National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic; 3rd School of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic.
Structural Brain Mapping Group, Department of Neurology, Jena University Hospital, Erlanger Alle 101, D - 07747, Jena, Germany.
J Psychiatr Res. 2018 Apr;99:151-158. doi: 10.1016/j.jpsychires.2018.02.012. Epub 2018 Feb 10.
Obesity and dyslipidemia may negatively affect brain health and are frequent medical comorbidities of schizophrenia and related disorders. Despite the high burden of metabolic disorders, little is known about their effects on brain structure in psychosis. We investigated, whether obesity or dyslipidemia contributed to brain alterations in first-episode psychosis (FEP).
120 participants with FEP, who were undergoing their first psychiatric hospitalization, had <24 months of untreated psychosis and were 18-35 years old and 114 controls within the same age range participated in the study. We acquired 3T brain structural MRI, fasting lipids and body mass index. We used machine learning trained on an independent sample of 504 controls to estimate the individual brain age of study participants and calculated the BrainAGE score by subtracting the chronological from the estimated brain age.
In a multiple regression model, the diagnosis of FEP (B = 1.15, SE B = 0.31, p < 0.001) and obesity/overweight (B = 0.92, SE B = 0.35, p = 0.008) were each additively associated with BrainAGE scores (R = 0.22, F(3, 230) = 21.92, p < 0.001). BrainAGE scores were highest in participants with FEP and obesity/overweight (3.83 years, 95%CI = 2.35-5.31) and lowest in normal weight controls (-0.27 years, 95%CI = -1.22-0.69). LDL-cholesterol, HDL-cholesterol or triglycerides were not associated with BrainAGE scores.
Overweight/obesity may be an independent risk factor for diffuse brain alterations manifesting as advanced brain age already early in the course of psychosis. These findings raise the possibility that targeting metabolic health and intervening already at the level of overweight/obesity could slow brain ageing in FEP.
肥胖和血脂异常可能会对大脑健康产生负面影响，且是精神分裂症和相关障碍的常见合并症。尽管代谢紊乱的负担很高，但对于其在精神病中的对大脑结构的影响知之甚少。我们研究了肥胖或血脂异常是否会导致首发精神病（FEP）患者的大脑改变。
120 名患有 FEP 的参与者参与了这项研究，他们正在接受首次精神住院治疗，未经治疗的精神病发作时间<24 个月，年龄在 18-35 岁之间，114 名年龄在同一范围内的对照者也参与了研究。我们采集了 3T 脑结构 MRI、空腹血脂和体重指数。我们使用在 504 名对照者的独立样本上训练的机器学习来估计研究参与者的个体脑龄，并通过从估计的脑龄中减去实际年龄来计算脑龄得分。
在多元回归模型中，FEP 的诊断（B=1.15，SE B=0.31，p<0.001）和肥胖/超重（B=0.92，SE B=0.35，p=0.008）都与脑龄得分呈相加关系（R²=0.22，F（3，230）=21.92，p<0.001）。FEP 合并肥胖/超重患者的脑龄得分最高（3.83 岁，95%CI=2.35-5.31），正常体重对照组的脑龄得分最低（-0.27 岁，95%CI=-1.22-0.69）。LDL-胆固醇、HDL-胆固醇或甘油三酯与脑龄得分无关。
超重/肥胖可能是精神病早期弥漫性大脑改变的独立危险因素，表现为大脑年龄的提前。这些发现提示，针对代谢健康，甚至在超重/肥胖阶段进行干预，可能会减缓 FEP 患者的大脑衰老。
