住院精神分裂症患者炎症因子水平与代谢、语言流畅性和信息处理功能的关系
Relationship between inflammatory cytokine levels and metabolism, language fluency, and information processing function in hospitalized schizophrenia patients
投稿时间:2023-09-27  修订日期:2024-06-18
DOI:
中文关键词:  精神分裂症  炎症因子  代谢综合征  认知功能
英文关键词:Schizophrenia  Inflammatory cytokines  Metabolic syndrome  Cognitive function
基金项目:1.安徽省重点研究与开发计划(项目名称:基于CaMKK2/AMPK信号通路改善肠道菌群紊乱引发的精神分裂症伴代谢综合征的应用机制,项目编号:2022e07020002) 2.2020年度中央公益项目(项目名称:双相情感障碍的语音识别研究,项目编号:GY2020G-3)
作者单位邮编
王聪 安徽医科大学精神卫生与心理科学学院 
朱翠珍 安徽医科大学精神卫生与心理科学学院 
张雪莹 苏州市广济医院 
高桦 安徽医科大学附属心理医院 
潘忠德 司法鉴定科学研究所上海市法医学重点实验室司法部司法鉴定重点实验室上海市司法鉴定专业技术服务平台 
程健 安徽医科大学附属心理医院 
杨德英 安徽医科大学附属心理医院 
郑明明 安徽医科大学附属心理医院 
张许来* 安徽医科大学精神卫生与心理科学学院 230022
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中文摘要:
      背景 炎症因子在精神分裂症发病机制中起着重要作用,现有的炎症因子相关研究表现出较多的异质性。目的 探讨炎症因子水平与精神分裂症患者代谢水平、语言流畅性和信息处理功能的关系,为临床了解精神分裂症患者的神经病理机制提供参考。方法 纳入2021年1月—2022年12月在合肥市第四人民医院住院治疗的、符合《精神障碍诊断与统计手册(第5版)》(DSM-5)精神分裂症诊断标准的患者为研究组(n=96),同期纳入在合肥市第四人民医院体检中心体检的健康人群作为对照组(n=42)。采用Meso Scale Discovery(MSD)电化学发光法检测炎症因子水平。采用阳性和阴性症状量表(PANSS)评估患者的临床症状,采用言语流畅性试验(VFT)、Stroop色词测验(SCWT)评估被试的语言流畅性和信息处理功能。采用Spearman相关分析考查炎症因子与代谢水平、语言流畅性和信息处理功能之间的相关性。采用多元线性回归分析考查代谢水平、语言流畅性和信息处理功能影响因素,绘制ROC曲线评估相关炎症因子预测代谢水平、语言流畅性和信息处理功能的有效性。结果 健康对照组与精神分裂症患者的体质量指数(BMI)、腰围、空腹血糖、甘油三酯、谷草转氨酶、载脂蛋白A和肌酐、白细胞介素-5(IL-5)、白细胞介素-13(IL-13)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、白细胞介素-15(IL-5)、白细胞介素-7(IL-7)、白细胞介素-10(IL-10)水平比较,差异均有统计学意义(t=3.740、4.362、2.407、2.940、3.131、-9.814、-2.682、-2.417、5.942、9.735、2.164、-17.876、2.992、4.415,P均<0.05)。在VFT-家电,VFT-动物、VFT-水果、VFT-蔬菜名称、VFT-以“水”开头命名、VFT-以“自我”开头命名方面,研究组的正确个数均少于对照组,差异均有统计学意义(t=-7.022、-3.760、-5.282、-6.809、-3.790、-2.111,P均<0.05)。SWCT评定结果显示,研究组点反应时间、字反应时间和字色反应时间均长于对照组,差异均有统计学意义(t=4.682、4.680、2.923,P均<0.05)。精神分裂症患者空腹血糖水平与IL-5和IL-15水平均呈负相关,差异均有统计学意义(r=-0.231、-0.231,P均<0.05),与IL-10水平呈正相关,差异有统计学意义(r=0.242,P<0.05)。IL-10和IL-15同时为腰围(β=0.199、-0.252,t=2.021、-2.568,P均<0.05)、空腹血糖(β=0.226、-0.218,t=2.295、-2.216,P均<0.05)、甘油三酯(β=0.322、-0.264,t=3.432、-2.817,P均<0.01)的影响因素,IL-13为载脂蛋白A(β=-0.236,t=-2.350,P<0.05)的影响因素。IL-10为VFT-家电(β=-0.212,t=-2.100,P<0.05)和VFT-以“水”字开头命名(β=-0.204,t=-2.019,P<0.05)的影响因素。IL-15是以VFT-以“自我”开头命名(β=0.298,t=3.022,P<0.01)的影响因素,IL-4是字反应时间(β=0.257,t=2.574,P<0.05)的影响因素。ROC曲线分析显示,IL-13水平能够预测精神分裂症患者载脂蛋白A参数异常,临界值为1.355 mmol/L,敏感性为0.905,特异性为0.812;IL-10水平可以预测精神分裂症患者VFT-家电语言功能受损,临界值为9.500,敏感性为0.857,特异性为0.719;IL-10水平可以预测精神分裂症患者VFT-以“水”字开头命名语言功能受损,临界值为5.500,敏感性为0.619,特异性为0.719;IL-15水平可以预测精神分裂症患者VFT-以“自我”字开头命名语言功能受损,临界值为8.500,敏感性为0.333,特异性为0.844;IL-4水平可以预测精神分裂症患者字反应时间受损,临界值为10.205,敏感性为0.619,特异性为0.760。结论 精神分裂症患者的炎症因子可能对患者的代谢水平、语言流畅性和信息处理功能有影响。
英文摘要:
      Background Inflammatory factors play an important role in the pathogenesis of schizophrenia, and existing research on inflammatory factors shows significant heterogeneity. Objective To explore the relationship between levels of inflammatory factors and metabolic levels, language fluency, and information processing function in patients with schizophrenia, providing reference for clinical understanding of the neuropathological mechanisms of schizophrenia. Methods 96 patients with schizophrenia who were hospitalized at the Fourth People's Hospital of Hefei from January 2021 to December 2022 and met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) were included as the study group, while 42 healthy individuals who underwent physical examinations at the examination center of the Fourth People's Hospital of Hefei were included as the control group. Inflammatory factor levels were measured using the Meso Scale Discovery (MSD) electrochemiluminescence assay. