Abstract
Vitamin status and the presence of subclinical inflammation may affect cognitive performance and behavior. We have investigated the relationship between serum fat soluble vitamins (vitamins A, D, and E) and inflammatory markers with aggression and cognitive abilities, in a population of healthy adolescents. A cross-sectional study of 940 adolescent girls was performed. Serum concentrations of vitamins A, D, and E, hs-C-reactive protein (hs-CRP), and antibody titers to Hsp27 (anti-Hsp27) were measured. Hematological indices including lymphocyte, neutrophil, platelet counts, and red blood cell distribution width (RDW) were evaluated. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and RDW to platelet ratio (RPR) were calculated. A Cognitive Abilities Questionnaire and the Buss-Perry Aggression Questionnaire were applied to assess cognitive performance and aggression, respectively. There was a positive correlation between serum vitamins A with vitamins D and E, as well as between serum hs-CRP with serum vitamin E. Linear regression analysis showed that serum vitamin D, hs-CRP, anti-Hsp27, and RDW were significantly associated with aggression score. Furthermore, serum vitamin E, hs-CRP, anti-Hsp27, NLR, and RPR were significantly associated with cognitive ability score. Inflammatory processes may affect cognitive performance and behavior. Prospective studies are warranted to determine the potential of targeting antioxidant and inflammatory pathways for the treatment of psychological disorder.
Similar content being viewed by others
References
Akıl E, Bulut A, Kaplan İ, Özdemir HH, Arslan D, Aluçlu MU (2015) The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson’s disease. Neurol Sci 36(3):423–428
Anderson DK, Waters TR, Means ED (1988) Pretreatment with alpha tocopherol enhances neurologic recovery after experimental spinal cord compression injury. J Neurotrauma 5(1):61–67
Aung K, Burnett J, Smith SM, Dyer CB (2007) Vitamin D deficiency associated with self-neglect in the elderly. J Elder Abuse Negl 18(4):63–78
Balion C, Griffith LE, Strifler L, Henderson M, Patterson C, Heckman G, … Raina P (2012) Vitamin D, cognition, and dementia a systematic review and meta-analysis. Neurology 79(13):1397–1405
Behl C, Davis J, Cole GM, Schubert D (1992) Vitamin E protects nerve cells from amyloid βprotein toxicity. Biochem Biophys Res Commun 186(2):944–950
Bourre J-M (2006) Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging 10(5):377
Buell JS, Dawson-Hughes B (2008) Vitamin D and neurocognitive dysfunction: preventing “D” ecline? Mol Asp Med 29(6):415–422
Çakır U, Can Tuman T, Yıldırım O (2015) Increased neutrophil/lymphoctye ratio in patients with bipolar disorder: a preliminary study. Psychiatr Danub 27(2):184
Chen Yj, Li Zd, Mao Cy, Kang X, Zhang Sh (2018) An investigation of the levels of vitamins A, D, and E in the serum of Chinese pregnant women. J Clin Lab Anal 32(1). https://doi.org/10.1002/jcla.22176
Choi DW, Rothman SM (1990) The role of glutamate neurotoxicity in hypoxic-ischemic neuronal death. Annu Rev Neurosci 13(1):171–182
Coccaro EF (2006) Association of C-reactive protein elevation with trait aggression and hostility in personality disordered subjects: a pilot study. J Psychiatr Res 40(5):460–465
Coccaro EF, Lee R, Breen EC, Irwin MR (2015) Inflammatory markers and chronic exposure to fluoxetine, divalproex, and placebo in intermittent explosive disorder. Psychiatry Res 229(3):844–849
