Homocisteína y trastornos neurocognitivos. ¿Una luz al final del túnel?

  • Gilberto J. Vizcaíno-Salazar Universidad Técnica de Manabí - Universidad del Zulia
Palabras clave: homocisteína, metilentetrahidrofolato reductasa, ácido fólico, vitamina B12, vitamina B6, disfunción cognitiva, demencia, enfermedad de Alzheimer.

Resumen

El deterioro cognitivo es uno de los procesos que acompañan al envejecimiento y puede depender de factores nutricionales, genéticos o ambientales. La identificación de factores de riesgo modificables proporciona un enfoque esencial para la prevención de dicho deterioro y de los trastornos neurocognitivos. Uno de los factores de riesgo involucrados es la elevada concentración de homocisteína plasmática, la cual se ha relacionado con hallazgos histopatológicos en demencia senil y enfermedad de Alzheimer. Los diferentes estudios sobre esta asociación revelan inconsistencia o contradicción en los resultados. El propósito de esta revisión es relacionar la posible interacción de tres factores en la instalación y progresión del deterioro neurocognitivo: a) factores de tipo nutricional (homocisteína, ácido fólico y vitamina B12), b) la utilización de pruebas para el diagnóstico de disfunción o deterioro cognitivo como el Mini Examen del Estado Mental, y c) la presencia de variantes genéticas polimórficas de la enzima metilentetrahidrofolato reductasa. Una consecuencia directa de esta triple relación es que el tratamiento con ácido fólico y vitamina B12 logra disminuir las elevadas concentraciones de homocisteína plasmática, asumiendo que una mejoría en los síntomas clínicos de deterioro cognitivo puede retrasar los cambios relacionados con progresión a estados demenciales. La intervención temprana mediante políticas de promoción y prevención de la salud mental puede ser efectiva si se comienza con la administración de ácido fólico y vitamina B12 en los estadios iniciales de la alteración cognitiva, logrando así reducir sus funestas consecuencias. Las políticas de salud pública centradas en la salud mental de ancianos pueden identificar a las personas con disfunción cognitiva inicial a través de la promoción de la salud y medidas preventivas; en esta etapa puede ser posible la administración de vitaminas B para reducir o minimizar la progresión del deterioro cognitivo, que podría conducir a trastornos neurocognitivos como la demencia y la enfermedad de Alzheimer.

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Biografía del autor/a

Gilberto J. Vizcaíno-Salazar, Universidad Técnica de Manabí - Universidad del Zulia

Médico, Especialista en Hematología, PhD en Ciencias Médicas. Profesor Titular, Facultad de Ciencias de la Salud, Universidad Técnica de Manabí. Portoviejo, Ecuador. Facultad de Medicina, Universidad del Zulia. Maracaibo, Venezuela. E-mail: gilvizcaino@gmail.com.

Citas

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Cómo citar
1.
Vizcaíno SalazarGJ. Homocisteína y trastornos neurocognitivos. ¿Una luz al final del túnel?. Med. Lab. [Internet]. 3 de marzo de 2020 [citado 28 de marzo de 2020];24(2):111-29. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/210
Publicado
2020-03-03
Sección
Artículos de revisión