Yan Junwei, Chen Yuanyuan, Ju Peijun, Gao Jianliang, Zhang Loufeng, Li Jingwei, Wang Keming, Zhang Jie, Li Chao, Xia Qingrong, Zhu Cuizhen, Zhang Xulai
Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.
Department of Medical Education and Research, Hefei Fourth People's Hospital, Hefei, China.
Front Psychiatry. 2022 Feb 22;13:834539. doi: 10.3389/fpsyt.2022.834539. eCollection 2022.
Cardiovascular disease (CVD) risk factors such as dyslipidemia and systemic aberrant inflammatory processes may occur in patients with psychotic disorders, which may cause increased mortality. The interplay between immune and metabolic markers and its contribution to the clinical symptoms of schizophrenia (SCZ) remain unclear. This study aimed to examine the association of a series of inflammatory factors, plasma biochemical indicators, and SCZ clinical symptomatology with the severity of SCZ symptoms.
A total of 115 participants, including 79 first-episode drug-naïve patients with SCZ and 36 healthy controls, were enrolled in this study. Semi-structured interviews were used to collect sociodemographic data, family history of SCZ, and medical and psychiatric history. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were administered by a clinical psychiatrist to evaluate the symptom severity of patients with SCZ. Plasma inflammatory cytokines were measured by a fully automated electrochemiluminescent immunoassay (Meso Scale Discovery).
Blood routine, biochemical, and inflammation cytokine test results showed that the levels of white blood cell count, neutrophil count, natrium, CRP, IL-8, IL-6, IL-13, and IL-16 significantly increased in the case group than in the healthy controls ( < 0.05), whereas levels of red blood cell count, hemoglobin concentration, mean corpuscular hemoglobin concentration, total protein, albumin, total bile acid, high-density lipoprotein (HDL), apolipoprotein A1, blood urea nitrogen, kalium and IL-15 were lower than in the healthy controls ( < 0.05). Correlation network analysis results shown that the natrium, HDL and red blood cell count were the top 3 factors closely to with BPRS and PANSS related clinical symptoms among of correlation network (degree = 4). ROC curve analysis explored the IL-16, IL-8, IL-13, IL-15, natrium, and HDL had highly sensitivity and specificity to the predictive validity and effectiveness for SCZ symptoms.
Our study revealed a complex interactive network correlation among the cardiovascular risk factors, biological immunity profiles, and psychotic symptoms in first-episode patients. Abnormal inflammatory factors and CVD risk factors had high sensitivity and specificity for predicting SCZ symptoms. Generally, our study provided novel information on the immune-related mechanisms involved in early CVD risk in patients with psychotic disorders.
心血管疾病（CVD）风险因素，如血脂异常和全身性异常炎症过程，可能在精神障碍患者中出现，这可能导致死亡率增加。免疫和代谢标志物之间的相互作用及其对精神分裂症（SCZ）临床症状的影响仍不清楚。本研究旨在探讨一系列炎症因子、血浆生化指标与SCZ临床症状学与SCZ症状严重程度之间的关联。
本研究共纳入115名参与者，包括79名首次发作未用药的SCZ患者和36名健康对照。采用半结构化访谈收集社会人口学数据、SCZ家族史以及医疗和精神病史。由临床精神科医生使用简明精神病评定量表（BPRS）和阳性与阴性症状量表（PANSS）评估SCZ患者的症状严重程度。血浆炎症细胞因子通过全自动电化学发光免疫分析（Meso Scale Discovery）进行检测。
血常规、生化和炎症细胞因子检测结果显示，病例组白细胞计数、中性粒细胞计数、钠、CRP、IL-8、IL-6、IL-13和IL-16水平显著高于健康对照组（<0.05），而红细胞计数、血红蛋白浓度、平均红细胞血红蛋白浓度、总蛋白、白蛋白、总胆汁酸、高密度脂蛋白（HDL）、载脂蛋白A1、血尿素氮、钾和IL-15水平低于健康对照组（<0.05）。相关网络分析结果显示，在相关网络中，钠、HDL和红细胞计数是与BPRS和PANSS相关临床症状最密切的前3个因素（度数=4）。ROC曲线分析发现，IL-16、IL-8、IL-13、IL-15、钠和HDL对SCZ症状的预测有效性和准确性具有较高的敏感性和特异性。
我们的研究揭示了首发患者心血管危险因素、生物免疫特征和精神症状之间存在复杂的交互网络相关性。异常炎症因子和CVD危险因素对预测SCZ症状具有较高的敏感性和特异性。总体而言，我们的研究为精神障碍患者早期CVD风险的免疫相关机制提供了新的信息。