Courtet P, Jaussent I, Genty C, Dupuy A, Guillaume S, Ducasse D, Olié E (2015) Increased CRP levels may be a trait marker of suicidal attempt. Eur Neuropsychopharmacol 25(10):1824–1831
Dickerson F, Stallings C, Origoni A, Vaughan C, Khushalani S, Yolken R (2012) Additive effects of elevated C-reactive protein and exposure to herpes simplex virus type 1 on cognitive impairment in individuals with schizophrenia. Schizophr Res 134(1):83–88
Dik M, Jonker C, Hack C, Smit J, Comijs H, Eikelenboom P (2005) Serum inflammatory proteins and cognitive decline in older persons. Neurology 64(8):1371–1377
Driskell WJ, Neese JW, Bryant CC, Bashor MM (1982) Measurement of vitamin a and vitamin E in human serum by high-performance liquid chromatography. J Chromatogr B Biomed Sci Appl 231(2):439–444
Engelhart MJ, Geerlings MI, Ruitenberg A, van Swieten JC, Hofman A, Witteman JC, Breteler MM (2002) Dietary intake of antioxidants and risk of Alzheimer disease. Jama 287(24):3223–3229
Fan X, Goff DC, Henderson DC (2007) Inflammation and schizophrenia. Expert Rev Neurother 7(7):789–796
Garcia-Rizo C, Fernandez-Egea E, Oliveira C, Justicia A, Bernardo M, Kirkpatrick B (2012) Inflammatory markers in antipsychotic-naïve patients with nonaffective psychosis and deficit vs. nondeficit features. Psychiatry Res 198(2):212–215
Gibbs HM, Davis L, Han X, Clothier J, Eads LA, Cáceda R (2016) Association between C-reactive protein and suicidal behavior in an adult inpatient population. J Psychiatr Res 79:28–33
Gouado I, Ejoh RA, Kenne M, Ndifor F, Mbiapo FT (2005) Serum concentration of vitamins a and E and lipid in a rural population of North Cameroon. Ann Nutr Metab 49(1):26–32
Graham JE, Robles TF, Kiecolt-Glaser JK, Malarkey WB, Bissell MG, Glaser R (2006) Hostility and pain are related to inflammation in older adults. Brain Behav Immun 20(4):389–400
Group, P. S (1993) Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. N Engl J Med 1993(328):176–183
Jiménez-Jiménez FJ, Molina JA, Bustos F, Ortí-Pareja M, Benito-León J, Tallón-Barranco A, … Arenas J (1999) Serum levels of β-carotene, α-carotene and vitamin a in patients with Alzheimer's disease. Eur J Neurol 6(4):495–497
Jorde R, Waterloo K, Saleh F, Haug E, Svartberg J (2006) Neuropsychological function in relation to serum parathyroid hormone and serum 25–hydroxyvitamin D levels. J Neurol 253(4):464–470
Joseph J, Depp C, Martin AS, Daly RE, Glorioso DK, Palmer BW, Jeste DV (2015) Associations of high sensitivity C-reactive protein levels in schizophrenia and comparison groups. Schizophr Res 168(1):456–460
Komulainen P, Lakka TA, Kivipelto M, Hassinen M, Penttilä IM, Helkala E-L, … Rauramaa R (2007) Serum high sensitivity C-reactive protein and cognitive function in elderly women. Age Ageing 36(4):443–448
Kuyumcu ME, Yesil Y, Oztürk ZA, Kizilarslanoğlu C, Etgül S, Halil M, … Arıoğul S (2012) The evaluation of neutrophil-lymphocyte ratio in Alzheimer’s disease. Dement Geriatr Cogn Disord 34(2):69–74
Lee DM, Tajar A, Ulubaev A, Pendleton N, O’Neill TW, O’Connor DB, … Casanueva FF (2009) Association between 25-hydroxyvitamin D levels and cognitive performance in middle-aged and older European men. J Neurol Neurosurg Psychiatry, 80(7), 722–729
Liu G-L, Pi H-C, Hao L, Li D-D, Wu Y-G, Dong J (2015) Vitamin D status is an independent risk factor for global cognitive impairment in peritoneal dialysis patients. PLoS One 10(12):e0143782
Marsland AL, Prather AA, Petersen KL, Cohen S, Manuck SB (2008) Antagonistic characteristics are positively associated with inflammatory markers independently of trait negative emotionality. Brain Behav Immun 22(5):753–761
