Rogalski Jakub, Tomczak Tomasz
Military Teaching and Veterans Central Hospital, Medical University of Lodz, Poland.
Department of Child and Adolescent Psychiatry, Medical University of Lodz, Poland.
Postep Psychiatr Neurol. 2024 Sep;33(3):178-187. doi: 10.5114/ppn.2024.142136. Epub 2024 Sep 6.
Schizophrenia is a chronic condition that is associated with various comorbidities, including metabolic ones. Particular attention has been paid to the metabolic dysfunction-associated steatotic liver disease (MASLD), the liver equivalent of the metabolic syndrome. It is postulated that ferroptosis, a form of novel cell death connected with iron overload and lipid peroxidation, may be an interplaying factor in both of these conditions. This review aims to show the specific role of ferroptosis in the development and possible progression of MASLD among patients with schizophrenia. It will be accompanied by a consideration of the probable causes of the associations that occur.
Scientific reports suggest that there may be a genetic predisposition, in terms of ferroptosis, to the development of both schizophrenia and MASLD. Moreover, the role of poor dietary habits, specifically a high-fat diet and insufficient antioxidant intake, in excessive lipid peroxidation and iron overload is emphasized. Additionally, intestinal permeability, caused by iron overload, may contribute to a state of inflammation within the liver tissue. Finally, we cannot forget about the impact of antipsychotic drugs on the ferroptosis process - some of them may initiate this process through carbohydrate-lipid metabolism dysregulation, or causing hepatocyte iron overload, as well as disturbing cellular redox balance.
The process of ferroptosis should be considered as one of the possible pathways which predispose a group of patients with schizophrenia to the development and progression of MASLD. Finding a possible marker of ferroptosis among the mentally ill population may be helpful in the identification of a subgroup of patients particularly vulnerable to steatotic liver disease.
精神分裂症是一种慢性疾病，与多种合并症相关，包括代谢性合并症。代谢功能障碍相关脂肪性肝病（MASLD），即肝脏方面的代谢综合征，已受到特别关注。据推测，铁死亡这种与铁过载和脂质过氧化相关的新型细胞死亡形式，可能在这两种病症中都起作用。本综述旨在阐述铁死亡在精神分裂症患者MASLD发生及可能进展中的具体作用，并探讨相关关联的可能原因。
科学报告表明，在铁死亡方面，精神分裂症和MASLD的发生可能存在遗传易感性。此外，强调了不良饮食习惯，特别是高脂肪饮食和抗氧化剂摄入不足，在过度脂质过氧化和铁过载中的作用。另外，铁过载引起的肠道通透性可能导致肝组织内的炎症状态。最后，我们不能忽视抗精神病药物对铁死亡过程的影响——其中一些药物可能通过碳水化合物 - 脂质代谢失调引发这一过程，或导致肝细胞铁过载以及扰乱细胞氧化还原平衡。
铁死亡过程应被视为使一组精神分裂症患者易患MASLD及其进展的可能途径之一。在精神病患者群体中找到铁死亡的可能标志物，可能有助于识别特别易患脂肪性肝病的患者亚组。
