Effects Of Homocysteine On Relapse And Clinical Outcomes Of Male Alcohol Dependence Patients

Objective: Alcohol dependence is a chronic mental disorder charact erized by a high recurrence rate.How to reduce the rate of alcohol dependence relapse has become a problem for clinicians.Homocysteine(Hc y)is a sulfur-containing amino acid related to alcohol use.Among the alcoholics,patients with high levels of Hcy have higher psychological and physical cravings for alcohol than patients with normal Hcy.The pur pose of this study was to investigate the prediction of plasma Hcy level s for re-drinking and clinical outcomes in men with alcohol dependence.Methods: Objects of study were 234 patients with alcohol dependence who were hospitalized at the Institute of Mental Health of First Hospital Mental Health Center,all male patients.The venous blood was drawn on an empty stomach the next day after hospitalization,and plasma homocysteine concentration and other laboratory indicators were measured.The patients were followed up for three months after discharge.SPSS 21.0 was used for statistical analysis of the final data.The measurement data were analyzed by two independent samples t-test and non-parametric test(Mann-Whitney U test).The count data were analyzed by chi-square test.Univariate and multivariate logistic regression analysis was usedto analyze the predictive factors of re-drinking in alcohol-dependent patients.Kaplan-Meier survival analysis was used for prognostic analysis and risk assessment.The receiver operating characteristic curve(ROC)wasused to predict homocysteine to predict relapse The ability to drink,determine the optimal cut-off value,and the area under the curve(AUC)represents the predicted value.Results: 135(57.69%)of 234 male alcohol dependent patients weredischarged within 3 months after discharge.The levels of plasma Hcy in patients who were re-drank were significantly higher than those who were not relapse(P <0.001).Univariate analysis showed that the average age(P = 0.008),years of education(P = 0.011),daily alcohol consumption(P = 0.015),plasma Hcy concentration(P <0.001),aspartate aminotransferase,(P = 0.007)and glutamyl transpeptidase(P = 0.009)wereobvious different.In multivariate analysis,Hcy was significantly correlated with relapse(P = 0.010 OR = 2.919).The area under the AUC curve of Hcy was 0.681(95% CI 0.623,0.753),and the best cutoff value for Hcy At 21.83 umol / L(sensitivity: 0.793,specificity: 0.515).Patientswith Hcy ?21.83 mmol / L had a higher risk of brain atrophy(P = 0.041)and seizures(P = 0.029)than patients with Hcy.Conclusions: High plasma Hcy levels are associated with relapse behaviors and adverse clinical outcomes after alcohol withdrawal in malealcohol dependence patients.Plasma Hcy levels can be used as one of the biological indicators to assess the risk of relapse and predict the outcome of alcohol dependence.