University of California San Diego, La Jolla, CA, United States.
Department of Psychiatry, University of Oxford, UK.
Schizophr Res. 2019 Feb;204:96-103. doi: 10.1016/j.schres.2018.09.022. Epub 2018 Sep 22.
Patients with schizophrenia have a high prevalence of metabolic disorders and cardiovascular mortality. It is possible that a vulnerability to metabolic abnormalities is associated with risk for psychosis, symptoms and functionality. In this study, we evaluate demographic information, cardiometabolic indices, symptoms and functioning in an antipsychotic free cohort at Clinical High Risk (CHR) for psychosis from the NAPLS Omega 3 fatty acid clinical trial.
Subjects received physical exams and metabolic monitoring prior to randomization into the Omega 3 versus Placebo trial. Anthropometrical measures, vital signs, glucose, and lipids were assessed along with symptoms, functioning, dietary Omega 3 fatty acids, erythrocyte polyunsaturated fatty acid content and a measure of lipid peroxidation (TBARS, Thiobarbituric acid-reactive substances).
The sample included 113 CHR subjects (42.1% female; 17.5% Latino) ages 12-29. The mean BMI was 24.3 with a trend toward higher BMI and a higher incidence of metabolic syndrome in Latino subjects; 36% of the sample was obese/overweight; 37.6% met criteria for prehypertension/hypertension; 4.2% met criteria for prediabetes/diabetes; 9.6% showed evidence of insulin resistance and 44.7% had dyslipidemia. The TBARS was elevated at 9.8 μM ± 6.1 (normal 1.86-3.94 μM). Metabolic parameters and a diet low in Omega 3 rich foods were significantly associated with prodromal symptoms and poor functioning.
CHR subjects show a high percentage of metabolic abnormalities prior to exposure to antipsychotic medication. These findings reinforce that early detection of metabolic disturbances and food insecurity is crucial since these factors are modifiable with the potential for significant gains in terms of quality of life, physical and mental health.
精神分裂症患者代谢紊乱和心血管死亡率较高。代谢异常的易感性可能与精神病风险、症状和功能有关。在这项研究中，我们评估了来自 NAPLS Omega 3 脂肪酸临床试验的精神病临床高风险（CHR）无抗精神病药物队列的人口统计学信息、心脏代谢指标、症状和功能。
受试者在随机分配到 Omega 3 与安慰剂试验之前接受了身体检查和代谢监测。评估了人体测量指标、生命体征、血糖和血脂，以及症状、功能、饮食中的 Omega 3 脂肪酸、红细胞多不饱和脂肪酸含量和脂质过氧化（TBARS，硫代巴比妥酸反应物质）的测量值。
样本包括 113 名 CHR 受试者（42.1%为女性；17.5%为拉丁裔），年龄在 12-29 岁之间。平均 BMI 为 24.3，拉丁裔受试者的 BMI 呈上升趋势，代谢综合征的发生率较高；36%的样本超重/肥胖；37.6%符合高血压前期/高血压标准；4.2%符合糖尿病前期/糖尿病标准；9.6%有胰岛素抵抗证据，44.7%有血脂异常。TBARS 升高至 9.8µM±6.1（正常 1.86-3.94µM）。代谢参数和富含 Omega 3 的食物低饮食与前驱症状和功能不良显著相关。
在接触抗精神病药物之前，CHR 受试者表现出高比例的代谢异常。这些发现强调了早期发现代谢紊乱和食物不安全的重要性，因为这些因素是可以改变的，有可能在生活质量、身心健康方面取得显著的收益。
