Objective:To analyze the level of homocysteine (HCY) and its influencing factors in different ethnic groups in Lhasa, and to explore its reference interval.Methods:Reference interval study. The serum HCY (μmol/L) level of 820 healthy subjects was analyzed in Tibet autonomous region People′s hospital from January to December 2018. All the subjects were divided into groups according to ethnicity, gender, age and season. The general linear model was used to analyze the differences in serum HCY levels groups. According to the CLSI C28 document, the Nested ANOVA and Z test were used to analyze and determine whether or not different groups need to establish the reference interval. Results:Ethnicity, age and gender had significant effects on serum HCY. The level of HCY in Tibetan was higher than that in Han (P<0.001); the level of Hcy in male was higher than that in female ( P<0.001); the level of HCY in over-50 year old group was higher than that in under-50 year old group ( P=0.01). There was no significant difference in serum HCY level in seasonal distribution ( P=0.22). Nested ANOVA and Z tests confirmed that the HCY reference interval in Lhasa should be established according to ethnicity and gender in clinical application. The reference interval of HCY level in Lhasa area was established according to difference genders, including<22.41 μmol/L for Tibetan men,<18.41 μmol/L for Tibetan women. Conclusions:The serum HCY levels of the apparent healthy people in Lhasa area were slightly different among people of different ethnicities, genders and ages. We established the reference intervals of HCY of different ethnic groups and gender groups in Tibet and our results have practical significance for the prevention and treatment of cardiovascular and cerebrovascular diseases at high altitude.

Objective To investigate the state of anxiety and depression in patients with Parkinson disease due to high-altitude exposure in Tibet， China and its impact on quality of life. Methods A total of 93 patients with Parkinson disease who attended Tibet Autonomous Region People’s Hospital from February 2023 to November 2024 were enrolled， and basic information and assessment scales were collected. The Unified Parkinson’s Disease Rating Scale Part Ⅲ （UPDRS-Ⅲ） and Hoehn-Yahr （H-Y） stage were used to evaluate disease severity； Parkinson’s Disease Quality of Life Questionnaire （PDQ-39） was used to evaluate the quality of life of patients； the diagnostic criteria for depression and anxiety in Parkinson disease were used for the diagnosis of depression and anxiety in patients with Parkinson disease； Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to assess the severity of depression and anxiety. Results Among the 93 patients with Parkinson disease， the prevalence rates of depression and anxiety were 59.1% and 44.1%， respectively. There were significant differences between the depression group and the non-depression group in the somatization， despair， cognitive impairment， block factor， and day-night changes of anxiety， but there were no significant differences in sleep disorders and body weight between the two groups. The depression group had significantly higher PDQ-39 scores than the non-depression group， and the anxiety group had significantly higher PDQ-39 scores than the non-anxiety group. Depressive state was negatively correlated with folate and was positively correlated with blood homocysteine. Anxiety state was positively correlated with H-Y stage and UPDRS Ⅲ score. Conclusion There are relatively high prevalence rates of depression and anxiety in patients with Parkinson disease in Tibetan plateau area， which significantly affects the quality of life of patients.
Parkinson Disease ; Depression ; Anxiety