Гомоцистеин при депрессии позднего возраста

The increased plasma homocysteine concentration (Hcy) is noted in vascular, cognitive and depressive disorders. Since comorbid vascular pathology and cognitive disorders often meet in depressions of old age and reduce efficiency of the carried-out psychopharmacotherapy, it is possible to examine Hcy as an additional biomarker of the therapeutic response.Objective. Investigating plasma Hcy concentration of elderly depressive patients as a biomarker of the response to antidepressive therapy.Materials and methods. Depression severity and Hcy concentration were investigated in 51 in-patients (50-82 years old) with a depressive episode before and after a 28-day antidepressive therapy. Depression severity and existence of cognitive disorders were estimated using HAMD-17, MMSE. Plasma Hcy concentration was measured on a threefold mass spectrometer of Agilent 6410-2K in the mode of detecting of the set masses (136,0  90,0) in the conditions of positive chemical ionization mode with an atmospheric pressure.Results. Prior to treatment the Hcy level correlates with age of patients (0,28), simple types of depressions (0,39), seasonal nature of their relapses (0,32) and number of vascular diseases (0,29), at the end of the therapy - with existence of vascular changes on MRT of a brain (0,41), total number of somatic diseases (0,28) and their decompensation in the phase (0,28). These results confirm data about relation of a hyperhomocysteinemia with vascular diseases and allow suppose considerable participation of a vascular factor in development of the simple depressions in aged. Hcy сoncentration is not directly connected with efficiency of the psychopharmacotherapy.Conclusions. Plasma Hcy concentration of elderly depressive patients is a biomarker vascular disorders. Its monitoring can help to optimize the combined therapy.

депрессии позднего возраста, гомоцистеин, эффективность терапии, предикторы, old age depressions, homocysteine, efficiency of psychopharmacotherapy, predictors

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