Kiedy psychiatra powinien pamiętać o badaniu stężenia homocysteiny? – przegląd literatury
DOI:
https://doi.org/10.2478/cpp-2021-0006Słowa kluczowe:
homocysteina, depresja, zaburzenie afektywne dwubiegunowe, schizofreniaAbstrakt
Wstęp: Homocysteina jest endogennym aminokwasem siarkowym, powstającym w wyniku przemian biochemicznych metioniny. Prawidłowe stężenie homocysteiny u osób zdrowych mieści się w granicach 5 - 15 µmol/l, a wartości powyżej 15 µmol/l określane są mianem hiperhomocysteinemii. Wykazano, że poziom homocysteiny może mieć związek z występowaniem zaburzeń psychicznych. Celem tego artykułu było poszukiwanie zależności pomiędzy poziomem tego aminokwasu, a występowaniem oraz rokowaniem w chorobie afektywnej dwubiegunowej, depresji, zaburzeniach lękowych, schizofrenii czy chorobie Alzheimera.
Materiał i metoda: Dokonano przeglądu dostępnej literatury przeszukując bazy PubMed oraz Google Scholar przy użyciu następujących słów-kluczy: homocysteina, depresja, choroba afektywna dwubiegunowa, schizofrenia, choroba Alzheimera w przedziale czasowym od 1992 do 2021 roku.
Wyniki: Z przeprowadzonych dotychczas badań wynika, że istnieje znacząca korelacja pomiędzy podwyższonym poziomem homocysteiny a występowaniem i gorszym przebiegiem wyżej wymienionych zaburzeń psychicznych.
Wnioski: W celu zapobieżenia konsekwencjom zwiększonego poziomu homocysteiny należy okresowo monitorować stężenie w surowicy krwi oraz wdrożyć odpowiednie postępowanie w przypadku nieprawidłowych wyników. Istotne jest przekazanie pacjentom wiedzy o następstwach nieleczonej hiperhomocysteinemii m.in.: miażdżyca naczyń, udar mózgu, choroba niedokrwienna serca, osteoporoza, wady cewy nerwowej, zaburzenia psychiczne i choroby neurodegeneracyjne. Należy także ustalić strategię obniżenia poziomu tego aminokwasu poprzez zmianę stylu życia, a także podaż kwasu foliowego, witamin: B12, B6, B2, N-acetylocysteiny i betainy.
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