Levels of Serum Vitamin B6 and GABA In Clinically Depressed Patients: A Study

Background:Depression is the most common type of mental illness. As per the WHO criterion of prevalence of depression, this disease has a prevalence of 4.4% all over the world and 4.5% in India. Some water-soluble vitamins like vitamin B2, B6, B9, B12; play an important role in mental health. Of these vitamins pyridoxal phosphate, the active form of vitamin B6 plays a pivotal role in a number of transamination reactions, decarboxylation reactions and in the control of plasma homocysteine concentration. PLP is vital for the biosynthesis of GABA, which is being used as the neurotransmitter in at least 40% of the inhibitory synaptic processing in the brain. Therefore, the present study was planned to assay the blood levels of vitamin B6 and GABA in patients with depression. The objective of the study was to help psychiatrists to take appropriate and informed decision about supplementation of vitamin B6 and use of specific antidepressant medication in the treatment of depression cases. Methods: Current study was an experimental case control study conducted at Santosh Medical College and Hospitals. A total of 204 (102 controls and 102 patients) both males and females, in the age group between 18-65 years were included in the study. Hamilton Depression Rating Scale (HDRS) 17 items was used to rate the level of depression. Results: In the present study, a total of 204 subjects including 97 females and 107 males participated, out of which 102 were clinically diagnosed cases of depression attending psychiatry OPD and included 55 females and 47 males. 47.1% of the cases were of mild depression, 23.5% were of moderate depression, 11.8% of severe depression and the remaining 17.6% belonged to very severe depression category. The mean value of vitamin B6 was found lowest in severe to very severe depressed patients (5.25) than in mild to moderate depressed patients (8.83) and the mean value of GABA was found to be highest in severe to very severe category (5571.73) than in mild to moderate depressed patients (5184.73). Conclusion: This study showed that majority of the patients with clinical depression had vitamin B6 deficiency and increase in GABA levels.

Levels of Serum Folate and Cobalamine in Clinically Depressed Patients in North Indian Population

Background: Depression, the most common type of mental illness is the second leading cause of disability worldwide next to CAD. Vitamin B6, folate and vitamin B12 are involved in a series of methylation reaction that produce monoamine neurotransmitters, phospholipids and nucleotide. Therefore the present study was planned to assay the blood levels of vitamin B12 and folate in patients with depression. The objective of this was to study if metabolites are affected by diet and may be helpful in the prevention of depression. Methods: Current study was an experimental case control study, was conducted at Santosh Medical College. A total of 88 cases (44 patients and 44 controls) both males and females in the age between 18 - 65 years were included in the study. Hamilton depression rating scale (HDRS) -17 items scale was used to rate the level of depression. Results: In the present study a total of 88 subjects including 45 females and 43 males participated, out of which 44 were control, 24 males and rest 20 were females. Majority 55 patients were of no depression category, 11 were of mild depression category, 10 were of severe depression and rest 9, were of moderate depression category. Mean value of B12 were found lowest in ‘moderate’ depressed patients (115), than in ‘most severe depressed’ (137), followed by ‘severe’ and ‘mild’ depressed patients category. Value of HDRS increases with severity of depression, it was found lowest in the ‘mild’ (10.64), then it steadily increases with severity, moderate (15.11), severe (21.20) and most severe (27.55). Conclusion: This study showed that majority of the patients with clinical depression had vitamin B12 deficiency.

Altered serum levels of thyroxine, triiodothyroinine and thyroid stimulating hormone in patients with depression.

OBJECTIVE: To assess serum level of Thyroxine (T4), Triiodothyronine(T3) and thyroid stimulating hormone(TSH) in patient with depression. METHODS: Thirty one clinically diagnosed depressed patients and equal number of healthy, age and sex matched control subjects were included in this study. Ham-D scale was used to classify the degree of depression into mild, moderate and severe grades. The biochemical parameters (T3, T4 and TSH) were estimated using commercially available kits. The data were analyzed by using (SPSS-10 software), one way ANOVA and chi2 test. RESULT: Female depressed (n=17) cases outnumber the male depressed cases. The distributions of patients in mild, moderate and severe categories were similar. The T3 and T4 level were found to be significantly raised in the moderate depression as compared to the healthy controls. ANOVA with multiple comparisons testing among the patient group showed a significant high TSH level (F>3.17) at 5% level of significance. A total of six depressive patients were found to have thyroid abnormalities. CONCLUSION: This study therefore points towards presence of thyroid dysfunction among the depressive which most often characterized as a "Lower Thyroid Syndrome". Thus inclusion of thyroid screening test among depressive patients may be helpful in proper management of cases.

Measurement of creatinine by Jaffe's reaction--determination of concentration of sodium hydroxide required for maximum color development in standard, urine and protein free filtrate of serum.

Creatinine in serum or urine is determined by Jaffe's reaction where creatinine produces quantitatively an orange color with picric acid in alkaline medium. After allowing an incubation time of 15 min at room temperature for color development the color is measured at 520 nm. Without taking into consideration the acidic nature of standard, protein free filtrate (PFF) of serum and urine, 1% picric acid and 0.75N NaOH are used in this reaction for color development in standard, PFF of serum and urine. An investigation was thought to be necessary to determine the optimum alkali concentration required in standard, PFF of serum and urine. The results show that 0.25, 0.75 and 1N NaOH give maximum color in urine, standard and PFF of serum respectively. A standard solution of creatinine is prepared in 0.1N HCl and the PFF of serum is obtained by addition of fresh tungstic acid. Alkali is consumed to neutralise the acids in both these cases. For urine creatinine measurement, a direct diluted urine sample is used. The difference in the requirement of NaOH is conceivable. The routine use of 0.75N NaOH irrespective of the nature of specimen as is done in all biochemical laboratories, for creatinine measurement needs modification in the light of this investigation.