1
|
Kim A, Zhang Z, Legros C, Lu Z, de Smith A, Moore JE, Mancuso N, Gazal S. Inferring causal cell types of human diseases and risk variants from candidate regulatory elements. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.17.24307556. [PMID: 38798383 PMCID: PMC11118635 DOI: 10.1101/2024.05.17.24307556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The heritability of human diseases is extremely enriched in candidate regulatory elements (cRE) from disease-relevant cell types. Critical next steps are to infer which and how many cell types are truly causal for a disease (after accounting for co-regulation across cell types), and to understand how individual variants impact disease risk through single or multiple causal cell types. Here, we propose CT-FM and CT-FM-SNP, two methods that leverage cell-type-specific cREs to fine-map causal cell types for a trait and for its candidate causal variants, respectively. We applied CT-FM to 63 GWAS summary statistics (average N = 417K) using nearly one thousand cRE annotations, primarily coming from ENCODE4. CT-FM inferred 81 causal cell types with corresponding SNP-annotations explaining a high fraction of trait SNP-heritability (~2/3 of the SNP-heritability explained by existing cREs), identified 16 traits with multiple causal cell types, highlighted cell-disease relationships consistent with known biology, and uncovered previously unexplored cellular mechanisms in psychiatric and immune-related diseases. Finally, we applied CT-FM-SNP to 39 UK Biobank traits and predicted high confidence causal cell types for 2,798 candidate causal non-coding SNPs. Our results suggest that most SNPs impact a phenotype through a single cell type, and that pleiotropic SNPs target different cell types depending on the phenotype context. Altogether, CT-FM and CT-FM-SNP shed light on how genetic variants act collectively and individually at the cellular level to impact disease risk.
Collapse
Affiliation(s)
- Artem Kim
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zixuan Zhang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Come Legros
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zeyun Lu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Adam de Smith
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jill E Moore
- Department of Genomics and Computational Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Nicholas Mancuso
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Quantitative and Computational Biology, University of Southern California, Los Angeles, CA, USA
| | - Steven Gazal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Quantitative and Computational Biology, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
2
|
Jawad MY, Meshkat S, Tabassum A, Mckenzie A, Di Vincenzo JD, Guo Z, Musavi NB, Phan L, Ceban F, Kwan AT, Ramachandra R, Le GH, Mansur RB, Rosenblat JD, Ho R, Rhee TG, McIntyre RS. The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia. CNS Spectr 2023; 28:541-560. [PMID: 36268655 DOI: 10.1017/s1092852922001043] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic-inflammatory disease associated with poor outcomes and decreased quality of life. NAFLD is overrepresented in patients with psychiatric disorders like depression, bipolar disorder, and schizophrenia; however, a comprehensive review on NAFLD and psychiatric disorders remains to be delineated. This review endeavors to investigate the association of NAFLD with psychiatric disorders, including shared pathogenesis and future clinical derivatives. Extant literature suggests that patients with psychiatric disorders (in particular, mood disorders) are more susceptible to the development of NAFLD due to multiple reasons, including but not limited to hypothalamic-pituitary-adrenal axis dysregulation, metabolic syndrome, and chronic perceived stress. Moreover, the clinical manifestations of mood disorders (e.g., anhedonia, psychomotor retardation, lifestyle modification, etc.), and potentially long-term treatment with weight-gaining agents, differentially affect these patients, making them more prone to NAFLD. Considering the increased morbidity associated with both mood disorders and NAFLD, our review recommends regular screenings for NAFLD in select patients with mood disorders exhibiting signs of increased risk (i.e., obesity, metabolic syndrome, diabetes, or family history of NAFLD) for better diagnosis and holistic care of both potentially interrelated conditions.
