Toriumi Kazuya, Miyashita Mitsuhiro, Yamasaki Syudo, Suzuki Kazuhiro, Tabata Koichi, Yamaguchi Satoshi, Usami Satoshi, Itokawa Masanari, Nishida Atsushi, Kamiguchi Hidenori, Arai Makoto
Schizophrenia Research Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
BJPsych Open. 2025 Mar 31;11(3):e77. doi: 10.1192/bjo.2025.20.
Glucuronic acid (GlcA) is crucial in the glucuronidation pathway, facilitating the metabolism and elimination of various substances and drugs. Recent studies have noted elevated GlcA levels in patients with schizophrenia (SCZ) compared with healthy individuals. However, it remains unclear whether this elevation contributes to SCZ pathophysiology or results from medication effects.
This study investigated the relationship between peripheral GlcA levels and clinical characteristics in patients with SCZ and assess whether these associations persist independently of psychotropic medication effects to provide insight into the potential role of GlcA in the pathophysiology of SCZ.
Plasma GlcA levels were analysed in 218 patients with SCZ, examining their association with clinical features. The correlation between GlcA levels and symptom severity, assessed using the Positive and Negative Syndrome Scale (PANSS), was analysed in 35 patients. In addition, multiple regression analysis was conducted to adjust for age and psychotropic medication effects.
Significant correlations were observed between GlcA levels and PANSS scores for negative symptoms, general psychopathology and total scores. After adjustment for age and psychotropic medications, significant correlations between GlcA levels and PANSS scores persisted for negative symptoms (adjusted β [95% CI], 13.926 [2.369, 25.483]) and general psychopathology (adjusted β [95% CI], 19.437 [3.884, 34.990]), while the total score was no longer significant (adjusted β [95% CI], 34.054 [-0.517, 68.626]).
Elevated GlcA levels in patients with SCZ are associated with specific symptom severity irrespective of the medication dose, suggesting a potential role of GlcA in SCZ pathophysiology.
葡萄糖醛酸（GlcA）在葡萄糖醛酸化途径中至关重要，有助于各种物质和药物的代谢及消除。最近的研究指出，与健康个体相比，精神分裂症（SCZ）患者的GlcA水平有所升高。然而，这种升高是导致SCZ病理生理变化还是药物作用的结果仍不清楚。
本研究调查了SCZ患者外周血GlcA水平与临床特征之间的关系，并评估这些关联是否独立于精神药物作用而持续存在，以深入了解GlcA在SCZ病理生理学中的潜在作用。
分析了218例SCZ患者的血浆GlcA水平，并研究其与临床特征的关联。在35例患者中分析了GlcA水平与使用阳性和阴性症状量表（PANSS）评估的症状严重程度之间的相关性。此外，进行了多元回归分析以调整年龄和精神药物的影响。
观察到GlcA水平与PANSS阴性症状、一般精神病理学和总分之间存在显著相关性。在调整年龄和精神药物后，GlcA水平与PANSS阴性症状（调整后β[95%CI]，13.926[2.369，25.483]）和一般精神病理学（调整后β[95%CI]，19.437[3.884，34.990]）之间的显著相关性仍然存在，而总分不再显著（调整后β[95%CI]，34.054[-0.517，68.626]）。
SCZ患者GlcA水平升高与特定症状严重程度相关，与药物剂量无关，提示GlcA在SCZ病理生理学中可能发挥作用。
