Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
Sci Rep. 2021 Jul 20;11(1):14818. doi: 10.1038/s41598-021-94381-4.
Obesity is a critical issue in patients with schizophrenia, which is considered to be brought about by both environmental and genetic factors. Apolipoprotein E (APOE) gene polymorphisms might be involved in the pathogenesis of schizophrenia, however, the effect of APOE gene polymorphism on obesity has never been investigated in Chinese aging with schizophrenia. This cross-sectional study was to investigate the effect of obesity on cognitive and psychiatric symptoms in elderly participants with schizophrenia. At the same time, we also discussed the inner link between APOE E4 and obesity. 301 elderly participants with schizophrenia and 156 normal controls were included in the study. Their cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and APOE gene polymorphism was determined by polymerase chain reaction (PCR). The prevalence of obesity in elderly schizophrenic patients and healthy controls accounted for 15.9% (48/301) and 10.3% (16/156), respectively, with no statistically significant difference. By using stepwise linear regression analysis, we found that elevated fasting blood glucose, hypertension, and hyperlipidemia were risk factors for obesity in elderly schizophrenic patients. Although there was no direct correlation between APOE E4 and obesity in patients with schizophrenia, it was significantly correlated with hyperlipemia(r = - 0.154, p = 0.008), suggesting that APOE E4 may induce obesity in elderly patients with schizophrenia through hyperlipemia, However, the above conclusions do not apply to the normal elderly. What's more, we did not find a link between obesity and cognitive function or mental symptoms for both patients with schizophrenia and normal controls. APOE E4 is associated with hyperlipidemia in elderly schizophrenic patients, which may be a risk factor for obesity, however, the above conclusion does not apply to the normal elderly.
肥胖是精神分裂症患者的一个关键问题，被认为是由环境和遗传因素共同导致的。载脂蛋白 E（APOE）基因多态性可能与精神分裂症的发病机制有关，然而，APOE 基因多态性对肥胖的影响在患有精神分裂症的中国老年人中从未被研究过。本横断面研究旨在探讨肥胖对老年精神分裂症患者认知和精神症状的影响。同时，我们还讨论了 APOE E4 与肥胖之间的内在联系。研究纳入了 301 名老年精神分裂症患者和 156 名正常对照者。使用蒙特利尔认知评估量表（MoCA）评估他们的认知功能，使用阳性和阴性症状量表（PANSS）评估他们的精神症状，使用聚合酶链反应（PCR）确定 APOE 基因多态性。老年精神分裂症患者和健康对照者中肥胖的患病率分别为 15.9%（48/301）和 10.3%（16/156），差异无统计学意义。通过逐步线性回归分析，我们发现空腹血糖升高、高血压和高脂血症是老年精神分裂症患者肥胖的危险因素。尽管精神分裂症患者中 APOE E4 与肥胖之间没有直接相关性，但与高脂血症显著相关（r= -0.154，p=0.008），这表明 APOE E4 可能通过高脂血症导致老年精神分裂症患者肥胖，然而，上述结论不适用于正常老年人。更重要的是，我们没有发现肥胖与精神分裂症患者和正常对照者的认知功能或精神症状之间存在联系。APOE E4 与老年精神分裂症患者的高脂血症有关，可能是肥胖的一个危险因素，然而，上述结论不适用于正常老年人。