Collapse
Affiliation(s)
- Muhammad Youshay Jawad
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Aniqa Tabassum
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Andrea Mckenzie
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua D Di Vincenzo
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Ziji Guo
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | | | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Angela Th Kwan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ranuk Ramachandra
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Gia Han Le
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Taeho Greg Rhee
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
3
|
Sun L, Li N, Zhang L, Chen J. The Role of ElastPQ in Assessing Liver Stiffness for Non-Alcoholic Fatty Liver Disease in Patients Treated with Atypical Antipsychotic Drugs. Neuropsychiatr Dis Treat 2023; 19:1491-1502. [PMID: 37408709 PMCID: PMC10319346 DOI: 10.2147/ndt.s409210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
Objective To evaluate the role of elastography point quantification (ElastPQ) for the quantitative assessment of stiffness in the fatty liver disease in mental disorder patients and to provide a noninvasive detection method for non-alcoholic fatty liver (NAFLD) caused by atypical antipsychotics drugs (AAPDs). Methods A total number of 168 mental disorder patients treated with AAPDs and 58 healthy volunteers were enrolled in this study. All the subjects underwent ultrasound and ElastPQ tests. The basic data of the patients were analyzed. Results BMI, liver function, and the value of ElastPQ were considerably higher in the patient group than that in the healthy volunteers. The values of liver stiffness obtained by ElastPQ were increased gradually from 3.48(3.14-3.81) kPa in the normal liver to 8.15(6.44-9.88) in the severe fatty liver. The receiver operating characteristic (ROC) for the diagnosis of fatty liver with ElastPQ were 0.85, 0.79, 0.80, and 0.87 for the diagnosis of normal, mild, moderate, and severe steatosis, respectively, with a sensitive/specificity of 79%/76.4%, 85.7%/78.3%, 86.2%/73%, and 81.3%/82.1%, correspondingly. Moreover, ElastPQ in the olanzapine group was higher than those in the risperidone and aripiprazole groups (5.11(3.83-5.61) kPa vs 4.35(3.63-4.98) kPa, P < 0.05; 5.11(3.83-5.61) kPa vs 4.79(4.18-5.24) kPa, P < 0.05). After one-year treatment, the value of ElastPQ was 4.43(3.85-5.22) kPa, but it was 5.81(5.09-7.33) kPa in patients treated for more than three years. This value increased with treatment prolongation (P < 0.05). Conclusion ElastPQ is a real-time, quantitative method for assessing the stiffness of NAFLD. The liver stiffness value could be varied in the different stages of fatty liver. Olanzapine has a considerable influence on liver stiffness. The long-term use of AAPDs can increase the stiffness value of fatty liver.
Collapse
Affiliation(s)
- Linlin Sun
- Department of Ultrasound, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Nan Li
- Department of Ultrasound, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Ligang Zhang
- Department of Psychiatry, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| | - Jingxu Chen
- Department of Psychiatry, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China
| |
Collapse
|
4
|
Matuszewska A, Kowalski K, Jawień P, Tomkalski T, Gaweł-Dąbrowska D, Merwid-Ląd A, Szeląg E, Błaszczak K, Wiatrak B, Danielewski M, Piasny J, Szeląg A. The Hypothalamic-Pituitary-Gonadal Axis in Men with Schizophrenia. Int J Mol Sci 2023; 24:ijms24076492. [PMID: 37047464 PMCID: PMC10094807 DOI: 10.3390/ijms24076492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/18/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
Schizophrenia is a severe mental disorder with a chronic, progressive course. The etiology of this condition is linked to the interactions of multiple genes and environmental factors. The earlier age of onset of schizophrenia, the higher frequency of negative symptoms in the clinical presentation, and the poorer response to antipsychotic treatment in men compared to women suggests the involvement of sex hormones in these processes. This article aims to draw attention to the possible relationship between testosterone and some clinical features in male schizophrenic patients and discuss the complex nature of these phenomena based on data from the literature. PubMed, Web of Science, and Google Scholar databases were searched to select the papers without limiting the time of the publications. Hormone levels in the body are regulated by many organs and systems, and take place through the neuroendocrine, hormonal, neural, and metabolic pathways. Sex hormones play an important role in the development and function of the organism. Besides their impact on secondary sex characteristics, they influence brain development and function, mood, and cognition. In men with schizophrenia, altered testosterone levels were noted. In many cases, evidence from available single studies gave contradictory results. However, it seems that the testosterone level in men affected by schizophrenia may differ depending on the phase of the disease, types of clinical symptoms, and administered therapy. The etiology of testosterone level disturbances may be very complex. Besides the impact of the illness (schizophrenia), stress, and antipsychotic drug-induced hyperprolactinemia, testosterone levels may be influenced by, i.a., obesity, substances of abuse (e.g., ethanol), or liver damage.
