Serum 25-Hydroxyvitamin D,homocysteine levels and cognitive function in patients with refractory epilepsy
MA Shuning
LI Saisai
WANG Sisi
DENG Yu
WANG Heng
FAN Hongbin
Abstract：Objective To explore the relationship between serum 25-hydroxyvitamin D[25(OH)D],homocysteine(Hcy)levels and cognitive function in patients with refractory epilepsy.Methods Sixty-seven patients with refractory epilepsy diagnosed in our hospital from October 2022 to August 2024 were selected as the refractory group and further divided into the cognitive dysfunction group(n=43)and the non-cognitive dysfunction group(n=24)based on their cognitive function status.Another 50 healthy individuals who underwent physical examinations were included in the healthy control group.Serum 25(OH)D and Hcy levels were measured in all included subjects.General data and serum 25(OH)D and Hcy levels of each group were compared.The relationship between serum 25(OH)D,Hcy and cognitive function in patients with refractory epilepsy were analyzed by Pearson correlation analysis.The risk factors for cognitive dysfunction in patients with refractory epilepsy were explored by Multivariate logistic regression analysis.Results The serum 25(OH)D level in the refractory group was lower compared with healthy control group,and the serum Hcy level was higher compared with healthy control group(P<0.05).The disease duration,seizure frequency,APACHE Ⅱ score and serum Hcy level in the cognitive dysfunction group were higher than those in the non-cognitive dysfunction group,while the MoCA score and serum 25(OH)D level were lower than those in the non-cognitive dysfunction group(P<0.05).Serum 25(OH)D level was positively correlated with MoCA score in patients with refractory epilepsy(r=0.399),and serum Hcy level was negatively correlated with MoCA score(r=-0.411)(P<0.05).Multivariate analysis showed that disease duration≥5.15 years(OR=1.919,95%CI:1.447～2.545),MoCA score<26.00 points(OR=2.413,95%CI:1.621-3.593),APACHE Ⅱ score≥14.54 points(OR=2.779,95%CI:1.696-4.554),serum 25(OH)D<20.50 ng/mL(OR=3.762,95%CI:2.045-6.921),and Hcy≥32.22 μmol/L(OR=3.766,95%CI:1.980-7.163)were all risk factors for cognitive dysfunction in patients with refractory epilepsy(P<0.05).Conclusion Decreased serum 25(OH)D level and increased Hcy level are closely related to the occurrence of cognitive dysfunction in patients with refractory epilepsy and can be used as effective markers for evaluating the occurrence of cognitive dysfunction in these patients.
Keywords：refractory epilepsy25-Hydroxyvitamin Dhomocysteinecognitive function
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：5( 97-101 )