首发精神分裂症患者Hcy、UA和脂代谢变化与患者精神病理学状态的相关性

Correlation between changes in homocysteine, uric acid, and lipid metabolism in patients with first-episode schizophrenia and their psychopathological status

目的探讨首发精神分裂症患者同型半胱氨酸(homocysteine,Hcy)、尿酸(uric acid,UA)和脂代谢变化与患者精神病理学状态的相关性。方法选取温州市第七人民医院2021年6月至2023年6月收治的首发精神分裂症患者82例为研究组,另选取该院同期健康体检受试者82例为对照组。采用酶循环法测定Hcy水平;采用尿酸酶法测定UA水平;采用全自动生化分析仪测定脂代谢水平。评价首发精神分裂症患者阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评分(阳性、阴性和一般精神病理学);比较两组血清Hcy、UA水平以及脂代谢水平;采用Pearson分析一般精神病理学评分与Hcy、UA和脂代谢水平相关性;采用多因素logistic回归分析Hcy、UA和脂代谢与首发精神分裂症影响因素。结果首发精神分裂症患者阳性症状评分为(25.74±5.63)分,阴性症状评分为(23.12±6.76)分,一般病理精神学状态评分为(37.91±5.87)分,总分为(86.77±7.75)分。研究组血清Hcy[(23.12±3.78)μmol/L]和UA[(345.12±27.38)μmol/L]均显著高于对照组[(8.81±2.19)μmol/L、(218.48±23.51)μmol/L](t=-29.66、-31.78,均P<0.05)。两组总胆固醇(total cholesterol,TC)和三酰甘油(triacylglycerol,TG)水平比较,差异均无统计学意义(均P>0.05);研究组低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)[(3.26±1.04)mmol/L]显著高于对照组[(2.34±0.78)mmol/L],高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)[(1.02±0.13)mmol/L]显著低于对照组[(1.17±0.14)mmol/L],差异均有统计学意义(t=-6.41、7.11,均P<0.05)。经Pearson分析显示,一般精神病理学评分与Hcy、UA和LDL-C呈线性正相关,而与HDL-C呈线性负相关。经多因素logistic回归分析显示,Hcy、UA、LDL-C和HDL-C与首发精神分裂症密切相关。结论首发精神分裂症患者Hcy、UA、LDL-C水平升高,而HDL-C水平降低,且与精神病理学状态密切相关。

Objective To investigate the correlation between the changes in homocysteine,uric acid,and lipid metabolism and the psychopathological status of patients with first-episode schizophrenia.Methods Between June 2021 and June 2023,a total of 82 patients with first-episode schizophrenia who received treatment at Wenzhou Seventh People's Hospital were included in the study group.Additionally,82 individuals who underwent physical examination at the same hospital during the same period were included in the control group.The homocysteine levels were measured using the enzyme cycling method,while uric acid levels were determined via the uric acid enzyme method.Lipid metabolism levels were assessed using a fully automated biochemical analyzer.The positive and negative syndrome(PANSS)scale scores,which assess positive,negative,and general psychopathological status in patients with first-episode schizophrenia,were obtained.Serum homocysteine and uric acid levels,as well as lipid metabolism levels,were compared between the two groups.Pearson correlation analysis was used to assess the correlation between general psychopathological status scores and homocysteine,uric acid,and lipid metabolism levels.Multivariate logistic regression analysis was performed to investigate the factors(homocysteine,uric acid,or lipid metabolism levels)that affect first-episode schizophrenia.Results The patients with first-episode schizophrenia exhibited positive symptom scores of(25.74±5.63)points,negative symptom scores of(23.12±6.76)points,general psychopathological status scores of(37.91±5.87)points,and a total score of(86.77±7.75)points.The serum homocysteine and uric acid levels in the study group were(23.12±3.78)μmol/L and(345.12±27.38)μmol/L,respectively.These values were significantly higher than those in the control group[(8.81±2.19)μmol/L,(218.48±23.51)μmol/L,t=29.66,-31.78,both P<0.05].There were no significant differences in total cholesterol and triacylglycerol levels between the two groups(both P>0.05).However,serum level of low density lipoprotein cholesterol in the study group was(3.26±1.04)mmol/L,which was significantly higher than that in the control group[(2.34±0.78)mmol/L,t=-6.41,P<0.05].Serum level of high density lipoprotein cholesterol in the study group was(1.02±0.13)mmol/L,which was significantly lower than that in the control group[(1.17±0.14)mmol/L,t=7.11,P<0.05].Pearson correlation analysis indicated a positive linear correlation between the general psychopathological status score and homocysteine,uric acid,and low density lipoprotein cholesterol levels.Conversely,it exhibited a negative linear correlation with high density lipoprotein cholesterol levels.Multivariate logistic regression analysis further showed that homocysteine,uric acid,and low density lipoprotein cholesterol levels were strongly associated with first-episode schizophrenia.Conclusion In patients with first-episode schizophrenia,homocysteine,uric acid,and low density lipoprotein cholesterol levels are elevated,while high density lipoprotein cholesterol levels are reduced.There markers are closely related to patients'psychopathological status.