Mata-Granados J, Cuenca-Acevedo J, de Castro ML, Holick M, Quesada-Gomez J (2013) Vitamin D insufficiency together with high serum levels of vitamin a increases the risk for osteoporosis in postmenopausal women. Arch Osteoporos 8(1–2):124
McCann JC, Ames BN (2008) Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB J 22(4):982–1001
McGrath J, Scragg R, Chant D, Eyles D, Burne T, Obradovic D (2007) No association between serum 25-hydroxyvitamin D3 level and performance on psychometric tests in NHANES III. Neuroepidemiology 29(1–2):49–54
Mecocci P, Polidori MC, Cherubini A, Ingegni T, Mattioli P, Catani M, … Senin U (2002) Lymphocyte oxidative DNA damage and plasma antioxidants in Alzheimer disease. Arch Neurol 59(5):794–798
Isaac MG, Quinn R, Tabet N (2008) Vitamin E for Alzheimer’s disease and mild cognitive impairment. Cochrane Database Syst Rev (3):CD002854. https://doi.org/10.1002/14651858.CD002854.pub2
Motevalian SA, Asadi-Lari M, Rahimi H, Eftekhar M (2011) Validation of a persian version of motorcycle rider behavior questionnaire. Paper presented at the Annals of Advances in Automotive Medicine/Annual Scientific Conference
Nejati V (2013) Cognitive abilities questionnaire: development and evaluation of psychometric properties. Adv Cog Sci 15(2):11–19
Nes M, Sem S, Rousseau B, Bjørneboe G, Engedal K, Trygg K, Pedersen J (1988) Dietary intakes and nutritional status of old people with dementia living at home in Oslo. Eur J Clin Nutr 42(7):581–593
Nowson CA, McGrath JJ, Ebeling PR, Haikerwal A, Daly RM, Sanders KM, … Mason RS (2012) Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 196(11):686–687
O'donovan A, Rush G, Hoatam G, Hughes BM, McCrohan A, Kelleher C, … Malone KM (2013) Suicidal ideation is associated with elevated inflammation in patients with major depressive disorder. Depress Anxiety 30(4):307–314
Ortega RM, Requejo AM, López-Sobaler AM, Andrés P, Navia B, Perea JM, Robles F (2002) Cognitive function in elderly people is influenced by vitamin E status. J Nutr 132(7):2065–2068
Öztürk ZA, Ünal A, Yiğiter R, Yesil Y, Kuyumcu ME, Neyal M, Kepekçi Y (2013) Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)? Arch Gerontol Geriatr 56(1):50–54
Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, … Myers GL (2003) Markers of inflammation and cardiovascular disease. Circulation 107(3):499–511
Pourghadamyari H, Moohebati M, Parizadeh SMR, Falsoleiman H, Dehghani M, Fazlinezhad A, … Paydar R (2011) Serum antibody titers against heat shock protein 27 are associated with the severity of coronary artery disease. Cell Stress Chaperones 16(3):309–316
Przybelski RJ, Binkley NC (2007) Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Arch Biochem Biophys 460(2):202–205
Rahal A, Singh V, Mehra D, Rajesh S, Ahmad A (2009) Prophylactic efficacy of Podophyllum hexandrum in alleviation of immobilization stress induced oxidative damage in rats. J Nat Prod 2:110–115
Ranjit N, Diez-Roux AV, Shea S, Cushman M, Seeman T, Jackson SA, Ni H (2007) Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med 167(2):174–181
Ravaglia G, Forti P, Maioli F, Brunetti N, Martelli M, Servadei L, … Mariani E (2005) Serum C-reactive protein and cognitive function in healthy elderly Italian community dwellers. J Gerontol Ser A Biol Med Sci 60(8):1017–1021
Rinaldi P, Polidori MC, Metastasio A, Mariani E, Mattioli P, Cherubini A, … Mecocci P (2003) Plasma antioxidants are similarly depleted in mild cognitive impairment and in Alzheimer’s disease. Neurobiol Aging 24(7):915–919
