Kelley L, Sanders A F P, Beaton E A
Department of Psychology,University of New Orleans,New Orleans,LA,USA.
J Dev Orig Health Dis. 2016 Dec;7(6):616-625. doi: 10.1017/S2040174416000428.
Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a complex developmental disorder with serious medical, cognitive and emotional symptoms across the lifespan. This genetic deletion also imparts a lifetime risk for developing schizophrenia that is 25-30 times that of the general population. The origin of this risk is multifactorial and may include dysregulation of the stress response and immunological systems in relation to brain development. Vitamin D is involved in brain development and neuroprotection, gene transcription, immunological regulation and influences neuronal signal transduction. Low levels of vitamin D are associated with schizophrenia, depression and anxiety in the general population. Yet, little is known about how vitamin D levels in children with 22q11.2DS could mediate risk of psychosis in adulthood. Blood plasma levels of vitamin D were measured in children aged 7-16 years with (n=11) and without (n=16) 22q11.2DS in relation to parent reports of children's anxiety and atypicality. Anxiety and atypicality in childhood are risk indicators for the development of schizophrenia in those with 22q11.2DS and the general population. Children with 22q11.2DS had lower vitamin D levels, as well as elevated anxiety and atypicality compared with typical peers. Higher levels of anxiety, depression and internalizing problems but not atypicality were associated with lower levels of vitamin D. Vitamin D insufficiency may relate to higher levels of anxiety and depression, in turn contributing to the elevated risk of psychosis in this population. Further study is required to determine casual linkages between anxiety, stress, mood and vitamin D in children with 22q11.2DS.
22号染色体q11.2缺失综合征（22q11.2DS）是一种复杂的发育障碍，在整个生命周期中会出现严重的医学、认知和情感症状。这种基因缺失还会使患精神分裂症的终生风险增加，是普通人群的25至30倍。这种风险的起源是多因素的，可能包括与大脑发育相关的应激反应和免疫系统失调。维生素D参与大脑发育和神经保护、基因转录、免疫调节，并影响神经元信号转导。普通人群中维生素D水平低与精神分裂症、抑郁症和焦虑症有关。然而，关于22q11.2DS儿童的维生素D水平如何介导成年期患精神病的风险，人们知之甚少。测量了7至16岁患有（n=11）和未患有（n=16）22q11.2DS儿童的血浆维生素D水平，并与家长报告的儿童焦虑和非典型性情况进行了关联分析。儿童期的焦虑和非典型性是22q11.2DS患者和普通人群中患精神分裂症的风险指标。与正常同龄人相比，患有22q11.2DS的儿童维生素D水平较低，焦虑和非典型性情况也有所增加。较高水平的焦虑、抑郁和内化问题（而非非典型性）与较低的维生素D水平相关。维生素D不足可能与较高水平的焦虑和抑郁有关，进而导致该人群患精神病的风险升高。需要进一步研究以确定22q11.2DS儿童焦虑、应激、情绪和维生素D之间的因果关系。
