双相情感障碍中肥胖与皮质形态关联的荟萃分析：针对2832名参与者的ENIGMA研究
Mega-analysis of association between obesity and cortical morphology in bipolar disorders: ENIGMA study in 2832 participants.
作者信息
McWhinney Sean R, Abé Christoph, Alda Martin, Benedetti Francesco, Bøen Erlend, Del Mar Bonnin Caterina, Borgers Tiana, Brosch Katharina, Canales-Rodríguez Erick J, Cannon Dara M, Dannlowski Udo, Diaz-Zuluaga Ana M, Dietze Lorielle M F, Elvsåshagen Torbjørn, Eyler Lisa T, Fullerton Janice M, Goikolea Jose M, Goltermann Janik, Grotegerd Dominik, Haarman Bartholomeus C M, Hahn Tim, Howells Fleur M, Ingvar Martin, Jahanshad Neda, Kircher Tilo T J, Krug Axel, Kuplicki Rayus T, Landén Mikael, Lemke Hannah, Liberg Benny, Lopez-Jaramillo Carlos, Malt Ulrik F, Martyn Fiona M, Mazza Elena, McDonald Colm, McPhilemy Genevieve, Meier Sandra, Meinert Susanne, Meller Tina, Melloni Elisa M T, Mitchell Philip B, Nabulsi Leila, Nenadic Igor, Opel Nils, Ophoff Roel A, Overs Bronwyn J, Pfarr Julia-Katharina, Pineda-Zapata Julian A, Pomarol-Clotet Edith, Raduà Joaquim, Repple Jonathan, Richter Maike, Ringwald Kai G, Roberts Gloria, Ross Alex, Salvador Raymond, Savitz Jonathan, Schmitt Simon, Schofield Peter R, Sim Kang, Stein Dan J, Stein Frederike, Temmingh Henk S, Thiel Katharina, Thomopoulos Sophia I, van Haren Neeltje E M, Vargas Cristian, Vieta Eduard, Vreeker Annabel, Waltemate Lena, Yatham Lakshmi N, Ching Christopher R K, Andreassen Ole A, Thompson Paul M, Hajek Tomas
机构信息
Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
出版信息
Psychol Med. 2023 Oct;53(14):6743-6753. doi: 10.1017/S0033291723000223. Epub 2023 Feb 27.
BACKGROUND
Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact.
METHODS
We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations.
RESULTS
BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI.
CONCLUSIONS
We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
背景
肥胖非常普遍且会导致功能障碍，尤其是在患有严重精神疾病（包括双相情感障碍，BD）的个体中。大脑是肥胖和双相情感障碍的靶器官。然而，我们并不清楚双相情感障碍和肥胖中大脑皮质改变是如何相互作用的。
方法
我们从ENIGMA - BD工作组的13个国家的1231名双相情感障碍患者和1601名对照个体中获取了体重指数（BMI）以及磁共振成像（MRI）得出的区域皮质厚度、表面积数据。我们使用混合效应联合对双相情感障碍和BMI对脑结构的统计效应进行建模，并测试相互作用和中介作用。我们还研究了药物对BMI相关关联的影响。
结果
BMI和双相情感障碍对许多相同脑区的结构产生累加影响。BMI和双相情感障碍均与皮质厚度呈负相关，但与表面积无关。在大多数区域，在控制BMI的情况下，联合使用的精神科药物类别数量仍与较低的皮质厚度相关。在单个脑区梭状回中，联合使用的精神科药物数量与皮质厚度之间约三分之一的负相关是由药物数量与较高BMI之间的关联介导的。
结论
我们证实在整个脑壳中，较高的BMI与较低的皮质厚度（而非表面积）之间存在一致的关联，这些脑区也与双相情感障碍有关。双相情感障碍患者中较高的BMI表明脑改变更为明显。BMI对于理解双相情感障碍中的神经解剖学变化以及精神科药物对大脑的影响很重要。
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