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the clinical symptoms of patients. Verbal Fluency Test (VFT) and Stroop Color Word Test (SCWT) were used to evaluate the language fluency and information processing function of participants. Multiple linear regression analyses were used to examine the factors affecting metabolic level, verbal fluency and information processing function, and ROC curves were plotted to assess the validity of related inflammatory factors in predicting metabolic level, verbal fluency and information processing function. Results The body mass index (BMI), waist circumference, fasting blood glucose, triglycerides, ghrelin, apolipoprotein A and creatinine, interleukin-5 (IL-5), interleukin-13 (IL-13), interleukin-4 (IL-4), interleukin-8 (IL-8), interleukin-15 (IL-5), interleukin interleukin-7 (IL-7), and interleukin-10 (IL-10) levels were compared, and the differences were statistically significant (t=3.740, 4.362, 2.407, 2.940, 3.131, -9.814, -2.682, -2.417, 5.942, 9.735, 2.164, -17.876, 2.992, 4.415, p< 0.05). The number of correct VFT-appliances, VFT-animals, VFT-fruits, VFT-vegetable names, VFT-naming starting with "water", and VFT-naming starting with "self" were less in the study group than in the control group, and the differences were statistically significant (t=-7.022, -3.760, -5.282, -6.809, -3.790, -2.111, p<0.05). The results of SWCT ratings showed that the study group had longer dot reaction time, word reaction time and word colour reaction time than the control group, and the differences were statistically significant (t=4.682, 4.680, 2.923, all p<0.05). 0.05). Fasting blood glucose levels in schizophrenic patients were negatively correlated with both IL-5 and IL-15 levels, with statistically significant differences (r=-0.231, -0.231, P<0.05), and positively correlated with IL-10 levels, with statistically significant differences (r=0.242, P<0.05). IL-10 and IL-15 were simultaneously the waist circumference (β=0.199, -0.252, t=2.021, -2.568, P<0.05), fasting blood glucose (β=0.226, -0.218, t=2.295, -2.216, P<0.05), and triglycerides (β=0.322, -0.264, t=3.432, -2.817, P<0.01), and IL-13 as a factor of IL-10 for VFT-appliances (β=-0.212, t=-2.100, P<0.05) and VFT-named after the word ‘water’ (β=-0.204, t=-2.019, P<0.019, P<0.01), and VFT-named after the word ‘water’ (β=-0.204, t=-2.817, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01). 2.019, P < 0.05). IL-15 was an influencing factor of VFT-named starting with the word ‘self’ (β = 0.298, t = 3.022, P < 0.01), and IL-4 was an influencing factor of word reaction time (β = 0.257, t = 2.574, P < 0.05). factors.ROC curve analysis showed that IL-13 level could predict abnormal ApoA parameters in schizophrenia patients with a critical value of 1.355 mmol/L, sensitivity of 0.905, and specificity of 0.812;IL-10 levels predicted impaired VFT-appliance language function in patients with schizophrenia, with a critical value of 9.500, sensitivity of 0.857, and specificity of 0.719; IL-10 levels predicted impaired VFT-beginning-with-the-word-water language function in patients with schizophrenia, with a critical value of 5.500, sensitivity 0.619, specificity 0.719; IL-15 levels predicted impaired VFT-beginning-with-self language function in schizophrenic patients, with a critical value of 8.500, a sensitivity of 0.333, and a specificity of 0.844; IL-4 levels predicted impaired word reaction time in schizophrenic patients, with a critical value of 10.205, sensitivity of 0.619, and specificity of 0.760. Conclusions Inflammatory factors in patients with schizophrenia may have an impact on patients' metabolic levels, verbal fluency, and information processing functions.
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