Jin Xiaoying, Lu Chenghao, Liu Nannan, Li Yanzhe, Dong Yeqing, Wang Xinxu, Li Shen, Li Jie
Department of Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, No. 13, Liulin Road, Hexi District, Tianjin, 300222, China.
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
J Neural Transm (Vienna). 2025 Feb;132(2):313-322. doi: 10.1007/s00702-024-02842-7. Epub 2024 Oct 10.
Schizophrenia (SCZ) shortens life expectancy, with cardiovascular disease (CVD) as the leading cause of death. The links between psychiatric symptoms, cognitive function and CVD are unclear, and sex differences in this relationship are understudied. This study examined the relationship between clinical characteristics and 10-year cardiovascular risk in males and females with SCZ.
This study included 802 patients with chronic SCZ. Fasting venous blood samples were collected from all patients to measure relevant glycolipid metabolic indices. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The Framingham risk score (FRS) was used to estimate the 10-year CVD risk.
The mean 10-year cardiovascular risk for all patients was 11.76 ± 8.99%. Among patients with SCZ, 52.8% exhibited an intermediate-high 10-year cardiovascular risk. Multivariate linear regression analysis showed that FRS increased with higher body mass index, blood pressure, glucose, total cholesterol and triglyceride levels, while it was inversely related to high density lipoprotein levels. The general psychopathological scores were negatively associated with FRS (male: B = - 0.086, P = 0.013; female: B = - 0.056, P = 0.039). Negative symptom (B = - 0.088, P = 0.024) and total PANSS scores (B = - 0.042, P = 0.013) showed a negative association with FRS only in males. Additionally, in patients over 60 years old, general psychopathology (B = - 0.168, P = 0.001) and PANSS total scores (B = - 0.057, P = 0.041) were associated with reduced FRS, while immediate memory (B = 0.073, P = 0.025) was associated with higher FRS.
Patients with SCZ have an elevated risk of developing CVD, with males showing a higher 10-year cardiovascular risk than females. Significant sex differences exist in the relationship between the FRS and psychiatric symptoms, with negative symptoms being negatively related to FRS only in males.
精神分裂症（SCZ）会缩短预期寿命，心血管疾病（CVD）是主要死因。精神症状、认知功能与心血管疾病之间的联系尚不清楚，且这种关系中的性别差异研究不足。本研究探讨了SCZ男性和女性患者临床特征与10年心血管疾病风险之间的关系。
本研究纳入802例慢性SCZ患者。采集所有患者的空腹静脉血样本以测量相关糖脂代谢指标。采用阳性和阴性症状量表（PANSS）评估精神症状。使用可重复神经心理状态评估量表（RBANS）评估认知功能。采用弗雷明汉风险评分（FRS）来估计10年心血管疾病风险。
所有患者的平均10年心血管疾病风险为11.76±8.99%。在SCZ患者中，52.8%表现出中高10年心血管疾病风险。多变量线性回归分析显示，FRS随着体重指数、血压、血糖、总胆固醇和甘油三酯水平升高而增加，而与高密度脂蛋白水平呈负相关。一般精神病理学评分与FRS呈负相关（男性：B = -0.086，P = 0.013；女性：B = -0.056，P = 0.039）。阴性症状（B = -0.088，P = 0.024）和PANSS总分（B = -0.042，P = 0.013）仅在男性中与FRS呈负相关。此外，在60岁以上患者中，一般精神病理学（B = -0.168，P = 0.001）和PANSS总分（B = -0.057，P = 0.041）与FRS降低相关，而即刻记忆（B = 0.073，P = 0.025）与FRS升高相关。
SCZ患者发生心血管疾病的风险升高，男性的10年心血管疾病风险高于女性。FRS与精神症状之间的关系存在显著性别差异，阴性症状仅在男性中与FRS呈负相关。
