Department of Psychiatry, The First Hospital of Hebei Medical University, 050031 Shijiazhuang, Hebei, China.
Actas Esp Psiquiatr. 2024 Apr;52(2):99-106. doi: 10.62641/aep.v52i2.1548.
This study aims to explore the correlation and clinical significance of homocysteine and high-sensitivity C-reactive protein levels with cognitive function in patients with bipolar disorder (BD) and borderline personality disorder (BPD).
Patients with BD admitted to our hospital from January 2022 to December 2022 were chosen retrospectively. BPD patients were categorized into comorbidity groups, while those without BPD were assigned to non-comorbidity groups, each consisting of 60 cases. Enzyme-linked immunosorbent assay (ELISA) was utilized to assess serum levels of homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in both patient groups. Clinical symptoms were evaluated by the Hamilton Depression Rating Scale (HAMD) and the Young Mania Rating Scale (YMRS). Cognitive function was evaluated and compared using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pearson correlation analysis was performed on the correlation between patients' serum Hcy and hs-CRP levels and HAMD, YMRS, and RBANS scores.
In the comorbidity group, patients exhibited significantly elevated serum Hcy and hs-CRP levels compared to the non-comorbidity group (p < 0.05). Patients in the comorbidity group displayed higher HAMD and YMRS scores than those in the non-comorbidity group (p < 0.05). Additionally, attention, speech, visual span, immediate memory, and delayed memory in the comorbidity group were notably lower than in the non-comorbidity group (p < 0.05). The speech, visual span, and immediate memory of RBANS in bipolar depressive patients with comorbid BPD were lower than those in bipolar depressive patients without comorbid BPD (p < 0.05), the speech of RBANS in bipolar manic patients with comorbid BPD was lower than those in bipolar manic patients without comorbid BPD (p < 0.05). Pearson correlation analysis showed that the expression of Hcy and hs-CRP in the comorbid group was positively correlated with HAMD and YMRS scores, and negatively correlated with attention, speech, visual span, immediate memory, and delayed memory, and these differences were statistically significant (p < 0.05).
High serum Hcy and hs-CRP expression levels may regulate inflammatory responses, aggravating cognitive impairment in patients with BD and BPD. Serum Hcy and hs-CRP expression levels are significantly related to cognitive dysfunction. They are expected to guide the prevention and treatment of BD comorbid BPD patients.
本研究旨在探讨同型半胱氨酸和高敏 C 反应蛋白水平与双相障碍(BD)和边缘型人格障碍(BPD)患者认知功能的相关性及其临床意义。
回顾性选择 2022 年 1 月至 12 月我院收治的 BD 患者,将 BPD 患者分为合并组,无 BPD 患者分为非合并组,每组各 60 例。采用酶联免疫吸附法(ELISA)检测两组患者血清同型半胱氨酸(Hcy)和高敏 C 反应蛋白(hs-CRP)水平。采用汉密尔顿抑郁量表(HAMD)和 Young 躁狂量表(YMRS)评估临床症状。采用重复性成套神经心理状态测验(RBANS)评估并比较认知功能。对患者血清 Hcy 和 hs-CRP 水平与 HAMD、YMRS 和 RBANS 评分的相关性进行 Pearson 相关性分析。
合并组患者血清 Hcy 和 hs-CRP 水平明显高于非合并组(p<0.05)。合并组患者 HAMD 和 YMRS 评分均高于非合并组(p<0.05)。此外,合并组患者注意力、言语、视觉广度、即刻记忆和延迟记忆明显低于非合并组(p<0.05)。伴 BPD 的双相抑郁患者 RBANS 言语、视觉广度和即刻记忆评分低于不伴 BPD 的双相抑郁患者(p<0.05),伴 BPD 的双相躁狂患者 RBANS 言语评分低于不伴 BPD 的双相躁狂患者(p<0.05)。Pearson 相关性分析显示,合并组 Hcy 和 hs-CRP 表达与 HAMD 和 YMRS 评分呈正相关,与注意力、言语、视觉广度、即刻记忆和延迟记忆呈负相关,差异均有统计学意义(p<0.05)。
高血清 Hcy 和 hs-CRP 表达水平可能通过调节炎症反应,加重 BD 和 BPD 患者的认知损害。血清 Hcy 和 hs-CRP 表达水平与认知功能障碍显著相关,有望指导 BD 合并 BPD 患者的防治。