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可改变的心血管危险因素对首发精神病认知、功能和炎症标志物的影响:一项为期 2 年的随访研究结果。

The influence of modifiable cardiovascular risk factors on cognition, functioning, and inflammatory markers in first-episode psychosis: Results from a 2-year follow-up study.

机构信息

Institute of Neuropsychiatry and Addiction of the Barcelona MAR Health Park, Passeig Marítim de la Barceloneta, 25-29, Barcelona 08003, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.

Institute of Neuropsychiatry and Addiction of the Barcelona MAR Health Park, Passeig Marítim de la Barceloneta, 25-29, Barcelona 08003, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.

出版信息

Psychiatry Res. 2022 Oct;316:114760. doi: 10.1016/j.psychres.2022.114760. Epub 2022 Aug 1.

Abstract

To explore the influence of cardiovascular risk factors (CVRFs) on cognitive symptoms, functional impairment, and systemic inflammatory markers in first-episode psychosis (FEP) patients at baseline and 2-year follow-up. Method: In a sample of 70 FEP patients and 85 age- and sex-matched healthy controls, we assessed nine modifiable CVRFs. All participants were classified into two subgroups according to their CVRF profile: lower (0-1 CVRFs) or higher (≥2 CVRFs). The following outcomes were measured at baseline and 2-year follow-up: cognition; functional outcomes; and white blood cell (WBC) subtype. Adjusted general linear models were conducted to study the effect of diagnosis and CVRF profile on cognition, functioning, WBC, and longitudinal changes in these variables. At baseline, FEP patients with a higher CVRF profile showed a significantly slower performance on the TMT-A test for psychomotor speed and higher lymphocyte levels than patients with a lower CVRF profile. No longitudinal changes were observed in primary outcomes at 2-year follow-up. Among FEP patients with a higher CVRF profile, slower psychomotor speed performance did not correlate with increased lymphocyte levels. Our findings suggest that the cognitive effects of CVRFs manifest early in the course of psychosis, thus highlighting the importance of targeting both CVRFs and cognitive deficits in FEP.

摘要

目的

探讨心血管危险因素(CVRFs)对首发精神病(FEP)患者基线和 2 年随访时认知症状、功能障碍和全身炎症标志物的影响。方法:在 70 名 FEP 患者和 85 名年龄和性别匹配的健康对照者中,我们评估了 9 种可改变的 CVRFs。所有参与者根据其 CVRF 特征分为两组:低危(0-1 个 CVRFs)或高危(≥2 个 CVRFs)。在基线和 2 年随访时测量以下结果:认知;功能结果;和白细胞(WBC)亚型。采用调整后的一般线性模型研究诊断和 CVRF 特征对认知、功能、WBC 以及这些变量的纵向变化的影响。在基线时,CVRF 特征较高的 FEP 患者在 TMT-A 测试中表现出明显较慢的精神运动速度,且淋巴细胞水平高于 CVRF 特征较低的患者。在 2 年随访时,主要结果没有观察到纵向变化。在 CVRF 特征较高的 FEP 患者中,较慢的精神运动速度表现与淋巴细胞水平的升高无关。我们的研究结果表明,CVRFs 的认知影响在精神病的早期阶段就表现出来,因此强调了在 FEP 中既要针对 CVRFs,也要针对认知缺陷的重要性。

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