South Carolina Department of Mental Health and Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC, USA.
World J Biol Psychiatry. 2011 Feb;12(1):73-9. doi: 10.3109/15622975.2010.489619. Epub 2010 Jun 29.
We sought to evaluate clinical correlates of low serum carnitine levels in hospitalized psychiatric patients.
We retrospectively reviewed the charts of 40 psychiatric inpatients identified to have low serum carnitine levels.
Cognitive impairment was present in 38 (95%) cases, frequently accompanied by imbalance, agitation and extrapyramidal symptoms. Valproate therapy was encountered in 28 (70%) patients. The dosage of valproate negatively correlated with total and free carnitine levels (P = 0.003 and 0.0136). Polypharmacy also affected carnitine levels, indicating additional modulatory effects on carnitine metabolism. We encountered a disproportionately high prevalence of mental retardation and dementia in association with hypocarnitinemia.
We hypothesize that in the context of mental illness hypocarnitinemia may be associated with metabolic encephalopathy and cognitive impairment. As carnitine deficiency is a potentially treatable condition further studies are warranted.
我们旨在评估住院精神科患者低血清肉碱水平的临床相关性。
我们回顾性地分析了 40 名被确定为低血清肉碱水平的住院精神科患者的病历。
38 例（95%）患者存在认知障碍，常伴有失衡、激越和锥体外系症状。28 例（70%）患者接受了丙戊酸盐治疗。丙戊酸盐的剂量与总肉碱和游离肉碱水平呈负相关（P=0.003 和 0.0136）。多种药物治疗也会影响肉碱水平，表明对肉碱代谢有额外的调节作用。我们发现智力迟钝和痴呆与低肉碱血症的发病率不成比例地高。
我们假设在精神疾病的背景下，低肉碱血症可能与代谢性脑病和认知障碍有关。由于肉碱缺乏是一种潜在可治疗的疾病，因此需要进一步的研究。
