Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Mol Psychiatry. 2022 Mar;27(3):1448-1454. doi: 10.1038/s41380-021-01387-5. Epub 2021 Nov 19.
Schizophrenia is a serious mental disorder with considerable somatic and psychiatric morbidity. It is unclear whether comorbid health conditions predominantly arise due to shared genetic risk or consequent to having schizophrenia. To explore the contribution of genetic risk for schizophrenia, we analysed the effect of schizophrenia polygenic risk scores (PRS) on a broad range of health problems in 406 929 individuals with no schizophrenia diagnosis from the UK Biobank. Diagnoses were derived from linked health data including primary care, hospital inpatient records, and registers with information on cancer and deaths. Schizophrenia PRS were generated and tested for associations with general health conditions, 16 ICD10 main chapters, and 603 diseases using linear and logistic regressions. Higher schizophrenia PRS was significantly associated with poorer overall health ratings, more hospital inpatient diagnoses, and more unique illnesses. It was also significantly positively associated with 4 ICD10 chapters: mental disorders; respiratory diseases; digestive diseases; and pregnancy, childbirth and the puerperium, but negatively associated with musculoskeletal disorders. Thirty-one specific phenotypes were significantly associated with schizophrenia PRS, and the 19 novel findings include several musculoskeletal diseases, respiratory diseases, digestive diseases, varicose veins, pituitary hyperfunction, and other peripheral nerve disorders. These findings extend knowledge of the pleiotropic effect of genetic risk for schizophrenia and offer insight into how some conditions often comorbid with schizophrenia arise. Additional studies incorporating the genetic basis of hormone regulation and involvement of immune mechanisms in the pathophysiology of schizophrenia may further elucidate the biological mechanisms underlying schizophrenia and its comorbid conditions.
精神分裂症是一种严重的精神障碍,会导致相当多的躯体和精神疾病。目前尚不清楚合并症是否主要是由于共同的遗传风险还是由于患有精神分裂症而产生的。为了探讨精神分裂症遗传风险的作用,我们分析了精神分裂症多基因风险评分(PRS)对来自英国生物银行的 406929 名无精神分裂症诊断个体的广泛健康问题的影响。这些诊断是通过与健康相关的数据得出的,包括初级保健、住院记录以及癌症和死亡登记信息。通过线性和逻辑回归分析,生成并测试了精神分裂症 PRS 与一般健康状况、16 个 ICD10 主要章节和 603 种疾病之间的关联。较高的精神分裂症 PRS 与整体健康评分较差、更多的住院诊断和更多的独特疾病显著相关。它还与 4 个 ICD10 章节显著正相关:精神障碍、呼吸疾病、消化疾病和妊娠、分娩和产褥期,但与肌肉骨骼疾病显著负相关。31 种特定表型与精神分裂症 PRS 显著相关,其中 19 个新发现包括几种肌肉骨骼疾病、呼吸疾病、消化疾病、静脉曲张、垂体功能亢进和其他周围神经疾病。这些发现扩展了精神分裂症遗传风险的多效性影响的知识,并深入了解了一些常与精神分裂症共病的疾病是如何产生的。纳入激素调节的遗传基础以及免疫机制在精神分裂症病理生理学中的作用的进一步研究,可能会进一步阐明精神分裂症及其共病的生物学机制。