Doğanavşargil Baysal G Özge, Gökmen Zehra, Akbaş Halide, Cinemre Buket, Metin Özmen, Karaman Taha
Psikiyatri Bl., Akdeniz Üniv. Tıp Fak., Antalya.
Turk Psikiyatri Derg. 2013 Spring;24(1):7-16.
The relationship between homocysteine (HCY) levels and cognitive impairments, particularly executive functions in bipolar disorder (BD), has recently been investigated. However, conflicting results were reported. The aim of the present study is to investigate changes in serum HCY, methionine, vitamine B12 and levels in BD patients are relative to controls and to investigate the relationship between HCY, methionine, vitamin B12, and folate levels and clinical features, cognitive functions and psychosocial functioning in euthymic BD patients and controls.
Sixty BD type I euthymic patients and twenty controls were assessed with Global Assessment of Functioning and a battery of neuropsychological tests including the Wisconsin card sorting test, the Rey's auditory verbal learning test, the Cancellation test, Trail making test A, Trail making test B, and the Stroop test. HCY, vitamin B12, methionine and folate levels were measured together after collecting blood samples from both patient and controls.
Mean serum methionine concentration was different between groups. Low serum methionine was found to be a predictor of BD. However, a statistically significant difference was not detected between groups for mean serum values of HCY, folate, or vitamin B12. HCY levels showed a positive correlation with illness duration, the number of total episodes, and the number of manic episodes. A significant correlation was not found between HCY, methionine, folate, B12 levels with cognitive functions and functioning in the BD group.
Low serum methionine was found to be a predictor of BD, a condition which can lead to a decrease in SAM synthesis and thus to a variety of complications in methylation reactions. Additional studies are needed to clarify the impact of single carbon metabolism on BD.
近期已对同型半胱氨酸（HCY）水平与认知障碍，尤其是双相情感障碍（BD）的执行功能之间的关系展开研究。然而，研究结果相互矛盾。本研究旨在调查BD患者血清HCY、蛋氨酸、维生素B12水平相对于对照组的变化情况，并探究HCY、蛋氨酸、维生素B12和叶酸水平与处于心境正常期的BD患者及对照组的临床特征、认知功能和社会心理功能之间的关系。
对60例I型心境正常期的BD患者和20名对照组进行了功能总体评定，并进行了一系列神经心理学测试，包括威斯康星卡片分类测验、雷伊听觉词语学习测验、删字测验、连线测验A、连线测验B和斯特鲁普测验。在从患者和对照组采集血样后，同时测量HCY、维生素B12、蛋氨酸和叶酸水平。
两组间平均血清蛋氨酸浓度存在差异。低血清蛋氨酸被发现是BD的一个预测指标。然而，两组间HCY、叶酸或维生素B12的平均血清值未检测到统计学上的显著差异。HCY水平与病程、总发作次数和躁狂发作次数呈正相关。在BD组中，未发现HCY、蛋氨酸、叶酸、B12水平与认知功能及功能之间存在显著相关性。
低血清蛋氨酸被发现是BD的一个预测指标这种情况可导致S-腺苷甲硫氨酸合成减少，进而导致甲基化反应中出现各种并发症。需要进一步研究以阐明单碳代谢对BD的影响。
