The Effect Of Quetiapine On Homocysteine And Related Influencing Factors In Patients With Chronic Schizophrenia

Objctive To explore the effect of quetiapine therapy on homocysteine in patients with chronic schizophrenia,and to explore whether gene polymorphism is the influencing factor of this change.Method Thirty-seven patients with chronic schizophrenia admitted to Hulunbuir Mental Health Center from January 2022 to March 2023 were included in the study.Genetic testing and general information on gender,age,height,body mass,smoking,and years of disease were collected before the study began.Safety was assessed throughout the study.Before inclusion and at the end of the 12 th week of treatment,fasting venous blood was taken in the morning to determine homocysteine,folic acid,vitamin B12,fasting blood glucose and blood lipid.SPSS26.0 software was used for statistical test of all data analysis.All statistical tests were bilateral tests,P<0.05 on both sides was statistically significant.Results ⑴Homocysteine,folic acid and vitamin B12 were significantly different before and after treatment(P<0.05).After treatment with quetiapine,homocysteine levels were increased,while folate and vitamin B12 levels were decreased.⑵CYP3A4 metabolic phenotype was extensive in the majority of enrolled people,accounting for 97.2% of the total number.In this study,two nucleotide polymorphisms in HTR1 A and MC4 R genes were identified,which were consistent with Hardy-Weinberg law of genetic balance.⑶Analysis of variance showed that there were statistically significant differences in the levels of homocysteine among different HTR1 A genotypes(P=0.002),and the changes of homocysteine were most obvious in the CC genotype of HTR1 A.The same conclusion can also be obtained when the participants were divided into different dose groups,that is,the change level of homocysteine in the low dose group was different among the different HTR1 A genotypes,the difference was statistically significant(P=0.046),the change level of homocysteine in the high dose group was different among the different HTR1 A genotypes,the difference was statistically significant(P<0.05).The difference was statistically significant(P=0.029).Conclusion Quetiapine may increase homocysteine and decrease folate and vitamin B12 in patients with chronic schizophrenia.Homocysteine metabolism in patients with chronic schizophrenia may be affected by HTR1 A gene polymorphism,and patients with CC genotype of HTR1 A may be more prone to homocysteine increase than patients with other genotypes.