Association between homocysteine levels in acute stroke and poststroke depression: A systematic review and meta‐analysis

BACKGROUND: Homocysteine (Hcy) has been confirmed to be associated with depression, but its relationship with poststroke depression (PSD) remains controversial. So far, there is no meta-analysis of the correlation between Hcy level in acute stroke and PSD. METHODS: A systematic search of a sub-database of studies reporting the level of Hcy in the acute phase of ischemic stroke and PSD as of November 2021 was performed. Data extraction was performed strictly according to the inclusion and exclusion criteria. All data were analyzed using STATA 11.0. The standardized root mean square difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS: A total of 11 studies were included in this study, including 2789 participants. The results of this meta-analysis showed that admission the levels of Hcy were significantly higher in PSD survivors, compared to non-PSD survivors (SMD = 0.37, 95%CI = 0.07-0.66, P ＜ .001). Subgroup analysis showed that survivors with PSD diagnosed more than 3 months after stroke had significantly different the levels of from non-PSD survivors (6 months: SMD = 0.61, 95%CI = 0.40-0.82, 9 months: SMD = 1.00, 95%CI = 0.59-1.41). CONCLUSION: The level of Hcy in the acute phase of ischemic stroke is a risk factor for PSD.