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中文人群中双相障碍住院患者高同型半胱氨酸血症的患病率及临床-人口统计学相关性。

Prevalence and clinical-demographic correlates of hyperhomocysteinemia in inpatients with bipolar disorder in a Han Chinese population.

机构信息

Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.

Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.

出版信息

Psychiatry Res. 2018 Jan;259:364-369. doi: 10.1016/j.psychres.2017.08.063. Epub 2017 Aug 24.

DOI:10.1016/j.psychres.2017.08.063
PMID:29120844
Abstract

Recent studies have reported that hyperhomocystinemia (HHcy) is highly prevalent in patients with bipolar disorder (BD), placing them at greater risk of cardiovascular disease and possibly serving as a disease biomarker. However, the correlation of HHcy with demographic or clinical parameters is not well known. In this study, we examined the prevalence of HHcy and its association with these parameters in a sample of Chinese BD patients. Fasting plasma homocysteine (Hcy) levels were determined in 198 BD inpatients and 84 healthy controls. HHcy was defined when Hcy concentration exceeded 15.0µmol/L. Affective symptomatology was assessed by the Young Mania Rating Scale, Hamilton Depression Rating Scale and the Clinical Global Impressions severity scale. Compared to healthy controls, BD patients had a significantly higher prevalence (34.85% vs. 19.05%) of HHcy and a higher absolute level of homocysteine. Logistic regression analysis demonstrated that BD patients with HHcy were more likely to be male, have elevated BMI, more frequent treatment on lithium but less on valproate. These results suggest that Chinese inpatients with bipolar disorder have a higher rate of HHcy than the general population, and those at greatest risk are male, have an elevated BMI, and take more lithium but less valproate therapy.

摘要

最近的研究报告称,高同型半胱氨酸血症(HHcy)在双相情感障碍(BD)患者中非常普遍,使他们面临更大的心血管疾病风险,并且可能作为疾病生物标志物。然而,HHcy 与人口统计学或临床参数的相关性尚不清楚。在这项研究中,我们检查了中国 BD 患者样本中 HHcy 的患病率及其与这些参数的相关性。对 198 名住院 BD 患者和 84 名健康对照者进行了空腹血浆同型半胱氨酸(Hcy)水平测定。当 Hcy 浓度超过 15.0µmol/L 时,定义为 HHcy。通过 Young 躁狂评定量表、汉密尔顿抑郁评定量表和临床总体印象严重程度量表评估情感症状。与健康对照组相比,BD 患者 HHcy 的患病率(34.85% vs. 19.05%)显著更高,且同型半胱氨酸的绝对水平也更高。Logistic 回归分析表明,HHcy 的 BD 患者更可能为男性、BMI 升高、锂治疗更频繁而丙戊酸治疗更不频繁。这些结果表明,中国住院的双相情感障碍患者 HHcy 的发生率高于一般人群,而男性、BMI 升高、更多锂治疗而更少丙戊酸治疗的患者风险最大。

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