处于病情稳定期的双相情感障碍患者若出现功能衰退，其同型半胱氨酸水平会升高。
Elevated homocysteine levels in euthymic bipolar disorder patients showing functional deterioration.
作者信息
Osher Yamima, Sela Ben-Ami, Levine Joseph, Belmaker Robert H
机构信息
Stanley Research Center, Ministry of Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel.
出版信息
Bipolar Disord. 2004 Feb;6(1):82-6. doi: 10.1046/j.1399-5618.2003.00082.x.
OBJECTIVE
Previous studies have found elevated plasma homocysteine levels in schizophrenic patients. This study examined homocysteine levels in euthymic bipolar patients.
METHODS
Homocysteine levels in 41 euthymic outpatients with bipolar disorder (DSM IV) were compared with 305 comparison subjects from a large employee health screening program. Homocysteine levels were assessed using high-pressure liquid chromatography by fluorescence detection following labeling of homocysteine with monobromobimane. Functional deterioration in patients was rated as 'present' or 'absent' by consensus of two treating clinicians.
RESULTS
Data were analyzed by two-way (sex, patient versus control) ANCOVA, with age as the covariant. Significant effects were found for age (p < 0.001) and for sex (p < 0.001) and a significant two-way interaction was found for group by sex (p < 0.001). One-way (by group) ANCOVAs were then performed separately for each sex. For the male subjects, a main effect was found for group (p = 0.001) and for age (p < 0.001): young male bipolar patients have higher homocysteine levels than controls. Among the females, bipolar patients had homocysteine levels, which were lower than controls across all age groups (p < 0.05) with homocysteine levels increasing with age for both groups (p < 0.001). ANCOVA, which divided subjects into three groups - bipolar patients with and without functional deterioration versus comparison subjects - found a significant group by sex interaction (p < 0.05). Sheffe'post-hoc comparisons revealed that among the male subjects, bipolar patients showing deterioration had homocysteine levels which were significantly higher than those of comparison subjects, while bipolar subjects without deterioration had homocysteine levels which were almost identical to the comparison subjects.
CONCLUSION
Bipolar patients who show functional deterioration have plasma levels of homocysteine, which are significantly elevated as compared with controls.
目的
既往研究发现精神分裂症患者血浆同型半胱氨酸水平升高。本研究检测了心境正常的双相情感障碍患者的同型半胱氨酸水平。
方法
将41例心境正常的双相情感障碍（DSM-IV）门诊患者的同型半胱氨酸水平与来自大型员工健康筛查项目的305名对照受试者进行比较。同型半胱氨酸水平采用高压液相色谱法，在同型半胱氨酸用单溴双马来酰亚胺标记后通过荧光检测进行评估。由两名主治医生共同评定患者的功能恶化情况为“存在”或“不存在”。
结果
数据采用双向（性别、患者与对照）协方差分析，以年龄作为协变量。发现年龄（p < 0.001）和性别（p < 0.001）有显著影响，且发现组与性别的双向交互作用显著（p < 0.001）。然后对每种性别分别进行单向（按组）协方差分析。对于男性受试者，发现组（p = 0.001）和年龄（p < 0.001）有主效应：年轻男性双相情感障碍患者的同型半胱氨酸水平高于对照组。在女性中，双相情感障碍患者的同型半胱氨酸水平在所有年龄组均低于对照组（p < 0.05），且两组的同型半胱氨酸水平均随年龄增加（p < 0.001）。协方差分析将受试者分为三组——有和没有功能恶化的双相情感障碍患者与对照受试者——发现组与性别的交互作用显著（p < 0.05）。谢费尔事后比较显示，在男性受试者中，表现出功能恶化的双相情感障碍患者的同型半胱氨酸水平显著高于对照受试者，而没有功能恶化的双相情感障碍受试者的同型半胱氨酸水平与对照受试者几乎相同。
结论
表现出功能恶化的双相情感障碍患者的血浆同型半胱氨酸水平与对照组相比显著升高。
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