The Relationship Between Homocysteine Levels And Glycolipid Metabolism In Patients With Schizophrenia

Mortality risk of schizophrenia patients is 2~3 times that of the general population.The Cardiovascular diseases(CVD)risk in hospitalized patients is significantly higher than the general population in the next 10 years,and CVD is a major cause of early death of schizophrenia.Homocysteine(Hcy)contains sulfur amino acids,and high Hcy level is an independent risk factor for CVD.Plasma Hcy level in schizophrenia patients is significantly higher than the general population.,and is significantly higher in schizophrenia patients with Met S than those without Met S.After the short-term(4-week)treatment,the TG level of schizophrenia increase significantly(p<0.05),and the fasting glucose and TG levels of some patients also became abnormal.The purposes of this study were:(1)To investigate the relationship between Homocysteine(Hcy)and glycolipid metabolism in schizophrenia during the treatment.(2)To investigate the risk factors of abnormal glycolipid metabolism in schizophrenia,and to provide theoretical basis for the prevention and treatment of abnormal glycolipid metabolism in schizophrenia.This study collected hospitalized schizophrenia patients who met diagnostic criteria of International Classification of Diseases-10(ICD-10)in He Bei Province Mental Health Center from March to December in 2017.Patients who entered the study did not meet diagnostic criteria of other psychiatric disorders in ICD-10,without major physical diseases,such as cardiovascular and cerebrovascular diseases,hyperthyroidism and liver and kidney diseases,and pregnant or lactating women and people with a history of alcohol and tobacco were not included in the study,and the participants have no history of hypotensive drugs and antilipemic agents or hypoglycemic agent.The age range of the patients is from 18 to 44.The study was approved by the ethics committee of the Hebei Province Mental Health Center.The family members or patients were in formed and signed the consent.Blood plasma Hcy level was detected the day after the patient was hospitalized.The cut-off point of plasma Hcy level is 15.40μmol/L,and with this point,the patients in the hospital were divided into high Hcy group(plasma Hcy level:>15.40μmol/L)and normal Hcy group(plasma Hcy level:4.00~15.40μmol/L).Each group included 48 pateints.After admission,the Triglyceride(TG),High Density Lipoprotein(HDL),and Fasting Plasma Glucose(FPG)were detected,and the height,weight,calculated Body Mass Index(BMI)were measured for all the participants.None of the patients met one of the criteria for Metabolic Syndrome(Met S).The patients were treated with antipsychotic drugs then.During the 4-week study period,the patients who received other treatments,such as mood stabilizers,antidepressants,folic acid,vitamin B12,and Modified Electric Convulsire Therapy(MECT)were excluded,and the family members or patients requested to withdraw from the study and patients who have been hospitalized for less than 4 weeks were considered as missing samples.Plasma Hcy levels,TG,HDL,FPG and BMI were again detected after 4 weeks.The normal distribution data were described with the mean±standard deviation(?x±s),and the skewed distribution data were described with the quartile [M(Q25,Q75)].The t test,Wilcoxon test,Mann-Whitney U test,χ2 test,Spearman correlation and Logistic regression were used for statistical analysis.The SPSS 21.0 was used for statistical data analysis.P≤0.05 was considered statistically significant.The results of this study were:(1)Compared with the baseline,after 4 weeks,the TG level significantly increased in both of the high Hcy group(z=-5.159,P<0.001)and the normal Hcy group(z=-4.778,P<0.001),and there was a significant decrease in FPG in the high Hcy group(z=-3.554,P<0.001).At the end of the fourth week,the TG level of the high Hcy group was higher than that of the normal Hcy group(P<0.05)and the HDL level was lower than that of the normal Hcy group(P<0.05).(2)Spearman correlation analysis showed that plasma Hcy level in baseline was negative correlation with gender(female)(r=-0.409,P<0.001),at the end of the 4 weeks,the plasma Hcy level was positively correlated with age(r=0.250,P=0.014)and TG level(r=0.244,P=0.016),and negatively correlated with gender(female)(r=-0.369,P<0.001)and HDL(r=-0.244,P=0.017).(3)Multivariate Logistic regression analysis of abnormal glycolipid metabolism found that the plasma Hcy levels(P=0.041,OR=1.043,95% CI: 1.002 ~ 1.086)and BMI(P=0.020,OR=1.283,95% CI: 1.040~1.582)associated with glucolipid metabolic abnormalities.This study found that patients with schizophrenia with high plasma Hcy level had greater changes in glycolipid metabolism,and plasma Hcy level and BMI were related with abnormal glycolipid metabolism in patients with schizophrenia during short-term treatment...