Collapse
|
5
|
Gunther M, Dopheide JA. Antipsychotic Safety in Liver Disease: A Narrative Review and Practical Guide for the Clinician. J Acad Consult Liaison Psychiatry 2023; 64:73-82. [PMID: 36180017 DOI: 10.1016/j.jaclp.2022.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clinicians treating psychiatric disorders in medically ill patients need a comprehensive resource for comparing the risk and types of liver injury associated with antipsychotic therapy. OBJECTIVE We conducted a narrative review aimed at developing a comprehensive resource comparing antipsychotics with regard to risk of inducing or worsening liver injuries, types of liver injury, associated pharmacokinetic changes, dosing, monitoring, and patient counseling recommendations. METHODS We conducted database searches of LiverTox.nih.gov, DailyMed.nlm.nih.gov, and PubMed through June of 2022. Sources describing premarketing data, observational studies, case reports and case series of antipsychotic-induced liver injuries, types of hepatic dysfunction, interventions, recovery, and treatment for 15 antipsychotics were included. Duplicate reports were excluded. Antipsychotics were graded as low, low to moderate, moderate, moderate to high, or high risk for causing or worsening a liver disease. RESULTS Of the 1861 publications, 21 papers met criteria and were included. Evidence shows antipsychotic-induced liver dysfunction is uncommon to rare. Chlorpromazine, clozapine, and olanzapine pose the greatest risk of hepatoxicity; quetiapine and risperidone pose a moderate risk with haloperidol considered to pose low to moderate risk. Paliperidone, aripiprazole, lurasidone, and loxapine are lower-risk agents with no reports of liver failure. Transaminitis that is mild and self-limiting is the most common antipsychotic-induced liver injury followed by hepatocellular disease, steatosis, and mixed liver injury. A careful risk-benefit analysis should guide the decision to discontinue the antipsychotic in cases of severe liver disease. Dose adjustments and careful monitoring are recommended for a mild to moderate disease when the benefits of treating psychosis outweigh the risks. Patients without an existing liver disease initiating a treatment with a higher-risk antipsychotic should be counseled to report symptoms of liver injuries along with regular lab monitoring. CONCLUSIONS Antipsychotic selection, dosing, monitoring, and counseling should be individualized based on whether a patient has an existing liver disease and if they are receiving an agent that poses a higher risk of liver injury. The consultation-liaison psychiatry provider can guide the primary team in management through thoughtful integration of the known pathophysiologic changes in hepatic disease and risk-benefit analysis of antipsychotic safety profiles.
Collapse
Affiliation(s)
- Matthew Gunther
- LAC+USC Medical Center, Los Angeles, CA; Keck School of Medicine, Department of Psychiatry, University of Southern California, Los Angeles, CA.
| | - Julie A Dopheide
- LAC+USC Medical Center, Los Angeles, CA; Keck School of Medicine, Department of Psychiatry, University of Southern California, Los Angeles, CA; USC School of Pharmacy, University of Southern California, Los Angeles, CA
| |
Collapse
|
6
|
Correll CU, Bitter I, Hoti F, Mehtälä J, Wooller A, Pungor K, Tiihonen J. Factors and their weight in reducing life expectancy in schizophrenia. Schizophr Res 2022; 250:67-75. [PMID: 36368280 DOI: 10.1016/j.schres.2022.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 09/07/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Schizophrenia is associated with a wide range of socioeconomic and health-related problems, as well as 10-25 potential life-years lost. While lifestyle choices, comorbidities, and choice of medication are associated with schizophrenia disease burden and mortality, real-world evidence on the impact of these factors on expected life-years among patients with schizophrenia is limited. METHODS In this study, register-based, nationwide data from patients with schizophrenia in Finland during 1972-2015 were analysed to determine influential factors associated with mortality and to demonstrate their impact on expected life-years in patients with schizophrenia. RESULTS Factors reducing all-cause mortality were use of antipsychotics: HR 0.46 (95 % CI: 0.45, 0.47), ever use of lipid-modifying agents: HR 0.71 (95 % CI 0.68, 0.73), antidepressants HR 0.87 (95 % CI 0.85, 0.90), and lithium HR 0.90 (95 % CI 0.86, 0.95). Factors increasing all-cause mortality were cardiovascular disease: HR 2.41 (95 % CI: 2.34, 2.49), liver disease: HR 1.98 (95 % CI: 1.78, 2.21), renal disease: HR 1.63 (95 % CI:1.56, 1.70), diabetes: HR 1.40 (95 % C:1.35, 1.45), history of switching antipsychotics: HR 1.39 (95 % CI: 1.35, 1.44), longer duration of previous hospitalisations HR 1.96 (95 % CI: 1.90, 2.02), history of substance abuse HR 1.38 (95 % CI: 1.30, 1.46), and ever use of benzodiazepines HR 1.12 (95 % CI: 1.09, 1.16). CONCLUSIONS The results from this study could serve to motivate clinicians to support and encourage patients to adhere to antipsychotic treatment and achieve a healthier lifestyle, which could, in turn, increase the expected life-years of patients with schizophrenia.
