Schaefer Charlotte F M, Stapel Britta, Scharn Nicole, Bertele Sebastian, Glahn Alexander, Kahl Kai G, Proskynitopoulos Phileas J, Westhoff-Bleck Mechthild
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Front Psychiatry. 2025 Jun 3;16:1441605. doi: 10.3389/fpsyt.2025.1441605. eCollection 2025.
Life expectancy of patients with borderline personality disorder (BPD) is reduced compared to the general population, which has been in part attributed to a heightened risk for cardiometabolic disorders. One prior study reported increased values of epicardial adipose tissue (EAT), which has been shown to be a sensitive marker for cardiovascular disease risk. Against this background, studies assessing cardiac function in patients with BPD have been missing to date.
The present study included 28 female patients with a diagnosis of BPD and 28 age, sex, and BMI-matched controls (mean age 29 ± 11 years). EAT thickness and parameters of cardiac function were assessed by echocardiography. Diabetes risk was assessed using the Finnish Diabetes Risk (FINDRISC) score, and metabolic syndrome was defined in accordance to National Cholesterol Education Program Adult Treatment Panel-III (NCEP/ATPIII) criteria. Additionally, self-report questionnaires were used to assess lifestyle factors, retrospectively reported childhood trauma and current symptoms of depression and anxiety.
Our study confirmed significantly elevated levels of EAT in patients with BPD compared to controls. Additionally, significant decreases in right (TAPSE) and left (MAPSE) ventricular function, albeit within the normal range, were measured in BPD patients. Contrarily, left ventricular ejection fraction was similar in both groups. Further, patients with BPD reported high levels of childhood trauma and clinically relevant depression and anxiety symptoms. Diabetes risk and frequency of metabolic syndrome as well as serum levels of prognostic markers NT-proBNP and GDF15 were similar in both groups. BPD patients were more frequently smokers and reported lower levels of physical exercise compared to controls.
The present study demonstrates morphological and functional differences in a matched sample of female patients with BPD and healthy controls, pointing to an increased risk for the development of cardiovascular disorders. These findings highlight the importance of screening for cardiovascular risk markers and of including interventions that aim to improve adverse life-style habits early on in the clinical management of BPD.
与普通人群相比，边缘型人格障碍（BPD）患者的预期寿命缩短，部分原因是心脏代谢紊乱风险增加。一项先前的研究报告称，心外膜脂肪组织（EAT）的值升高，而EAT已被证明是心血管疾病风险的敏感标志物。在此背景下，迄今为止尚无评估BPD患者心脏功能的研究。
本研究纳入了28名诊断为BPD的女性患者以及28名年龄、性别和体重指数匹配的对照者（平均年龄29±11岁）。通过超声心动图评估EAT厚度和心脏功能参数。使用芬兰糖尿病风险（FINDRISC）评分评估糖尿病风险，并根据美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP/ATPIII）标准定义代谢综合征。此外，使用自我报告问卷评估生活方式因素、回顾性报告的童年创伤以及当前的抑郁和焦虑症状。
我们的研究证实，与对照组相比，BPD患者的EAT水平显著升高。此外，在BPD患者中测量到右心室（TAPSE）和左心室（MAPSE）功能显著下降，尽管仍在正常范围内。相反，两组的左心室射血分数相似。此外，BPD患者报告童年创伤程度高，且有临床相关的抑郁和焦虑症状。两组的糖尿病风险、代谢综合征发生率以及预后标志物NT-proBNP和GDF15的血清水平相似。与对照组相比，BPD患者吸烟更频繁，且体育锻炼水平较低。
本研究表明，在匹配的女性BPD患者和健康对照样本中存在形态和功能差异，这表明心血管疾病发生风险增加。这些发现凸显了在BPD临床管理中筛查心血管风险标志物以及纳入旨在改善不良生活方式习惯的干预措施的重要性。
