单相抑郁、双相抑郁及精神分裂症与一碳代谢营养素的相关性研究
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国家自然科学基金(82101600);北京市医院管理中心培育计划项目(PX2022076)


Association of one-carbon metabolizing nutrients with unipolar depression, bipolar depression and schizophrenia
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    摘要:

    目的 分析单相抑郁、双相抑郁、精神分裂症与一碳代谢营养素的相关性,为探索不同精 神疾病的机制提供线索,为辅助治疗提供依据。方法 选取 2013 年 1 月至 2019 年 12 月在首都医科大学 附属北京安定医院住院的 390 例单相抑郁患者、390 例双相抑郁患者、865 例精神分裂症患者作为研究对 象。比较 3 组患者的一般资料、临床资料及一碳代谢营养素(叶酸、维生素 B12、同型半胱氨酸)水平。采 用二项 Logistic 回归分析控制混杂因素,分析 3 种疾病与一碳代谢营养素的相关性。结果 与单相抑郁 和双相抑郁患者比较,精神分裂症患者的维生素 B12水平更低[438.5 (322.3, 581.3) pg/ml 比 449.9 (345.4, 613.3)pg/ml比376.9 (280.3, 505.3)pg/ml],同型半胱氨酸水平更高[14.3 (11.5, 18.7) μmol/L比14.0 (11.6, 18.3)μmol/L 比 15.4 (12.4, 22.1)μmol/L],维生素 B12缺乏的发生率[6.2%(24/390)比 4.9%(19/390)比 9.5% (82/865)]、高同型半胱氨酸血症的发生率更高[44.9%(175/390)比 41.8%(163/390)比 51.9%(449/865)], 差异均有统计学意义(P< 0.05)。3 种疾病患者的叶酸水平及叶酸缺乏发生率比较,差异无统计学意义 (P> 0.05)。多因素 Logistic 回归分析显示,维生素 B12水平(OR=0.998,95%CI=0.998~0.999)是精神分裂 症的影响因素(P< 0.05)。单相抑郁和双相抑郁患者之间的一碳代谢营养素水平比较,差异无统计学意 义(P> 0.05)。结论 与单相抑郁及双相抑郁患者相比,精神分裂症患者一碳代谢营养素不足更明显, 维生素 B12水平更低,同型半胱氨酸水平更高;双相抑郁与单相抑郁患者间一碳代谢营养素无明显差异

    Abstract:

    Objective To explore the correlation between unipolar depression, bipolar depression, schizophrenia and one carbon metabolizing nutrients, so as to provide clues for exploring the mechanism of different diseases and provide evidence for adjuvant therapy. Methods Inpatients in Beijing Anding Hospital Affiliated to Capital Medical University from January 2013 to December 2019 were selected as the research objects. A total of 390 patients with unipolar depression, 390 patients with bipolar depression and 865 patients with schizophrenia were included. General demographic data and one-carbon metabolizing nutrients (folic acid, vitamin B12, homocysteine) were compared among the three groups. Multiple Logistic regression analysis was used to control confounding factors and to clarify the correlation between the three diseases and one carbon metabolizing nutrient. Results Compared with unipolar depression and bipolar depression group, the level of vitamin B12 in schizophrenia patients was lower[438.5 (322.3, 581.3) pg/ml vs 449.9 (345.4, 613.3)pg/ml vs 376.9 (280.3, 505.3)pg/ml], the level of homocysteine was higher[14.3 (11.5, 18.7) μmol/L vs 14.0 (11.6, 18.3)μmol/L vs 15.4 (12.4, 22.1)μmol/L], the incidence rate of vitamin B12 deficiency was higher [6.2% (24/390) vs 4.9%(19/390)vs 9.5%(82/865)], and hyperhomocysteinemia was higher [44.9%(175/390) vs 41.8% (163/390) vs 51.9%(449/865)], and all differences were statistically significant (all P < 0.05). There was no significant difference in the distribution of folate level and folate deficiency among all groups (P>0.05). Multiple Logistic regression analysis showed that vitamin B12 level (OR=0.998, 95%CI=0.998-0.999) was the risk factors of schizophrenia (P< 0.05). There was no significant difference in the levels of one-carbon metabolizing nutrients between unipolar depression and bipolar depression group (P> 0.05). Conclusions Compared with unipolar depression and bipolar depression patients, schizophrenia patients have more obvious one-carbon metabolic nutrient deficiency, lower vitamin B12 level and higher homocysteine level. There was no significant difference in the levels of one-carbon metabolizing nutrients between unipolar depression and bipolar depression patients.

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吕楠,付冰冰,岳子祺,王瀚,黄娟,李金红,赵茜.单相抑郁、双相抑郁及精神分裂症与一碳代谢营养素的相关性研究[J].神经疾病与精神卫生,2023,23(3).
DOI :10.3969/j. issn.1009-6574.2023.03.007.

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  • 在线发布日期: 2023-05-06