Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
Psychiatry Clin Neurosci. 2020 Sep;74(9):466-471. doi: 10.1111/pcn.13074. Epub 2020 Jun 30.
Sex differences in serum folate concentrations are well known, but no studies have investigated the association between serum folate levels and schizophrenia based on sex. With this study in a Japanese population, we examined the difference in serum folate levels between patients with schizophrenia and non-psychiatric controls stratified by sex. The relations among serum folate levels, plasma total homocysteine (tHcy), and serum vitamin B6 (pyridoxal) levels were also examined using data from our previous studies.
The serum folate concentrations of 482 patients diagnosed with schizophrenia and 1350 non-psychiatric control subjects were measured. We conducted an analysis of covariance to examine the differences in serum folate levels between the two groups based on sex. Spearman's rank correlation was used to evaluate the relations among folate, tHcy, and vitamin B6 levels.
In the control group, serum folate concentrations were higher in women than in men. Lower levels of serum folate were observed in both male and female patients with schizophrenia. An inverse correlation between serum folate and plasma tHcy and a weak positive correlation between serum folate and vitamin B6 were observed in the combined cohort.
Our findings suggest that: (i) a low serum folate level may be associated with schizophrenia regardless of sex; and (ii) folate administration may be beneficial for the treatment of schizophrenia. In schizophrenic patients with low serum folate levels, folate administration might result in improvements in high tHcy and an increase in low vitamin B6 levels.
血清叶酸浓度的性别差异众所周知,但尚无研究基于性别探讨血清叶酸水平与精神分裂症之间的关系。本研究在日本人群中,按性别对精神分裂症患者和非精神科对照者的血清叶酸水平进行了分层比较。我们还利用来自先前研究的数据,考察了血清叶酸水平与血浆总同型半胱氨酸(tHcy)和血清维生素 B6(吡哆醛)水平之间的关系。
检测了 482 名精神分裂症患者和 1350 名非精神科对照者的血清叶酸浓度。我们采用协方差分析,基于性别比较两组间血清叶酸水平的差异。采用斯皮尔曼等级相关分析评估叶酸、tHcy 和维生素 B6 水平之间的关系。
在对照组中,女性的血清叶酸浓度高于男性。男性和女性精神分裂症患者的血清叶酸水平均较低。在合并队列中,观察到血清叶酸与血浆 tHcy 呈负相关,与维生素 B6 呈弱正相关。
我们的研究结果表明:(i)低血清叶酸水平可能与精神分裂症有关,而与性别无关;(ii)补充叶酸可能有益于精神分裂症的治疗。在血清叶酸水平较低的精神分裂症患者中,补充叶酸可能会改善高 tHcy 和增加低维生素 B6 水平。