Collapse
Affiliation(s)
- Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | - István Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | | | | | - Katalin Pungor
- Janssen-Cilag, Medical Affairs EMEA, Dusseldorf, Germany
| | - Jari Tiihonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden; Neuroscience Center, Helsinki, Finland
| |
Collapse
|
7
|
Grant RK, Brindle WM, Donnelly MC, McConville PM, Stroud TG, Bandieri L, Plevris JN. Gastrointestinal and liver disease in patients with schizophrenia: A narrative review. World J Gastroenterol 2022; 28:5515-5529. [PMID: 36304087 PMCID: PMC9594005 DOI: 10.3748/wjg.v28.i38.5515] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/29/2022] [Accepted: 09/21/2022] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia is a severe mental illness which can have a devastating impact on an individual’s quality of life. Comorbidities are high amongst patients and life expectancy is approximately 15 years less than the general population. Despite the well-known increased mortality, little is known about the impact of gastrointestinal and liver disease on patients with schizophrenia. We aimed to review the literature and to make recommendations regarding future care. Literature searches were performed on PubMed to identify studies related to gastrointestinal and liver disease in patients with schizophrenia. High rates of chronic liver disease were reported, with Non-Alcoholic Fatty Liver Disease being of particular concern; antipsychotics and metabolic syndrome were contributing factors. Rates of acute liver failure were low but have been associated with antipsychotic use and paracetamol overdose. Coeliac disease has historically been linked to schizophrenia; however, recent research suggests that a causal link is yet to be proven. Evidence is emerging regarding the relationships between schizophrenia and peptic ulcer disease, inflammatory bowel disease and irritable bowel syndrome; clinical vigilance regarding these conditions should be high. Patients with schizophrenia poorly engage with bowel cancer screening programmes, leading to late diagnosis and increased mortality. Clozapine induced constipation is a significant issue for many patients and requires close monitoring. There is a significant burden of gastrointestinal and liver disease amongst patients with schizophrenia. Better levels of support from all members of the medical team are essential to ensure that appropriate, timely care is provided.
Collapse
Affiliation(s)
- Rebecca K Grant
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom
| | - William M Brindle
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom
| | - Mhairi C Donnelly
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom
| | - Pauline M McConville
- General Adult Psychiatry, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - Thomas G Stroud
- General Adult Psychiatry, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - Lorenzo Bandieri
- General Adult Psychiatry, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - John N Plevris
- The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom
| |
Collapse
|
8
|
The development of the Metabolic-associated Fatty Liver Disease during pharmacotherapy of mental disorders - a review. CURRENT PROBLEMS OF PSYCHIATRY 2022. [DOI: 10.2478/cpp-2022-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: Metabolic-associated Fatty Liver Disease (MAFLD) is a term for Non-alcoholic Fatty Liver Disease (NAFLD) that highlights its association with components of the Metabolic Syndrome (MetS). MAFLD is becoming a clinically significant problem due to its increasing role in the pathogenesis of cryptogenic cirrhosis of the liver.
Material and methods: The resulting work is a review of the most important information on the risk of MAFLD development in the context of the use of particular groups of psychotropic drugs. The study presents the epidemiology, with particular emphasis on the population of psychiatric patients, pathophysiology and scientific reports analyzing the effect of the psychotropic medications on MAFLD development.
