同型半胱氨酸、叶酸及维生素B_(12)与强迫症的关联研究

Research of correlation between homocysteine,folic acid,vitamin B_(12) and obsessive-compulsive disorder

目的探讨强迫症患者血清同型半胱氨酸、叶酸及维生素B;水平与强迫症发病的相关性。方法选取2018年9月—2020年7月于郑州大学第一附属医院住院的符合《精神障碍诊断与统计学手册》第5版(DSM-5)中强迫症诊断标准的173例强迫症患者为强迫症患者组,同期本院体检中心的150例健康体检者为对照组,检测所有研究对象的血清同型半胱氨酸、叶酸及维生素B;浓度。结果(1)与健康对照组相比,强迫症患者组血清同型半胱氨酸水平显著增高(t=7.427,P<0.001),叶酸及维生素B_(12)水平均降低(t=-5.882,t=-6.650,P<0.001),差异具有统计学意义。(2)强迫症患者组血清叶酸与同型半胱氨酸水平呈显著负相关(r=-0.311,P<0.001),维生素B_(12)与同型半胱氨酸无相关性(r=-0.126,P>0.05)。(3)Logistic回归分析结果示,同型半胱氨酸、叶酸及维生素B_(12)的优势比(Odds Ratio,OR)分别为1.183[(95%CI:1.095~1.278),P<0.001]、0.906[(95%CI:0.851~0.966),P<0.01]及0.996[(95%CI:0.995~0.998),P<0.001]。结论强迫症的发病与众多因素有关,血清同型半胱氨酸水平增高可能是强迫症发病的重要危险因素,而叶酸及维生素B_(12)水平的增高可能是强迫症的保护性因素。

Objective To investigate the correlation between serum homocysteine,folic acid and vitamin B;levels and the incidence of obsessive-compulsive disorder in patients with obsessive-compulsive disorder.Methods Totally 173 patients with obsessive-compulsive disorder who met the diagnostic criteria of diagnostic and statistical manual of mental disorders fifth edition(DSM-5)in the First Affiliated Hospital of Zhengzhou University from September 2018 to July 2020 were selected as the obsessive-compulsive disorder group,and 150 healthy people in the physical examination center of our hospital during the same period were selected as the control group,serum homocysteine,folic acid and vitamin B_(12)were measured in all subjects.Results(1)Compared with the healthy control group,the serum homocysteine level in obsessive-compulsive disorder group was significantly higher(t=7.427,P<0.001),folic acid and vitamin B_(12)levels were decreased(t=-5.882,t=-6.650,P<0.001),the differences were statistically significant.(2)There was a significant negative correlation between serum folic acid and homocysteine in obsessive-compulsive disorder group(r=-0.311,P<0.001),but there was no correlation between vitamin B_(12)and homocysteine(r=-0.126,P>0.05).(3)Logistic regression analysis showed that the odds ratios(OR)of homocysteine,folic acid and vitamin B_(12)were 1.183[(95%CI:1.095~1.278),P<0.001],0.906[(95%CI:0.851~0.966),P<0.01]and 0.996[(95%CI:0.995~0.998),P<0.001]respectively.Conclusion The incidence of obsessive-compulsive disorder is related to many factors.The increase of serum homocysteine level may be a significant risk factor of obsessive-compulsive disorder,while the increased levels of folic acid and vitamin B_(12)may be the protective factors of obsessive-compulsive disorder.