Huang Hongna, Du Lizhao, Pu Zhengping, Shi Yuan, Xiao Zifan, Chen Xi, Yao Shun, Wang Lijun, Li Zezhi, Xue Ting, Cui Donghong
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
Psychiatry Investig. 2023 Oct;20(10):930-939. doi: 10.30773/pi.2023.0105. Epub 2023 Oct 24.
Sex differences have been observed in many aspects of schizophrenia, including cognitive deficits. Despite extensive research into the relationship between metabolic factors and cognitive deficits in schizophrenia, few studies have explored the potential sex difference in their association.
We recruited 358 schizophrenia patients and 231 healthy controls. The participants underwent measurements of body mass index (BMI), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. Metabolic risk factors included abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. A collection of these metabolic risk factors has been defined as metabolic syndrome. These diagnoses were based on the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. Cognitive performance was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A descriptive analysis, difference analysis, and linear regression model were used to identify the metabolic risk factors for cognitive function in schizophrenia.
Our findings revealed sex differences in the rate of abdominal obesity and hypertension in schizophrenic patients. Additionally, we observed sex differences in the association between metabolic risk factors and cognitive impairment in schizophrenia. Specifically, hyperglycemia was associated with the immediate memory index score of RBANS in male patients, while dyslipidemia was associated with language, attention, delayed memory index scores, and RBANS total score in female patients.
Our results suggest that sex should be considered when evaluating the impact of metabolic disorders on the cognitive function of schizophrenic patients. Moreover, our study identifies hyperglycemia and dyslipidemia as potential targets for precise treatment by sex stratification, which could benefit the improvement of cognitive impairment in schizophrenic patients.
在精神分裂症的许多方面都观察到了性别差异，包括认知缺陷。尽管对精神分裂症中代谢因素与认知缺陷之间的关系进行了广泛研究，但很少有研究探讨它们之间关联的潜在性别差异。
我们招募了358名精神分裂症患者和231名健康对照者。参与者接受了体重指数（BMI）、腰围、血压、甘油三酯、高密度脂蛋白胆固醇和空腹血糖的测量。代谢危险因素包括腹型肥胖、高血压、高血糖和血脂异常。这些代谢危险因素的集合被定义为代谢综合征。这些诊断基于美国国家胆固醇教育计划成人治疗小组第三次报告的标准。使用可重复神经心理状态评估量表（RBANS）测量认知表现。采用描述性分析、差异分析和线性回归模型来确定精神分裂症认知功能的代谢危险因素。
我们的研究结果揭示了精神分裂症患者腹型肥胖和高血压发生率的性别差异。此外，我们观察到精神分裂症患者代谢危险因素与认知障碍之间的关联存在性别差异。具体而言，高血糖与男性患者RBANS的即时记忆指数得分相关，而血脂异常与女性患者的语言、注意力、延迟记忆指数得分和RBANS总分相关。
我们的结果表明，在评估代谢紊乱对精神分裂症患者认知功能的影响时应考虑性别因素。此外，我们的研究确定高血糖和血脂异常是通过性别分层进行精准治疗的潜在靶点，这可能有助于改善精神分裂症患者的认知障碍。