Results: The drugs that can have the greatest impact on the development of MAFLD are atypical antipsychotics, especially olanzapine, and mood stabilizers (MS) - valproic acid (VPA). Their effect is indirect, mainly through dysregulation of organism’s carbohydrate and lipid metabolism.
Conclusions: The population of psychiatric patients is particularly vulnerable to the development of MAFLD. At the root of this disorder lies the specificity of mental disorders, improper dietary habits, low level of physical activity and tendency to addictions. Also, the negative impact of the psychotropic drugs on the systemic metabolism indirectly contributes to the development of MAFLD. In order to prevent fatty liver disease, it is necessary to monitor metabolic and liver parameters regularly, and patients should be screened by ultrasound examination of the liver. There are also important preventive actions from the medical professionals, including education of patients and sensitizing to healthy lifestyle.
Collapse
|
9
|
Son S, Kim YJ, Kim SH, Kim JI, Kim S, Roh S. Effects of Chronic Diseases on All-Cause Mortality in People with Mental Illness: A Retrospective Cohort Study Using the Korean National Health Insurance Service-Health Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9989. [PMID: 36011624 PMCID: PMC9408088 DOI: 10.3390/ijerph19169989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to compare mortality and the prevalence of chronic diseases between people with mental illness and the general population, and to explore which chronic diseases increase the risk of all-cause mortality, especially in people with mental illness. This study assessed data from the 2002-2019 Korean National Health Insurance Service-Health Screening sample cohort. Results revealed that all-cause mortality was higher in people with mental illness compared to people without mental illness (11.40% vs. 10.28%, p = 0.0022). Several chronic diseases have a higher prevalence and risk of all-cause mortality in individuals with mental illness than the general population. Among people with the same chronic disease, those with mental disorders had a higher risk of all-cause mortality. Cancer (aHR 2.55, 95% CI 2.488-2.614), liver cirrhosis (aHR 2.198, 95% CI 2.086-2.316), and arrhythmia (aHR 1.427, 95% CI 1.383-1.472) were the top three chronic diseases that increased the risk of all-cause mortality in people with mental illness compared to people without mental illness. Our results suggest the need for more attention to chronic diseases for people with mental illness in clinical practice by explaining the effect of chronic disease on all-cause mortality in people with mental illness.
Collapse
Affiliation(s)
- Sujin Son
- Department of Psychiatry, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
- Department of Psychiatry, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Yun Jin Kim
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Seok Hyeon Kim
- Department of Psychiatry, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
- Department of Psychiatry, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Sojung Kim
- Department of Psychiatry, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Sungwon Roh
- Department of Psychiatry, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
- Department of Psychiatry, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| |
Collapse
|
10
|
Han J, Lv Z, Shen M, Wan Q, Xiao L, Wang G. Risk factors for hospital-acquired pneumonia among inpatients with mental disorders in a large mental health center within a tertiary general hospital. Am J Infect Control 2022; 51:446-453. [PMID: 35728721 DOI: 10.1016/j.ajic.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Few researchers have investigated the incidence of and risk factors for hospital-acquired pneumonia (HAP) among inpatients with mental disorders in a general hospital. METHODS This study included patients with mental disorders hospitalized in a large mental health center (situated in a general hospital) between January 1, 2017 and July 31, 2021 (excluding January 1, 2020 to May 31, 2020). Risk factors for HAP were identified by logistic regression analysis after propensity score matching (PSM, 1:4) for gender, age, duration of observation and hospital ward. RESULTS The study included 16,864 patients. HAP incidence rate was 1.15% overall, 2.11% on closed wards, 0.75% on open wards, 4.45% in patients with organic mental disorders, 1.80% in patients with schizophrenia spectrum disorder, and 0.84% in patients with mood disorders. Risk factors for HAP after PSM were hypoproteinemia, chronic liver disease, use of clozapine, hospitalization during the previous 180 days, body mass index (BMI) ≤18.5 kg/m2, cholinesterase inhibitor use and mood stabilizer use. CONCLUSION HAP was common among inpatients with mental disorders. Risk factors for HAP in patients with mental disorders include hypoproteinemia, chronic liver disease, hospitalization during the past 180 days, BMI ≤18.5 kg/m2, and use of clozapine, cholinesterase inhibitors or mood stabilizers.
