Division of Mental Health and Addiction, Vestfold Hospital Trust, Sykehuset i Vestfold, PO Box 2168, 3103, Tonsberg, Norway.
Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317, Oslo, Norway.
BMC Psychiatry. 2021 Oct 26;21(1):527. doi: 10.1186/s12888-021-03522-6.
There is evidence of increased low grade inflammation (LGI) in schizophrenia patients. However, the inter-individual variation is large and the association with demographic, somatic and psychiatric factors remains unclear. Our aim was to explore whether levels of the novel LGI marker soluble urokinase plasminogen activator receptor (suPAR) were associated with clinical factors in schizophrenia and if such associations were sex-dependent.
In this observational study a total of 187 participants with schizophrenia (108 males, 79 females) underwent physical examination and assessment with clinical interviews (Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Alcohol Use Disorder Identification Test (AUDIT), and Drug Use Disorder Identification Test (DUDIT)). Blood levels of suPAR, glucose, lipids, and high sensitivity C-reactive protein (hsCRP) were determined and body mass index (BMI) calculated. Multivariable linear regression analyses were used adjusting for confounders, and sex interaction tested in significant variables.
Adjusting for sex, age, current tobacco smoking and BMI, we found that levels of hsCRP and depressive symptoms (CDSS) were positively associated with levels of suPAR (p < 0.001). The association between suPAR and CDSS score was significant in females (p < 0.001) but not in males. Immune activation measured by hsCRP was not associated with depressive symptoms after adjusting for BMI.
Our findings indicate that increased suPAR levels are associated with depressive symptoms in females with schizophrenia, suggesting aberrant immune activation in this subgroup. Our results warrant further studies, including longitudinal follow-up of suPAR levels in schizophrenia and experimental studies of mechanisms.
精神分裂症患者存在低度炎症（LGI）增加的证据。然而，个体间的差异很大，与人口统计学、躯体和精神因素的关联仍不清楚。我们的目的是探讨新型 LGI 标志物可溶性尿激酶型纤溶酶原激活物受体（suPAR）的水平是否与精神分裂症患者的临床因素有关，以及这种关联是否存在性别依赖性。
在这项观察性研究中，共有 187 名精神分裂症患者（男性 108 名，女性 79 名）接受了体格检查和临床访谈评估（阳性和阴性综合征量表（PANSS）、精神分裂症卡尔加里抑郁量表（CDSS）、酒精使用障碍识别测试（AUDIT）和药物使用障碍识别测试（DUDIT））。测定了 suPAR、血糖、血脂和高敏 C 反应蛋白（hsCRP）的水平，并计算了体重指数（BMI）。采用多元线性回归分析调整混杂因素，并对有意义的变量进行性别交互检验。
调整性别、年龄、当前吸烟和 BMI 后，我们发现 hsCRP 和抑郁症状（CDSS）与 suPAR 水平呈正相关（p<0.001）。suPAR 与 CDSS 评分的相关性在女性中具有统计学意义（p<0.001），而在男性中则没有。调整 BMI 后，hsCRP 测量的免疫激活与抑郁症状无关。
我们的研究结果表明，suPAR 水平升高与女性精神分裂症患者的抑郁症状有关，这表明该亚组存在异常的免疫激活。我们的研究结果需要进一步研究，包括精神分裂症患者 suPAR 水平的纵向随访和机制的实验研究。
