"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Margaret Mead
Research Article

Relationship between blood levels of methyl donor and folate and mild cognitive impairment in Chinese patients with type 2 diabetes: a case-control study


Type 2 diabetes is a risk factor for Alzheimer’s disease and mild cognitive impairment. Folate insufficiency fosters a decline in the sole methyl donor, S-adenosylmethionine, and decreases methylation potential, which is associated with Alzheimer’s disease in non-diabetic patients. However, little is known in diabetic patients. We analyzed plasma levels of S-adenosylmethionine, S-adenosylhomocysteine and serum level of folate in 100 elderly type 2 diabetic patients with and without mild cognitive impairment. S-adenosylmethionine/S-adenosylhomocysteine ratio was used to reflect the methylation potential. Patients with mild cognitive impairment had significantly lower levels of S-adenosylmethionine, folate and S-adenosylmethionine/S-adenosylhomocysteineratios. Furthermore, logistic regression analysis indicated the plasma S-adenosylmethionine, S-adenosylmethionine/S-adenosylhomocysteine ratio and serum folate (OR, 0.96, 0.698, 0.72, respectively; p<0.05) were negatively associated with risk of mild cognitive impairment, even after adjusting for related covariates. In addition, folate level was positively correlated with S-adenosylmethionine and the S-adenosylmethionine/S-adenosylhomocysteine ratio (r = 0.38, 0.46, respectively; p<0.05) among patients within the middle tertile of folate levels (6.3–9.1 µg/L). These findings indicate mild cognitive impairment is associated with lower levels of S-adenosylmethionine, folate and weakened methylation potential; plasma S-adenosylmethionine and methylation potential may be predicted by serum folate within a suitable range of folate concentrations in diabetic patients.