Collapse
Affiliation(s)
- Jingjing Han
- Department of Infection Control, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Zhihua Lv
- Department of Clinical laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Meiyu Shen
- Department of Mental Health Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Qirong Wan
- Department of Clinical Psychology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Ling Xiao
- Insititute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
| | - Gaohua Wang
- Insititute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
| |
Collapse
|
11
|
Menon V, Ransing R, Praharaj SK. Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases. Indian J Psychiatry 2022; 64:S379-S393. [PMID: 35602369 PMCID: PMC9122174 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_18_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walalwalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India E-mail:
| |
Collapse
|
12
|
Yan S, Ruan J, Wang Y, Xu J, Sun C, Niu Y. Association of Prenatal Famine Exposure With Inflammatory Markers and Its Impact on Adulthood Liver Function Across Consecutive Generations. Front Nutr 2022; 8:758633. [PMID: 35047538 PMCID: PMC8762197 DOI: 10.3389/fnut.2021.758633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Although there has been increasing recognition that famine exposure in the fetal stage damages liver function in adulthood, this deteriorated effect could be extended to the next generation remains vague. This study aimed to explore whether famine exposure was associated with liver function in the two consecutive generations, and its association with the mediation role of inflammatory markers. We analyzed the data of 2,681 participants from Suihua rural area, Heilongjiang Province, China. According to the date of birth, the participants were classified as fetal exposed and nonexposed. The F2 subjects were classified as having no parents exposed to famine, maternal famine exposure, paternal famine exposure, or parental famine exposure. In the mixed-effect models, prenatal exposure to famine was associated with the elevation of Δ aspartate aminotransferase (ΔAST) (β: 0.22, 95% CI: 0.01, 0.43) and Δ alanine aminotransferase (ΔALT) (β: 0.42, 95% CI: 0.19, 0.66) levels in F1 adults. The mediation analysis showed that the inflammatory markers including serum C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) might mediate the famine-liver function association. This longitudinal data were consistent with the hypothesis that the inflammatory markers explained part of the influence of prenatal famine exposure on liver function injury, and the natal mechanism was needed to be elucidated in the future study.
Collapse
Affiliation(s)
- Shiwei Yan
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| | - Jingqi Ruan
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| | - Yu Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| | - Jiaxu Xu
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| | - Yucun Niu
- Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, China
| |
Collapse
|
13
|
Ma Y, Wu H, Wang H, Chen F, Xie Z, Zhang Z, Peng Q, Yang J, Zhou Y, Chen C, Chen M, Zhang Y, Yu J, Wang K. Psychiatric Comorbidities and Liver Injury Are Associated With Unbalanced Plasma Bile Acid Profile During Methamphetamine Withdrawal. Front Endocrinol (Lausanne) 2022; 12:801686. [PMID: 35046900 PMCID: PMC8761939 DOI: 10.3389/fendo.2021.801686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022] Open
Abstract
Background The pathogenesis of methamphetamine usedisorders (MUDs) remains largely unknown; however, bile acids may play arole as potential mediators of liver injury and psychiatric comorbidities.The aim of this study was to characterize bile acid (BA) profiles in plasmaof patients with MUDs undergoing withdrawal. Methods Liver functions and psychiatric symptoms wereevaluated in a retrospective cohort (30 MUDs versus 30 control subjects) andan exploratory cohort (30 MUDs including 10 subjects each at the 7-day,3-month, and 12-month withdrawal stages versus 10 control subjects). BAcompositions in plasma samples from MUD patients in the exploratory cohortwere determined by gas-liquid chromatography. Results Both psychiatric comorbidities andmethamphetamine-induced liver injury were observed in patients in both MUDcohorts. The plasma concentrations of the total BA, cholic acid (CA), andchenodeoxycholic acid (CDCA) were lower in MUD patients relative tocontrols. The maximum decline was observed at the 3-month stage, withgradual recovery at the 12-month stage. Notably, the ratios of deoxycholicacid (DCA)/CA and lithocholic acid (LCA)/CDCA were statistically significantat the 3-month stage comparing with controls. Significant correlations werefound between the LCA/CDCA and taurolithocholic acid (TLCA)/CDCA ratios andthe levels of alanine transaminase and aspartate aminotransferase, andbetween the LCA/CDCA ratio and the HAM-A score. Conclusion BA profile during METH withdrawal weremarkedly altered, with these unbalanced BAs being associated with liverinjury. The associations between BA profiles and psychiatric symptomssuggest an association between specific BAs and disease progression,possibly through the liver-brain axis.
