Du Jianyan, Jiang Rui, Liu Yuanyuan, Zhou Jianan, Luo Guoshuai, Zhang Xiangyang
Tianjin Anding Hospital, Institute of Mental Health, Psychiatric Medical Center of Tianjin University, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
Affiliated Mental Health Center, Hefei Fourth People's Hospital, Anhui Mental Health Center, Anhui Medical University, 316 Huangshan Road, Hefei, 230022, China.
Eur Arch Psychiatry Clin Neurosci. 2025 Sep 9. doi: 10.1007/s00406-025-02106-9.
Elevated homocysteine levels, known as hyperhomocysteinemia (HHcy), have been implicated in the pathophysiology of schizophrenia. Most prior studies focused on first-episode or acute-phase schizophrenia patients, leaving the prevalence, determinants, and clinical correlates of HHcy in chronic schizophrenia understudied. This study aims to investigate the prevalence and determinants of HHcy in patients with chronic schizophrenia, as well as its clinical correlates. METHODS: A cross-sectional study was conducted involving 509 patients diagnosed with chronic schizophrenia, recruited from multiple psychiatric hospitals in China. Demographic, clinical, and lifestyle data were collected through structured interviews and medical record reviews. Blood samples were analyzed for homocysteine levels and other biochemical parameters. The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD), Insomnia Severity Index (ISI), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess clinical symptoms and cognitive function. Binary logistic regression analysis was performed to identify independent predictors of HHcy. RESULTS: The prevalence of HHcy in the study population was 56.2%. Patients with HHcy were significantly older (mean age: 52.1 ± 12.2 years) and had a higher proportion of males (67.1%) compared to those without HHcy. The HHcy group exhibited milder positive and general psychopathology symptoms, as indicated by lower PANSS scores, revealing unexpected inverse associations with symptom severity. Elevated levels of C-reactive protein (CRP), total bilirubin (TBIL), and creatine phosphokinase (CPK) were observed in the HHcy group. Binary logistic regression analysis identified female gender and older age as independent predictors of HHcy.
This study highlights a high prevalence of HHcy in patients with chronic schizophrenia, associated with older age and male gender. Contrary to expectations, HHcy was linked to milder symptom severity, suggesting a potential paradoxical relationship.
同型半胱氨酸水平升高，即高同型半胱氨酸血症（HHcy），与精神分裂症的病理生理学有关。大多数先前的研究集中于首发或急性期精神分裂症患者，慢性精神分裂症患者中HHcy的患病率、决定因素及临床相关性尚未得到充分研究。本研究旨在调查慢性精神分裂症患者中HHcy的患病率、决定因素及其临床相关性。方法：进行一项横断面研究，纳入了从中国多家精神病医院招募的509例诊断为慢性精神分裂症的患者。通过结构化访谈和病历审查收集人口统计学、临床和生活方式数据。分析血样中的同型半胱氨酸水平及其他生化参数。使用阳性和阴性症状量表（PANSS）、汉密尔顿抑郁量表（HAMD）、失眠严重程度指数（ISI）和可重复性神经心理状态评估量表（RBANS）评估临床症状和认知功能。进行二元逻辑回归分析以确定HHcy的独立预测因素。结果：研究人群中HHcy的患病率为56.2%。与无HHcy的患者相比，HHcy患者年龄显著更大（平均年龄：52.1±12.2岁），男性比例更高（67.1%）。HHcy组的阳性和一般精神病理学症状较轻，PANSS评分较低，显示出与症状严重程度意外的负相关。HHcy组的C反应蛋白（CRP）、总胆红素（TBIL）和肌酸磷酸激酶（CPK）水平升高。二元逻辑回归分析确定女性性别和年龄较大是HHcy的独立预测因素。结论：本研究突出了慢性精神分裂症患者中HHcy的高患病率，其与年龄较大和男性性别有关。与预期相反，HHcy与较轻的症状严重程度相关，提示可能存在矛盾关系。
