Changes and clinical significance of homocysteine, folate, and cardiac enzyme levels in patients with alcohol dependence and depression
10.3760/cma.j.cn341190-20231011-00276
- VernacularTitle:Hcy、叶酸及心肌酶水平在酒依赖伴抑郁症患者中的水平变化及临床意义
- Author:
Chenqi XU
1
;
Jinlei TANG
;
Mengmi LIN
;
Xiaolu WENG
Author Information
1. 温州市第七人民医院检验科，温州 325000
- Keywords:
Depressive disorder;
Psychoses, alcoholic;
Cysteine;
Folic acid;
L-lactate dehydrogenase;
Creatine kinase
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(8):1126-1132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the changes and clinical significance of homocysteine (Hcy), folate, and cardiac enzyme levels in patients with alcohol dependence and depression.Methods:A total of 102 patients with alcohol dependence and depression, who received treatment at Wenzhou Seventh People's Hospital from January 2022 to June 2023, were included in the observation group. The degree of alcohol dependence in patients in the observation group was assessed using the Michigan Alcoholism Screening Test (MAST). According to the assessment results, the patients in the observation group were divided into the following subgroups: mild alcohol dependence ( n = 33), moderate alcohol dependence ( n = 37), heavy alcohol dependence ( n = 15), and severe alcohol dependence ( n = 17). The severity of depression among patients in the observation group was assessed with the Hamilton Depression Scale (HAMD). Based on the assessment results, the patients in the observation group were divided into the following subgroups: mild depression ( n = 43), moderate depression ( n = 34), and severe depression ( n = 25). The cognitive function of patients in the observation group was assessed using the Montreal Cognitive Assessment Scale (MoCA). According to the assessment results, the patients in the observation group were divided into normal cognitive function ( n = 73) and cognitive impairment ( n = 29) subgroups. Thirty healthy volunteers from our hospital during the same period were included in the control group. The levels of Hcy, folate, and cardiac enzymes were compared among all groups. The correlations between Hcy, folate, and cardiac enzyme levels with HAMD, MoCA, and MAST scores were analyzed using the Pearson method. Results:The Hcy level in the observation group was (15.21 ± 1.99) μg/L, which was significantly higher than that in the control group [(11.38 ± 1.46) μg/L, t = -9.80, P < 0.001]. The levels of folate, lactate dehydrogenase (LDH), and creatine kinase (CK) in the observation group were (4.82 ± 1.77) μg/L, (122.69 ± 33.98) IU/L, and (87.83 ± 16.52) IU/L, respectively, which were significantly lower than those in the control group [(6.27 ± 1.35) μg/L, (150.56 ± 38.78) IU/L, (98.67 ± 20.29) IU/L, t = 4.16, 3.82, 2.99, all P < 0.05]. The Hcy levels in the mild , moderate, heavy, and severe alcohol dependence subgroups [(13.16 ± 1.23) μg/L, (15.35 ± 0.82) μg/L, (16.79 ± 1.38) μg/L, (17.63 ± 1.22) μg/L] increased sequentially, while the folate levels [(6.11 ± 1.51) μg/L, (4.95 ± 1.40) μg/L, (4.04 ± 0.99) μg/L, (2.70 ± 0.99) μg/L], LDH levels [(153.35 ± 27.47) IU/L, (123.29 ± 16.59) IU/L, (109.83 ± 14.41) IU/L, (73.24 ± 16.86) IU/L], and CK levels [(104.14 ± 12.78) IU/L, (86.48 ± 9.15) IU/L, (78.11 ± 7.85) IU/L, (67.71 ± 9.00) IU/L] decreased sequentially. These differences in Hcy, folate, LDH, and CK levels among the mild, moderate, heavy, and severe alcohol dependence subgroups were statistically significant ( F = 73.24, 26.53, 59.08, 53.86, all P < 0.001). The Hcy levels in the mild, moderate, and severe depression subgroups [(13.75 ± 1.54) μg/L, (15.46 ± 1.17) μg/L, (17.39 ± 1.31) μg/L] increased progressively, while the folate levels [(5.83 ± 1.77) μg/L, (4.67 ± 1.12) μg/L, (3.28 ± 1.26) μg/L], LDH levels [(138.09 ± 33.67) IU/L, (119.73 ± 26.39) IU/L, (100.24 ± 30.88) IU/L], and CK levels [(96.35 ± 15.24) IU/L, (86.73 ± 15.62) IU/L, (74.69 ± 9.71) IU/L] decreased progressively. The differenes in Hcy, folate , LDH, and CK levels among the four depression subgroups were statistically significant ( F = 56.57, 24.36, 12.23, 18.44, all P < 0.001). The Hcy levels in the cognitive impairment group [(17.01 ± 1.63) μg/L] was significantly higher than that in the normal cognitive function group [(14.50 ± 1.64) μg/L, t = -6.97, P < 0.001), and the folate, LDH, and CK levels in the cognitive impairment group were (3.76 ± 1.78) μg/L, (102.71 ± 31.08) IU/L, and (76.00 ± 13.37) IU/L respectively, which were significantly lower than those in the normal cognitive function group [(5.24 ± 1.58) μg/L, (130.63 ± 31.92) IU/L, (92.52 ± 15.31) IU/L, t = 4.11, 4.01, 5.09, all P < 0.001]. Hcy levels were positively correlated with HAMD and MAST scores ( r = 0.854, 0.846, both P < 0.05) and negatively correlated with MoCA scores ( r = -0.648, P < 0.001). Folate, LDH, and CK levels were negatively correlated with HAMD and MAST scores ( r = -0.644, -0.701; r = -0.551, -0.696; r = -0.505, -0.673; all P < 0.001), and they were positively correlated with MoCA scores ( r = 0.514, 0.436, 0.448, all P < 0.001). Conclusion:In patients with alcohol dependence and depression, abnormal levels of Hcy, folate, and cardiac enzymes were observed. These indicators were found to be associated with the severity of alcohol dependence, the level of depression, and cognitive function.
