Reduced folic acid, vitamin B12 and docosahexaenoic acid and increased homocysteine and cortisol in never-medicated schizophrenia patients: Implications for altered one-carbon metabolism

Anvita Kale, Nilesh Naphade, Swati Sapkale, Marellasv Kamaraju, Anilkumar R Pillai, Sadhana Joshi, Sahebarao Mahadik

Research output: Contribution to journalArticle

126 Scopus citations

Abstract

Abnormal one-carbon metabolism has long been suggested as one of the mechanisms for neuropathology and psychopathology of schizophrenia. Variable levels of components of one-carbon metabolism (folic acid and vitamin B12) and consequent altered levels of homocysteine and phospholipid docosahexaenoic acid (DHA) have been independently reported, mostly in medicated patients. This study examined the simultaneous levels of these key components of one-carbon metabolism and its consequences in unique, medication-naïve first-episode psychotic patients (FEP, n = 31) and healthy controls (HC, n = 48) matched for confounds such as race, diet and lifestyle to reduce the variability. Significantly lower levels of folate and vitamin B12 in plasma and folate in red blood cells were observed in FEP compared to HC. These reductions paralleled the significant increase in plasma homocysteine and cortisol levels. Significantly reduced levels of membrane DHA were also observed in FEP compared to HC. This study, using a unique cohort, provided a broader mechanism (disturbed folic acid-vitamin B12-DHA balance) of altered one-carbon metabolism and one of its key consequential components, an increased homocysteine level that together with cortisol, can contribute to the neuropathology of psychosis. These data may have important implications for the amelioration of psychopathology in schizophrenia.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalPsychiatry Research
Volume175
Issue number1-2
DOIs
StatePublished - Jan 30 2010

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Keywords

  • Cortisol
  • Docosahexaenoic acid
  • Folic acid
  • Homocysteine
  • Schizophrenia
  • Vitamin B

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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