共病2型糖尿病精神分裂症患者同型半胱氨酸水平与阴性症状及认知功能的相关性

Correlation of homocysteine levels with negative symptoms and cognitive function in people with schizophrenia complicating type 2 diabetes mellitus

目的探讨共病2型糖尿病(T2DM)精神分裂症患者血清同型半胱氨酸(Hcy)水平与阴性症状及认知功能的相关性。方法对2015年1月至2019年12月期间在南京市江宁区第二人民医院精神科住院的152例精神分裂症患者进行研究,根据是否共病T2DM分为共病组68例与无共病组84例,并招募68例健康人作为对照组。三组受试者空腹抽取静脉血测血清Hcy,采用阳性与阴性症状量表(PANSS)对精神分裂症患者的病情严重程度进行测定,蒙特利尔认知评估中文版(MoCA)进行认知功能评估。采用Pearson相关分析共病T2DM患者Hcy与PANSS各因子分、认知功能评分的相关性。结果三组受试者的年龄、吸烟史、BMI比较差异均无统计学意义(P>0.05);共病组患者的Hcy浓度为(16.68±9.01)μmol/L、无共病组(13.50±4.03)μmol/L,明显高于健康对照组的(12.01±4.84)μmol/L,差异有显著统计学意义(P<0.01);共病组与无共病组患者的PANSS总分比较差异无统计学意义(P<0.05);共病组患者的MoCA评分为(15.98±3.10)分,明显低于无共病组的(19.77±3.09)分,差异有统计学意义(P<0.05):经Pearson相关分析结果显示,共病组患者的血清Hcy水平与PANSS阴性症状因子分呈正相关(r=0.312,P<0.05),与MoCA评分呈负相关(r=-0.558,P<0.01)。结论共病T2DM的精神分裂症患者血清Hcy水平高于无共病者,共病组Hcy水平与精神分裂症患者阴性症状严重程度呈现正相关,与认知功能呈负相关。

Objective To investigate the correlation of serum homocysteine(Hcy)levels with negative symptoms and cognitive function in patients with schizophrenia complicating type 2 diabetes mellitus(T2DM).Methods A study was conducted on 152 schizophrenia patients who were hospitalized in Department of Psychiatry,the Second People's Hospital of Jiangning District of Nanjing between January 2015 and December 2019.The patients were divided into co-morbid group(n=68)and non-co-morbid group(n=84)according to whether or not they had co-morbid T2DM,and 68 healthy subjects were recruited as a control group.The severity of schizophrenia was measured by the Positive and Negative Symptom Scale(PANSS),and the cognitive function was assessed by the Montreal Cognitive Assessment Chinese Edition(MoCA).Pearson's correlation analysis was used to analyze the correlation between Hcy and each factor score of PANSS and cognitive function score in co-morbid group.Results The differences in age,smoking history,and BMI among the three groups were not statistically significant(P>0.05);the Hcy concentration of patients was(16.68±9.01)μmol/L in the co-morbid group and(13.50±4.03)μmol/L in non-co-morbid group,significantly higher than(12.01±4.84)μmol/L of healthy controls(P<0.01);the difference between the total PANSS score of patients in the co-morbid group and those in the non-co-morbid group was not statistically significant(P<0.05);the MoCA score of patients in the co-morbid group was(15.98±3.10)points,which was significantly lower than(19.77±3.09)points of the non-co-morbid group.Serum Hcy levels in the co-morbid group were positively correlated with the PANSS negative symptom factor score(r=0.312,P<0.05)and negatively correlated with the MoCA score(r=-0.558,P<0.01).Conclusion Serum Hcy levels were higher in schizophrenic patients with co-morbid T2DM than in those without co-morbid T2DM,and Hcy levels in the co-morbid group were positively correlated with the severity of negative symptoms in schizophrenic patients and negatively correlated with cognitive function.