Abstract
Objective It has been reported that the prevalence of metabolic syndrome (MS) in multiepisode patients with schizophrenia is 35.3%, which is 2- to 4-fold higher than in the general population. The study is designed to compare the glycolipid metabolism in patients with first-episode schizophrenia (FES) with sex- and age-matched healthy controls to investigate changes in serum levels of homocysteine (Hcy), macrophage migration inhibitory factor (MIF), and high-sensitive C-reactive protein (hs-CRP) and their relationships with the glycolipid metabolism in patients with FES. Methods His case-control study included 88 patients diagnosed with FES and 88 sex- and age-matched healthy controls. Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and 17-item Hamilton Rating Scale for Depression (HAMD-17). Patients with FES were classified into MS and non-MS groups. Results There were significant differences in the education level, body mass index (BMI), and waist circumference between the patients with FES and healthy controls (all p > 0.05). The patients with FES had higher levels of FPG and blood glucose at the oral glucose tolerance test (OGTT) (2 h glucose) concomitant with higher proportion of impaired glucose tolerance (IGT) and homeostasis model assessment of insulin resistance (HOMA2-IR) than healthy controls (all p < 0.001). It was revealed that the patients with FES showed higher serum levels of Hcy, MIF, and hs-CRP than healthy controls (all p < 0.001). The serum level of Hcy shared positive correlations with the score of PANSS totals (r = 0.551) and the negative syndrome of the PANSS scale (r = 0.494). The serum levels of MIF and hs-CRP was only positively correlated with the negative syndrome of the PANSS scale (r = 0.320 and r = 0.446). The level of Hcy shared positive correlations with the levels of FPG, 2 h glucose, and HOMA2-IR; the level of MIF was only positively correlated with the level of HOMA2-IR; the level of hs-CRP had a positive correlation with both levels of FPG and 2 h glucose (all p < 0.001). The levels of Hcy, MIF, and hs-CRP all shared positive correlations with the TG level and negative correlations with the HDL-C level (all p < 0.001). There were remarkable differences between the MS and non-MS groups with regard to BMI, waist circumference, negative subscale of the PANSS scale, FPG, TG, and HDL-C (all p < 0.05). Elevated levels of Hcy, MIF, and hs-CRP were detected in the MS group compared to the non-MS group (all p < 0.05). Conclusion These findings suggest that increased concentrations of HCY, MIF, and hs-CRP may contribute to the abnormal glycolipid metabolism in the context of schizophrenia.
Highlights
Schizophrenia is considered as a heterogeneous mental disease that is characterized by positive symptoms, such as hallucinations and delusions, and negative symptoms, including social withdrawal, depression, and a lack of motivation [1]
It was found that about 37.3% of schizophrenic patients receiving second-generation antipsychotic drugs had metabolic abnormalities, which leaded to the risk of coronary heart disease [12], and it was more prevalent in schizophrenic patients with negative symptoms, related to sedentary lifestyle and less physical activity [13]. erefore, the investigation of the glycolipid metabolism in schizophrenic patients is worth further exploring
Schizophrenia is featured with progressive cognitive impairment in attention, working memory, and executive function, which usually occurs in late adolescence or early adulthood [21]. e prevalence of schizophrenia is relatively low, but it was associated with high rate of disability, which ranked 12th in 310 diseases and injuries worldwide reported in 2016 [22]
Summary
Schizophrenia is considered as a heterogeneous mental disease that is characterized by positive symptoms, such as hallucinations and delusions, and negative symptoms, including social withdrawal, depression, and a lack of motivation [1]. Schizophrenia is related to less daily activities and impaired physical health and contributed to a reduced life expectancy (about 20 years) compared with the general population [8]. According to some research studies, the health-related risk factors involving cardiovascular diseases and metabolic abnormalities, such as hypertension, hyperlipidemia, and hyperglycemia, might be responsible for its high mortality [9], and compared with general population, the patients with schizophrenia are more prone to metabolic abnormalities and cardiovascular diseases, such as stroke and coronary heart disease [10, 11]. It was found that about 37.3% of schizophrenic patients receiving second-generation antipsychotic drugs had metabolic abnormalities, which leaded to the risk of coronary heart disease [12], and it was more prevalent in schizophrenic patients with negative symptoms, related to sedentary lifestyle and less physical activity [13]. We aimed at comparing the glycolipid metabolism in patients with firstepisode schizophrenia (FES) with sex- and age-matched healthy controls to investigate changes in serum levels of homocysteine (Hcy), macrophage migration inhibitory factor (MIF), and high-sensitive C-reactive protein (hsCRP) and their relationships with the glycolipid metabolism in patients with FES
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