Chen Cheng-Sheng, Tsai Jer-Chia, Tsang Hin-Yeung, Kuo Yu-Ting, Lin Hsiu-Fen, Chiang I-Chan, Devanand D P
Dept. of Psychiatry, Kaohsiung Medical University, Chung-Ho Memorial Hospital, No. 100, Tzyou 1 Rd, Kaohsiung City, Taiwan 807.
Am J Geriatr Psychiatry. 2005 Oct;13(10):869-75. doi: 10.1176/appi.ajgp.13.10.869.
Epidemiological studies suggest that elevated plasma homocysteine is associated with an increased risk of depression and cerebrovascular disease. There are no published reports of homocysteine levels and methylenetetrahydrofolate reductase (MTHFR) C677T genotype in clinical samples of patients with late-onset major depressive disorder (MDD). The purpose of this study was to examine the association of homocysteine levels or MTHFR C677T genotype and late-onset MDD and assess whether this may be affected by brain magnetic resonance imaging (MRI) hyperintensities.
Authors recruited 39 elderly patients with MDD with first episode occurring after age 50 and 20 comparison subjects and assessed total plasma homocysteine levels, MTHFR genotype, and brain MRIs.
Plasma total homocysteine levels were higher in elderly patients with late-onset MDD versus comparison subjects. The association did not change after controlling for MRI hyperintensities, and the distribution of MTHFR C677T genotype was not different between the groups.
In this exploratory study, elevated homocysteine levels were associated with late-onset MDD, and the association did not appear to be mediated by vascular pathology as identified by brain MRI hyperintensities.
流行病学研究表明，血浆同型半胱氨酸水平升高与抑郁症和脑血管疾病风险增加有关。关于晚发性重度抑郁症（MDD）患者临床样本中的同型半胱氨酸水平和亚甲基四氢叶酸还原酶（MTHFR）C677T基因型，尚无公开报告。本研究的目的是检验同型半胱氨酸水平或MTHFR C677T基因型与晚发性MDD之间的关联，并评估这是否可能受脑磁共振成像（MRI）高信号的影响。
作者招募了39名50岁后首次发作的老年MDD患者和20名对照受试者，并评估了血浆总同型半胱氨酸水平、MTHFR基因型和脑部MRI。
晚发性MDD老年患者的血浆总同型半胱氨酸水平高于对照受试者。在控制MRI高信号后，这种关联没有改变，两组之间MTHFR C677T基因型的分布没有差异。
在这项探索性研究中，同型半胱氨酸水平升高与晚发性MDD有关，且这种关联似乎不是由脑MRI高信号所识别的血管病变介导的。
