单相抑郁、双相抑郁及精神分裂症与一碳代谢营养素的相关性研究  

Association of one-carbon metabolizing nutrients with unipolar depression,bipolar depression and schizophrenia

作　　者：吕楠 付冰冰 岳子祺 王瀚 黄娟 李金红 赵茜 Lyu Nan;Fu Bingbing;Yue Ziqi;Wang Han;Huang Juan;Li Jinhong;Zhao Qian(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS&PUMC,Beijing 100037,China;The Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心、精神疾病诊断与治疗北京市重点实验室,100088 [2]中国医学科学院阜外医院国家心血管病中心,北京100037 [3]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《神经疾病与精神卫生》2023年第3期189-195,共7页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金(82101600);北京市医院管理中心培育计划项目(PX2022076)。

摘　　要：目的分析单相抑郁、双相抑郁、精神分裂症与一碳代谢营养素的相关性,为探索不同精神疾病的机制提供线索,为辅助治疗提供依据。方法选取2013年1月至2019年12月在首都医科大学附属北京安定医院住院的390例单相抑郁患者、390例双相抑郁患者、865例精神分裂症患者作为研究对象。比较3组患者的一般资料、临床资料及一碳代谢营养素(叶酸、维生素B12、同型半胱氨酸)水平。采用二项Logistic回归分析控制混杂因素,分析3种疾病与一碳代谢营养素的相关性。结果与单相抑郁和双相抑郁患者比较,精神分裂症患者的维生素B12水平更低[438.5(322.3,581.3)pg/ml比449.9(345.4,613.3)pg/ml比376.9(280.3,505.3)pg/ml],同型半胱氨酸水平更高[14.3(11.5,18.7)μmol/L比14.0(11.6,18.3)μmol/L比15.4(12.4,22.1)μmol/L],维生素B12缺乏的发生率[6.2%(24/390)比4.9%(19/390)比9.5%(82/865)]、高同型半胱氨酸血症的发生率更高[44.9%(175/390)比41.8%(163/390)比51.9%(449/865)],差异均有统计学意义(P<0.05)。3种疾病患者的叶酸水平及叶酸缺乏发生率比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,维生素B12水平(OR=0.998,95%CI=0.998~0.999)是精神分裂症的影响因素(P<0.05)。单相抑郁和双相抑郁患者之间的一碳代谢营养素水平比较,差异无统计学意义(P>0.05)。结论与单相抑郁及双相抑郁患者相比,精神分裂症患者一碳代谢营养素不足更明显,维生素B12水平更低,同型半胱氨酸水平更高;双相抑郁与单相抑郁患者间一碳代谢营养素无明显差异。Objective To explore the correlation between unipolar depression,bipolar depression,schizophrenia and one carbon metabolizing nutrients,so as to provide clues for exploring the mechanism of different diseases and provide evidence for adjuvant therapy.Methods Inpatients in Beijing Anding Hospital Affiliated to Capital Medical University from January 2013 to December 2019 were selected as the research objects.A total of 390 patients with unipolar depression,390 patients with bipolar depression and 865 patients with schizophrenia were included.General demographic data and one-carbon metabolizing nutrients(folic acid,vitamin B12,homocysteine)were compared among the three groups.Multiple Logistic regression analysis was used to control confounding factors and to clarify the correlation between the three diseases and one carbon metabolizing nutrient.Results Compared with unipolar depression and bipolar depression group,the level of vitamin B12 in schizophrenia patients was lower[438.5(322.3,581.3)pg/ml vs 449.9(345.4,613.3)pg/ml vs 376.9(280.3,505.3)pg/ml],the level of homocysteine was higher[14.3(11.5,18.7)μmol/L vs 14.0(11.6,18.3)μmol/L vs 15.4(12.4,22.1)μmol/L],the incidence rate of vitamin B12 deficiency was higher[6.2%(24/390)vs 4.9%(19/390)vs 9.5%(82/865)],and hyperhomocysteinemia was higher[44.9%(175/390)vs 41.8%(163/390)vs 51.9%(449/865)],and all differences were statistically significant(all P<0.05).There was no significant difference in the distribution of folate level and folate deficiency among all groups(P>0.05).Multiple Logistic regression analysis showed that vitamin B12 level(OR=0.998,95%CI=0.998-0.999)was the risk factors of schizophrenia(P<0.05).There was no significant difference in the levels of one-carbon metabolizing nutrients between unipolar depression and bipolar depression group(P>0.05).Conclusions Compared with unipolar depression and bipolar depression patients,schizophrenia patients have more obvious one-carbon metabolic nutrient deficiency,lower vitamin B12 level and higher homocysteine

关 键 词：抑郁 精神分裂症 叶酸 维生素B12 同型半胱氨酸 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.3[医药卫生—临床医学]