, inadequate dietary intake of vitamin B12 was significantly associated with accelerated cognitive decline, whereas adequate folate, vitamin B6, and vitamin B12 intakes were significantly associated with better cognitive reserve. In the case-control analysis, the DNA methylation levels of NUDT15 and TXNRD1 were examined, and significantly hypermethylated sites were identified in MCI patients. Significant correlations of hypermethylated sites with serum levels of folate, homocysteine (Hcy), and oxidative biomarkers were observed, and interactive effects of B vitamins and hypermethylated sites were significantly associated with cognitive performance.

Conclusion: Adequate dietary folate at baseline predicted a better cognitive reserve, while decreased serum levels of B vitamins may contribute to cognitive impairment by affecting methylation levels of specific redox-related genes.

Trial registration: EMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610.

Keywords: Cognitive impairment; DNA methylation; Folate; Oxidative stress; Vitamin B12.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Scatterplot matrix of serum folate and oxidative biomarkers. ROS reactive oxygen species, MDA malondialdehyde, 8-OHdG 8-hydroxy-desoxyguanosine, 8-iso-PGF2α 8-iso-prostaglandin F2α
Fig. 3
Fig. 3
Scatterplot matrix of serum Hcy and oxidative biomarkers. Hcy homocysteine, ROS reactive oxygen species, MDA malondialdehyde, 8-OHdG 8-hydroxy-desoxyguanosine, 8-iso-PGF2α 8-iso-prostaglandin F2α
Fig. 4
Fig. 4
Comparisons in DNA methylation for CpG_17 and CpG_19 located within NUDT15 between MCI patients and controls. The box lines represent median ± interquartile ranges of DNA methylation, which is expressed as a beta value (0-1). NUDT15 nudix hydrolase 15, TXNRD1 thioredoxin reductase 1, MCI mild cognitive impairment
Fig. 5
Fig. 5
Comparisons in DNA methylation for CpG_9 and CpG_11 located within TXNRD1 between MCI patients and controls. The box lines represent median ± interquartile ranges of DNA methylation, which is expressed as a beta value (0-1). NUDT15 nudix hydrolase 15, TXNRD1 thioredoxin reductase 1, MCI mild cognitive impairment
Fig. 6
Fig. 6
Scatterplot matrix of B vitamin and oxidative biomarkers correlated with DNA methylation levels of NUDT15. NUDT15 nudix hydrolase 15, Hcy homocysteine, ROS reactive oxygen species, 8-OHdG 8-hydroxy-desoxyguanosine
Fig. 7
Fig. 7
Scatterplot matrix of B vitamin and oxidative biomarkers correlated with DNA methylation levels of TXNRD1. TXNRD1 thioredoxin reductase 1, Hcy homocysteine, 8-iso-PGF2α 8-iso-prostaglandin F2α
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