Zhang Jingyuan, Liao Qiao, Chen Hengshu, Liu Fan, Sun Dongren, Luo Shihang, Xiao Yeqing, Xu Weiye, Tian Fafa, Song Mingyu
Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410005, People's Republic of China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410005, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Nov 26;20:2289-2298. doi: 10.2147/NDT.S480417. eCollection 2024.
Post-stroke depression (PSD) is a common neuropsychiatric complication after a stroke with complex mechanisms. However, few studies have identified the role of vitamin B12 and folate in the occurrence and pathophysiology of PSD. The aim of our study is to investigate the relationship among vitamin B12, folate, their transporter genes, and early-onset PSD.
A total of 173 ischemic stroke patients were recruited in Xiangya Hospital of Central South University. We collected peripheral blood samples, clinical data, and demographics at admission. The 17-item Hamilton Depression Scale was used for screening for the existence of depression at 2 weeks after stroke onset. Serum vitamin B12 and folate level were measured based on double-antibody sandwich enzyme-linked immune-sorbent assay. Four single nucleotide polymorphisms (SNP) of () and solute carrier family 19 member 1 were genotyped using SNPscan multiplex SNP typing Kit.
Eighty-four patients were diagnosed with PSD at 2 weeks after stroke onset, and the incidence rate was 48.6%. Serum vitamin B12 level in PSD group was significantly lower than those in the non-PSD group (=0.018). Binary logistic regression revealed that rs1801198 GG genotype and G allele were associated with an increased risk of PSD after adjustment for confounding factors (for GG genotype, OR = 4.253, 95% CI = 1.71110.572, = 0.002; for G allele, OR = 2.134, 95% CI = 1.3623.343, = 0.001). Moreover, individuals with the rs1801198 G allele in the PSD group exhibited lower vitamin B12 level than those with the rs1801198 G allele in the non-PSD group (0.045).
rs1801198 and vitamin B12 are associated with the risk of early-onset PSD, and they may be involved in the development of PSD. Our study presents a novel standpoint for the treatment of PSD and gains insights into the mechanistic underpinnings of PSD.
中风后抑郁（PSD）是中风后常见的神经精神并发症，机制复杂。然而，很少有研究确定维生素B12和叶酸在PSD发生及病理生理过程中的作用。本研究旨在探讨维生素B12、叶酸及其转运基因与早发性PSD之间的关系。
中南大学湘雅医院共招募了173例缺血性中风患者。入院时采集外周血样本、临床资料和人口统计学数据。采用17项汉密尔顿抑郁量表在中风发作后2周筛查是否存在抑郁。基于双抗体夹心酶联免疫吸附测定法测定血清维生素B12和叶酸水平。使用SNPscan多重SNP分型试剂盒对（）和溶质载体家族19成员1的四个单核苷酸多态性（SNP）进行基因分型。
84例患者在中风发作后2周被诊断为PSD，发病率为48.6%。PSD组血清维生素B12水平显著低于非PSD组（=0.018）。二元逻辑回归显示，在调整混杂因素后，rs1801198 GG基因型和G等位基因与PSD风险增加相关（对于GG基因型，OR = 4.253，95% CI = 1.71110.572，= 0.002；对于G等位基因，OR = 2.134，95% CI = 1.3623.343，= 0.001）。此外，PSD组中携带rs1801198 G等位基因的个体的维生素B12水平低于非PSD组中携带rs1801198 G等位基因的个体（0.045）。
rs1801198和维生素B12与早发性PSD风险相关，它们可能参与了PSD的发生发展。本研究为PSD的治疗提供了新的观点，并深入了解了PSD的发病机制。