Collapse
Affiliation(s)
- Yuru Ma
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongjin Wu
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Huawei Wang
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengrong Chen
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Zhenrong Xie
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zunyue Zhang
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Yunnan University, Kunming, China
| | - Qingyan Peng
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiqing Yang
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Yong Zhou
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cheng Chen
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Minghui Chen
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yongjin Zhang
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Juehua Yu
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kunhua Wang
- National Health Commission (NHC) Key Laboratory of Drug Addiction Medicine (Kunming Medical University), First Affiliated Hospital of Kunming Medical University, Kunming, China
- Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|
14
|
Ermakov EA, Melamud MM, Buneva VN, Ivanova SA. Immune System Abnormalities in Schizophrenia: An Integrative View and Translational Perspectives. Front Psychiatry 2022; 13:880568. [PMID: 35546942 PMCID: PMC9082498 DOI: 10.3389/fpsyt.2022.880568] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/30/2022] [Indexed: 12/12/2022] Open
Abstract
The immune system is generally known to be the primary defense mechanism against pathogens. Any pathological conditions are reflected in anomalies in the immune system parameters. Increasing evidence suggests the involvement of immune dysregulation and neuroinflammation in the pathogenesis of schizophrenia. In this systematic review, we summarized the available evidence of abnormalities in the immune system in schizophrenia. We analyzed impairments in all immune system components and assessed the level of bias in the available evidence. It has been shown that schizophrenia is associated with abnormalities in all immune system components: from innate to adaptive immunity and from humoral to cellular immunity. Abnormalities in the immune organs have also been observed in schizophrenia. Evidence of increased C-reactive protein, dysregulation of cytokines and chemokines, elevated levels of neutrophils and autoantibodies, and microbiota dysregulation in schizophrenia have the lowest risk of bias. Peripheral immune abnormalities contribute to neuroinflammation, which is associated with cognitive and neuroanatomical alterations and contributes to the pathogenesis of schizophrenia. However, signs of severe inflammation are observed in only about 1/3 of patients with schizophrenia. Immunological parameters may help identify subgroups of individuals with signs of inflammation who well respond to anti-inflammatory therapy. Our integrative approach also identified gaps in knowledge about immune abnormalities in schizophrenia, and new horizons for the research are proposed.
Collapse
Affiliation(s)
- Evgeny A Ermakov
- Laboratory of Repair Enzymes, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia.,Department of Natural Sciences, Novosibirsk State University, Novosibirsk, Russia
| | - Mark M Melamud
- Laboratory of Repair Enzymes, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
| | - Valentina N Buneva
- Laboratory of Repair Enzymes, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia.,Department of Natural Sciences, Novosibirsk State University, Novosibirsk, Russia
| | - Svetlana A Ivanova
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| |
Collapse
|
15
|
Yi W, Ji Y, Gao H, Pan R, Wei Q, Cheng J, Song J, He Y, Tang C, Liu X, Song S, Su H. Does the gut microbiome partially mediate the impact of air pollutants exposure on liver function? Evidence based on schizophrenia patients. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 291:118135. [PMID: 34534831 DOI: 10.1016/j.envpol.2021.118135] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
Air pollution may alter the composition of gut microbiome and subsequent liver-related metabolic disorders. Schizophrenia was often accompanied by liver dysfunction. But it was still unclear whether air pollutants affected liver function in patients with schizophrenia through gut microbiome. We aimed to clarify the impacts of long-term air pollutants on the gut microbiome and liver function in schizophrenia and to evaluate the intermediary effect of microbiome. Schizophrenia patients were recruited then serum biochemical indicators were tested. Air pollutant exposure in the previous year was retrospectively estimated by inverse distance weighting. The associations among air pollutants, gut microbiome, and liver function indicators in schizophrenia were estimated. Then the mediating effect of gut microbiome was further explored. The results showed that nitrogen dioxide (NO2), carbonic oxide (CO), ozone (O3), particulate matter with aerodynamic diameter ≤10 μm (PM10), and fine particulate matter (PM2.5) explained 2.68%-10.77% of the variation in gut microbiome composition (order level) in schizophrenia (all P < 0.05). Network correlation analysis indicated that air pollutants and liver function indicators were mainly related to Firmicutes, Actinobacteria, and Proteobacteria in schizophrenia. Long-term NO2 exposure significantly increased the levels of gamma-glutamyl transpeptidase (GGT) and glutamic pyruvic transaminase (GPT) in schizophrenia. Coriobacteriales mediated 13.98% and 49.56% (all P < 0.05) of the associations of long-term NO2 with GGT and GPT, respectively. To conclude, long-term NO2 exposure is positively associated with liver dysfunction in schizophrenia, in which gut microbiome plays an intermediary role. The two pathways, "NO2-Coriobacteriales-GGT" and "NO2-Coriobacteriales-GPT", would provide scientific evidence for the intervention of schizophrenia with liver dysfunction.
