Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.
Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Brain Behav. 2020 Dec;10(12):e01862. doi: 10.1002/brb3.1862. Epub 2020 Sep 30.
Early-onset psychosis (EOP) and bipolar disorder (EOBP) (at <18 years of age), are associated with an increased future risk of cardiovascular disease (CVD) and premature death. Yet it is unknown whether the arteries show visible signs of atherosclerosis in EOP and EOBP. This study investigated whether having EOP or EOBP was associated with detectable signs of preclinical atherosclerosis.
By using 22 MHz high-frequency ultrasound, different layers of the arterial wall of the left common carotid artery (LCCA) were assessed in 77 individuals with EOP (n = 25), EOBP (n = 22), and in age-matched healthy controls (n = 30). Conventional CVD confounders were included in the analyses.
Adolescents with EOP and EOBP, compared to controls, had a significantly thicker LCCA intima thickness (0.132 vs. 0.095 mm, p < .001) and intima/media ratio (0.24 vs. 0.17 p < .001). There was a nonsignificant intima difference between EOP and EOBP. Conventional CVD risk factors did not explain the association between EOP/EOBP and intima thickness. In the group of EOP/EOBP, there was a significant correlation between the dose of current antipsychotic medication and intima thickness; however, the correlation was attenuated to a nonsignificant level when adjusted for global function.
Adolescents with EOP or EOBP had an increased LCCA intima thickness, interpreted as a sign of preclinical atherosclerosis. Global function of the disorders was the strongest determinant of intima thickness. The findings, if replicated, might have implications for long-term treatment of EOP and EOBP in order to reduce a future risk of CVD.
早发性精神病（EOP）和双相情感障碍（EOBP）（<18 岁）与心血管疾病（CVD）和过早死亡的未来风险增加有关。然而，尚不清楚 EOP 和 EOBP 的动脉是否有可见的动脉粥样硬化迹象。本研究旨在调查 EOP 或 EOBP 是否与可检测的临床前动脉粥样硬化迹象相关。
通过使用 22MHz 高频超声，评估 77 名 EOP（n=25）、EOBP（n=22）和年龄匹配的健康对照者（n=30）左颈总动脉（LCCA）的不同动脉壁层。分析中包括了传统的 CVD 混杂因素。
与对照组相比，EOP 和 EOBP 青少年的 LCCA 内膜厚度（0.132 对 0.095mm，p<0.001）和内膜/中膜比值（0.24 对 0.17，p<0.001）明显增厚。EOP 和 EOBP 之间的内膜厚度没有差异。传统的 CVD 危险因素不能解释 EOP/EOBP 与内膜厚度之间的关系。在 EOP/EOBP 组中，当前抗精神病药物剂量与内膜厚度之间存在显著相关性；然而，当调整整体功能时，相关性减弱至无统计学意义。
EOP 或 EOBP 青少年的 LCCA 内膜厚度增加，这被解释为临床前动脉粥样硬化的迹象。疾病的整体功能是内膜厚度的最强决定因素。如果这些发现得到复制，可能会对 EOP 和 EOBP 的长期治疗产生影响，以降低未来 CVD 的风险。
