Hyperhomocysteinemia in chronic schizophrenia: prevalence, clinical correlates, and paradoxical associations with symptom severity.

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

European Archives of Psychiatry and Clinical Neuroscience Pub Date : 2025-09-09 DOI:10.1007/s00406-025-02106-9

Jianyan Du, Rui Jiang, Yuanyuan Liu, Jianan Zhou, Guoshuai Luo, Xiangyang Zhang

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引用次数: 0

Abstract

Background: 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.

Conclusions: 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.

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慢性精神分裂症的高同型半胱氨酸血症：患病率、临床相关性以及与症状严重程度的矛盾关联

背景：高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，对慢性精神分裂症中HHcy的患病率、决定因素和临床相关性研究不足。本研究旨在探讨慢性精神分裂症患者中HHcy的患病率和决定因素及其临床相关性。方法：对509名慢性精神分裂症患者进行横断面研究，这些患者来自中国多家精神病院。通过结构化访谈和病历回顾收集人口统计、临床和生活方式数据。分析血液样本的同型半胱氨酸水平和其他生化参数。采用Positive and Negative Syndrome Scale （PANSS）、Hamilton Depression Rating Scale （HAMD）、Insomnia Severity Index （ISI）、Repeatable Battery for Assessment for Neuropsychological Status （RBANS）评估临床症状和认知功能。采用二元logistic回归分析确定HHcy的独立预测因素。结果：hcy在研究人群中的患病率为56.2%。与非HHcy患者相比，HHcy患者明显年龄较大（平均年龄：52.1±12.2岁），男性比例较高（67.1%）。hcy组表现出较轻的阳性和一般精神病理症状，正如较低的PANSS评分所表明的那样，显示出意想不到的与症状严重程度的负相关。HHcy组c反应蛋白（CRP）、总胆红素（TBIL）、肌酸磷酸激酶（CPK）水平升高。二元logistic回归分析发现女性性别和年龄是HHcy的独立预测因素。结论：本研究强调慢性精神分裂症患者中HHcy的高患病率，与年龄和男性相关。与预期相反，HHcy与较轻的症状严重程度有关，这表明一种潜在的矛盾关系。

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来源期刊

European Archives of Psychiatry and Clinical Neuroscience 医学-精神病学

CiteScore

8.80

自引率

4.30%

发文量

154

审稿时长

6-12 weeks

期刊介绍： The original papers published in the European Archives of Psychiatry and Clinical Neuroscience deal with all aspects of psychiatry and related clinical neuroscience. Clinical psychiatry, psychopathology, epidemiology as well as brain imaging, neuropathological, neurophysiological, neurochemical and moleculargenetic studies of psychiatric disorders are among the topics covered. Thus both the clinician and the neuroscientist are provided with a handy source of information on important scientific developments.