Effect Of Early Folate And Vitamin B₁₂ Intervention On Changes Of Glycolipid Metabolism During Treatment Of Patients With Schizophrenia

Objectives:In this study,fasting blood glucose was measured by early folic acid and vitamin B12(VB₁₂)intervention in patients with schizophrenia with high homocysteine?Hcy?levels and no abnormal glucose and lipid metabolism.fasting plasma glucose,FPG),triglyceride?TG?,high-density lipoprotein?HDL?values,to investigate the role of folic acid and VB₁₂2 intervention to the glucose and lipid metabolism during treatment of schizophrenia patients,providing a theoretical basis for clinical diagnosis and treatment,and then developing effective prevention and treatment programs.Methods:The newly admitted patients with schizophrenia in the Sixth People's Hospital of Hebei Province from 2017.12—2018.12 were selected.Hcy,fasting blood glucose,blood lipid and body parameter measurement?including height,weight and blood pressure?were performed on the next day.And the patients with hyperhomocysteinemia?Hcy level greater than 15.4?mol/L?and no abnormal glucose and lipid metabolism were selected,then were randomly divided into intervention group and control group,89 cases in each group.The intervention group was given folic acid and vitamin B₁₂2 to reduce homocysteine.At the end of the 4th week,Hcy,body parameters,glucose and lipid metabolism were measured again.The glucose and lipid metabolism of the 4th week of the two groups were compared.Results:?1?There was no significant difference in the values of Hcy,BMI and glycolipid metabolism between the two groups at baseline?P>0.05?,which was comparable.There were significant differences in Hcy,TG and HDL between the two groups at 4 weeks of treatment?P<0.05?.According to the paired sample t-test,the differences of Hcy,BMI,TG and HDL in the intervention group,the differences of Hcy,BMI and TG in the control group were statistically significant before and after the intervention?P<0.05?.?2?Hcy levels in baseline were significantly associated with gender,and the Hcy levels were higher in male patients than in women?r=-0.258,P=0.001*?.?3?There was a statistically significant difference in the metabolic status of TG and HDL between the intervention group and the control group at the end of the 4th week of treatment.At the 4th weekend of treatment,29?32.6%?patients in the intervention group developed glycolipid metabolism abnormality,but in the control group,52patients?58.4%?had abnormal glucose and lipid metabolism,the difference was statistically significant?P<0.05?,RR value was 0.558?95%confidence interval was 0.394-0.789?;?3?The results of Spearman correlation showed that there was a significant correlation between the different levels of Hcy in the baseline and the abnormal glucose and lipid metabolism in the4th week of treatment?P<0.05?.?4?The?2 test showed that there was a statistically significant difference in the incidence of abnormal glucose and lipid metabolism between the two groups in different antipsychotic treatments at the end of the 4th week?P<0.05?;?5?The glucose and lipid metabolism of all patients at the 4th weeks was significantly correlated with gender and BMI in 4th weeks?P<0.05?;?6?Glycolipid metabolism was significantly correlated with gender and BMI at 4 weeks in all patients at 4 weeks?P<0.05?.?7?Binary Logistic regression analysis showed:BMI values at the 4th weeks?P=0.000,OR=1.482,95%CI:1.238 to 1.775?,folic acid and vitamin B12 intervention?P=0.000,OR=5.075,95%CI:2.301 to 11.194?and baseline Hcy levels?P=0.000,OR=3.701,95%CI:1.811⁷.563?were closely relatedand to glycolipids Metabolic abnormalities after the treatment of 4 weeks.Antipsychotic drugs were not associated with abnormal glucose and lipid metabolism?P=0.117?,but the results of comparison between the drug group and the aripiprazole group showed that the risk of abnormal glucose and lipid metabolism was higher in the olanzapine group than in the aripiprazole group.?P=0.43,OR=4.741,95%CI:1.054 to 21.335?.Conclusions:?1?Early folic acid and vitamin B₁₂2 intervention in patients with schizophrenia with hyperhomocysteinemia can effectively reduce the incidence of abnormal glucose and lipid metabolism;?2?High BMI and homocysteine levels are risk factors of abnormal glucose and lipid metabolism during the treatment of the patients with schizophrenia.Therefore,we can prevent the occurrence of abnormal glucose and lipid metabolism by lowering BMI and Hcy levels;?3?We should actively seek more effective interventions to reduce homocysteine levels,thereby reducing the effects of abnormal glucose and lipid metabolism on patients with schizophrenia.