Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jing Wu Road, Huaiyin District, Jinan, 250021, Shandong, China.
Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jing Wu Road, Huaiyin District, Jinan, 250021, Shandong, China.
Neurosci Lett. 2021 Feb 16;746:135650. doi: 10.1016/j.neulet.2021.135650. Epub 2021 Jan 21.
Serum creatinine (SCR) has been shown to be associated with many neurodegenerative diseases. In this study, we investigated the relationship between SCR levels and the incidence of psychiatric symptoms in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis.
The SCR levels were tested in 69 patients with anti-NMDAR encephalitis at admission. Clinical characteristics and blood and CSF parameters were compared between the group of patients with psychiatric symptoms (P + group) and the group of those without psychiatric symptoms (P- group). The association between SCR and the incidence of psychiatric symptoms was determined by multivariate-adjusted linear regression analyses.
The SCR levels in the P + group were significantly lower than those in the P- group (P < 0.001). In the female subgroup, the SCR levels in the P + group were significantly lower compared to the P- group (P < 0.001), whereas in the male subgroup, the SCR levels did not differ between the two groups (P = 0.084). Furthermore, the highest SCR tercile overall had a significantly lower incidence of psychiatric symptoms than the lowest tercile (P < 0.001), and a significant negative correlation between the SCR levels and the occurrence of psychiatric symptoms was observed (r = -0.392, P < 0.001). Multivariate logistic regression analysis showed that the association was independent after adjusting for age, cystatin C and the modified Rankin Scale (mRS) score (P = 0.001). A similar result was found in the female subgroup (P = 0.010), but not in the male subgroup (P = 0.225).
Our study indicated that the SCR level was negatively correlated with incidence of psychiatric symptoms in female patients, and higher SCR level could be a protective factor for psychiatric symptoms in female patients with anti-NMDAR encephalitis.
血清肌酐（SCR）已被证明与许多神经退行性疾病有关。在这项研究中，我们调查了血清肌酐水平与抗 N-甲基-D-天冬氨酸受体（抗 NMDAR）脑炎患者精神症状发生率之间的关系。
在入院时，对 69 例抗 NMDAR 脑炎患者进行了 SCR 水平检测。比较有精神症状组（P+组）和无精神症状组（P-组）之间的临床特征和血液及脑脊液参数。通过多元调整线性回归分析确定 SCR 与精神症状发生率之间的关联。
P+组的 SCR 水平明显低于 P-组（P < 0.001）。在女性亚组中，P+组的 SCR 水平明显低于 P-组（P < 0.001），而在男性亚组中，两组间 SCR 水平无差异（P = 0.084）。此外，总体上 SCR 三分位最高组的精神症状发生率明显低于三分位最低组（P < 0.001），且 SCR 水平与精神症状发生呈显著负相关（r = -0.392，P < 0.001）。多元逻辑回归分析显示，在校正年龄、胱抑素 C 和改良 Rankin 量表（mRS）评分后，这种关联仍然存在（P = 0.001）。在女性亚组中也得到了类似的结果（P = 0.010），但在男性亚组中则没有（P = 0.225）。
我们的研究表明，SCR 水平与女性患者精神症状发生率呈负相关，较高的 SCR 水平可能是女性抗 NMDAR 脑炎患者精神症状的保护因素。