Sandhaus LM, Meyer P (2002) How useful are CBC and reticulocyte reports to clinicians? Am J Clin Pathol 118(5):787–793
Semiz M, Yildirim O, Canan F, Demir S, Hasbek E, Tuman TC, … Tosun M (2014) Elevated neutrophil/lymphocyte ratio in patients with schizophrenia. Psychiatr Danub 26(3):0–225
Seo YJ, Choi JY, Moon IS (2014) Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for diagnosis and prognosis in patients with idiopathic sudden sensorineural hearing loss. Dis Markers 2014
Song I-U, Kim Y-D, Cho H-J, Chung S-W (2013) Is neuroinflammation involved in the development of dementia in patients with Parkinson's disease? Intern Med 52(16):1787–1792
Sriram K, Rodriguez-Fernandez M, Doyle FJ III (2012) A detailed modular analysis of heat-shock protein dynamics under acute and chronic stress and its implication in anxiety disorders. PLoS One 7(8):e42958
Suchankova P, Holm G, Träskman-Bendz L, Brundin L, Ekman A (2013) The+ 1444C> T polymorphism in the CRP gene: a study on personality traits and suicidal behaviour. Psychiatr Genet 23(2):70–76
Teunissen C, Van Boxtel M, Bosma H, Bosmans E, Delanghe J, De Bruijn C, … Steinbusch H (2003) Inflammation markers in relation to cognition in a healthy aging population. J Neuroimmunol 134(1):142–150
Tilvis RS, Kähönen-Väre MH, Jolkkonen J, Valvanne J, Pitkala KH, Strandberg TE (2004) Predictors of cognitive decline and mortality of aged people over a 10-year period. J Gerontol Ser A Biol Med Sci 59(3):M268–M274
Wang R-T, Jin D, Li Y, Liang Q-C (2013) Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer's disease. J Psychiatr Res 47(5):644–649
Weuve J, Ridker PM, Cook NR, Buring JE, Grodstein F (2006) High-sensitivity C-reactive protein and cognitive function in older women. Epidemiology 17(2):183–189
Wilkins CH, Sheline YI, Roe CM, Birge SJ, Morris JC (2006) Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry 14(12):1032–1040
Wium-Andersen MK, Ørsted DD, Nordestgaard BG (2013) Elevated C-reactive protein associated with late-and very-late-onset schizophrenia in the general population: a prospective study. Schizophr Bull 40(5):1117–1127
Yaffe K, Lindquist K, Penninx B, Simonsick E, Pahor M, Kritchevsky S, … Harris T (2003) Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology 61(1):76–80
Acknowledgements
We are grateful to all study participants and their parents.
Funding
This study was funded by Mashhad University of Medical Sciences (Code: 931188) and Sabzevar University of Medical Sciences.
Author information
Authors and Affiliations
Contributions
Concept: M G-M, HRS, H B-T.
Design: A B, H B-T.
Data collection or processing: A B, Z K, G A.F.
Analysis or interpretation: M T.
Literature search: H B-T.
Writing: G A. F, A B.
Corresponding authors
Ethics declarations
Ethics Committee Approval
The approval of the Ethic Committee of the Mashad University of Medical Sciences was obtained about this study (931188); informed consent: It was taken.
Informed Consent
“Informed consent was obtained from all individual participants included in the study.”
Conflict of Interest
The authors who have taken part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bahrami, A., Bahrami-Taghanaki, H., Khorasanchi, Z. et al. The Association Between Neuropsychological Function with Serum Vitamins A, D, and E and hs-CRP Concentrations. J Mol Neurosci 68, 243–250 (2019). https://doi.org/10.1007/s12031-019-01288-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12031-019-01288-x