Abstract

Objective: Previous studies consistently showed the interaction between Sirtuin 1 (SIRT1) and immune inflammation is significantly related to metabolic abnormalities, but their role in the pathogenesis of metabolic syndrome caused by second-generation antipsychotics (SGAs) in schizophrenia patients largely remains unknown. Hence, the present study aimed to fill this gap.Methods: A total of 54 schizophrenia patients with olanzapine or clozapine monotherapy [metabolic syndrome (MetS)/non-MetS patients, 27/27] and 67 healthy subjects were recruited in the present study. The Positive and Negative Syndrome Scale was used, and the plasma levels of SIRT1, interleukin 6 (IL-6), IL-8, IL-10, and tumor necrosis factor α (TNF-α) were measured.Results: The results showed that schizophrenia patients treated with olanzapine or clozapine (both MetS and non-MetS groups) had significantly higher plasma levels of IL-6, IL-10, and TNF-α compared to normal controls (all P < 0.05). Moreover, the MetS patients exhibited markedly lower plasma levels of SIRT1 and higher plasma levels of IL-6 than non-MetS patients and normal controls (all P < 0.05). However, there were no significant differences in IL-8 levels between groups. Our correlation analysis showed that SIRT1 was significantly correlated with diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol in schizophrenia patients. The stepwise logistic regression analysis further identified the IL-6 × SIRT1 (β = −0.463, t = 10.040, P = 0.002) as the influencing factor for the MetS in the patients.Conclusion: Our preliminary findings suggest that SIRT1 interacted with inflammatory cytokines associated with MetS in schizophrenia patients treated with SGA monotherapy.

Highlights

  • Schizophrenia is a severe and debilitating psychiatric disorder characterized by a wide range of symptoms, including positive symptoms, negative symptoms, and impaired cognition [1]

  • The results showed that schizophrenia patients treated with olanzapine or clozapine had significantly higher plasma levels of interleukin 6 (IL-6), IL-10, and tumor necrosis factor α (TNF-α) compared to normal controls

  • Our correlation analysis showed that Sirtuin 1 (SIRT1) was significantly correlated with diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol in schizophrenia patients

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Summary

Introduction

Schizophrenia is a severe and debilitating psychiatric disorder characterized by a wide range of symptoms, including positive symptoms, negative symptoms, and impaired cognition [1]. Antipsychotic drugs have been widely used to treat schizophrenia patients since the advent of chlorpromazine uniformly has alleviated positive symptoms in the 1950s [2]. Second-generation antipsychotics (SGAs) have been more frequently prescribed for schizophrenia patients profiting from the lower risk of extrapyramidal symptoms and tardive dyskinesia compared to the first-generation antipsychotics (FGAs) [3]. The Clinical Antipsychotic Trials of Intervention Effectiveness trial reported the prevalence of metabolic syndrome (MetS) to be around 40% in schizophrenia patients based on the National Cholesterol Education Program– Adult Treatment Panel III criteria (NCEP-ATP III) [5]. Searching for molecular markers of MetS induced by SGAs is of great significance to elucidate its pathological mechanism

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