Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain.
Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
Span J Psychiatry Ment Health. 2024 Jul-Sep;17(3):146-153. doi: 10.1016/j.rpsm.2023.03.002. Epub 2023 Jun 2.
The proxies used to compose cognitive reserve (CR) for patients of a first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to peripheral pathways of the central nervous system, yet despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR. Meanwhile, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL), cause worse global functioning and cognitive impairment. For these reasons, the present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP.
We included 668 FEP patients and 217 healthy controls. Participants were assessed for sociodemographic information, years of education, employment status, premorbid IQ and biological parameters: waist circumference, hypertension, and levels of HDL, triglycerides, and glucose.
The findings suggest that the years of education proxy showed correlational and higher relationship with HDL levels for both FEP patients (r=0.23, b=0.185) and controls (r=0.31, b=0.342). We found that the CR index composed of years of education and HDL levels showed a higher explanatory power for the phenomenon than the classical CR index composed of years of education, employment status and premorbid IQ.
This article proposes an objective and quantifiable method to measure CR that is more the multifactorial nature of FEP.
在首发精神分裂症（FEP）患者的认知储备（CR）研究中，用于构建 CR 的替代指标在文献中各不相同。尽管 FEP 的发病与中枢神经系统的外周通路有关，但目前尚无研究考虑将生物标志物作为 CR 的替代指标。同时，精神分裂症与代谢系统有关，这表明生物参数水平的变化，特别是高密度脂蛋白（HDL）的变化，会导致更差的整体功能和认知障碍。基于这些原因，本研究旨在创建一个可量化和客观的 CR 指数，以适应 FEP 的多因素性质。
我们纳入了 668 名首发精神分裂症患者和 217 名健康对照者。对参与者进行了社会人口学信息、受教育年限、就业状况、前期智商和生物参数（腰围、高血压以及 HDL、甘油三酯和血糖水平）的评估。
研究结果表明，受教育年限这一代替指标与 FEP 患者（r=0.23，b=0.185）和对照组（r=0.31，b=0.342）的 HDL 水平均具有相关性，且相关性更强。我们发现，由受教育年限和 HDL 水平组成的 CR 指数比由受教育年限、就业状况和前期智商组成的经典 CR 指数对这一现象具有更高的解释力。
本文提出了一种客观、可量化的方法来衡量 CR，该方法更能反映 FEP 的多因素性质。
