Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China; Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
Brain Res. 2024 Dec 15;1845:149220. doi: 10.1016/j.brainres.2024.149220. Epub 2024 Aug 31.
This study explores the intricate relationship between clozapine use, cardiovascular disease (CVD) risk, and cognitive function in patients with schizophrenia (SCZ).
A cohort comprising 765 patients was stratified based on clozapine usage. Data on demographics, clinical characteristics, and glycolipid metabolism were collected. The Framingham Risk Score and vascular age were calculated using gender-specific Cox regression calculators. Cognitive function was assessed with the Repeatable Battery for Assessment of Neuropsychological Status.
Among the patients, 34.6 % were clozapine users. Clozapine users exhibited lower systolic blood pressure, high-density lipoprotein cholesterol and total cholesterol (all ps < 0.05). Furthermore, clozapine users exhibited higher PANSS scores, along with lower scores in RBANS scores (all p < 0.05). Correlation analysis revealed positive correlation between CVD risk in non-clozapine users and negative symptom scores (r = 0.074, p = 0.043), and negative correlation with positive symptom scores and RBANS scores (r = -0.121, p = 0.001; r = -0.091, p = 0.028). Multivariate stepwise regression analysis indicated that attention scores as predictive factors for increased CVD risk in clozapine users (B = -0.08, 95 %CI = -0.11 to -0.03, p = 0.003).
Patients with SCZ using clozapine exhibit more severe clinical symptoms and cognitive impairments. Attention emerges as a predictor for increased CVD risk in clozapine users.
本研究探讨了氯氮平使用、心血管疾病（CVD）风险和精神分裂症（SCZ）患者认知功能之间的复杂关系。
本研究纳入了 765 名患者，根据氯氮平的使用情况进行了分层。收集了人口统计学、临床特征和糖脂代谢的数据。使用性别特异性 Cox 回归计算器计算了Framingham 风险评分和血管年龄。使用重复性成套神经心理状态评估（Repeatable Battery for Assessment of Neuropsychological Status，RBANS）评估认知功能。
在这些患者中，34.6%是氯氮平使用者。与非氯氮平使用者相比，氯氮平使用者的收缩压、高密度脂蛋白胆固醇和总胆固醇较低（均 p<0.05）。此外，氯氮平使用者的 PANSS 评分较高，而 RBANS 评分较低（均 p<0.05）。相关性分析显示，非氯氮平使用者的 CVD 风险与阴性症状评分呈正相关（r=0.074，p=0.043），与阳性症状评分和 RBANS 评分呈负相关（r=-0.121，p=0.001；r=-0.091，p=0.028）。多变量逐步回归分析表明，注意力评分是氯氮平使用者 CVD 风险增加的预测因素（B=-0.08，95%CI=-0.11 至-0.03，p=0.003）。
使用氯氮平的 SCZ 患者表现出更严重的临床症状和认知障碍。注意力是氯氮平使用者 CVD 风险增加的预测因素。