Collapse
Affiliation(s)
- Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yifu Ji
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Hua Gao
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
| |
Collapse
|
16
|
Cheng JS, Hu JH, Chang MY, Lin MS, Ku HP, Chien RN, Chang ML. Hepatitis C-associated late-onset schizophrenia: a nationwide, population-based cohort study. J Psychiatry Neurosci 2021; 46:E583-E591. [PMID: 34728558 PMCID: PMC8565883 DOI: 10.1503/jpn.200154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 07/07/2021] [Accepted: 07/26/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Whether infection with the hepatitis C virus (HCV) causes schizophrenia - and whether the associated risk reverses after anti-HCV therapy - is unknown; we aimed to investigate these topics. METHODS We conducted a nationwide, population-based cohort study using the Taiwan National Health Insurance Research Database (TNHIRD). A diagnosis of schizophrenia was based on criteria from the International Classification of Diseases, 9th revision (295.xx). RESULTS From 2003 to 2012, from a total population of 19 298 735, we enrolled 3 propensity-score-matched cohorts (1:2:2): HCV-treated (8931 HCV-infected patients who had received interferon-based therapy for ≥ 6 months); HCV-untreated (17 862); and HCV-uninfected (17 862) from the TNHIRD. Of the total sample (44 655), 82.81% (36 980) were 40 years of age or older. Of the 3 cohorts, the HCV-untreated group had the highest 9-year cumulative incidence of schizophrenia (0.870%, 95% confidence interval [CI] 0.556%-1.311%; p < 0.001); the HCV-treated (0.251%, 95% CI 0.091%-0.599%) and HCV-uninfected (0.118%, 95% CI 0.062%-0.213%) cohorts showed similar cumulative incidence of schizophrenia (p = 0.33). Multivariate Cox analyses showed that HCV positivity (hazard ratio [HR] 3.469, 95% CI 2.168-5.551) was independently associated with the development of schizophrenia. The HCV-untreated cohort also had the highest cumulative incidence of overall mortality (20.799%, 95% CI 18.739%-22.936%; p < 0.001); the HCV-treated (12.518%, 95% CI 8.707%-17.052%) and HCV uninfected (6.707%, 95% CI 5.533%-8.026%) cohorts showed similar cumulative incidence of mortality (p = 0.12). LIMITATIONS We were unable to determine the precise mechanism of the increased risk of schizophrenia in patients with HCV infection. CONCLUSION In a population-based cohort (most aged ≥ 40 years), HCV positivity was a potential risk factor for the development of schizophrenia; the HCV-associated risk of schizophrenia might be reversed by interferon-based antiviral therapy.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Ming-Ling Chang
- From the Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taiwan (Cheng, Ku); the Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan (Cheng); the Department of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan (Hu); the Division of Pediatric Neurologic Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan (M.-Y. Chang); the Division of Pediatric General Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan (M.-Y. Chang); the Department of Cardiology, Heart Failure Center, Chang Gung Memorial Hospital, Taiwan (Lin); the Department of Cardiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (Lin); the Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (Chien, M.-L. Chang); and the Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (Chien, M.-L. Chang)
| |
Collapse
|
17
|
Yeh TP, Huang LC, Chen YF, Cheng JF. The Relationship between the Second-Generation Antipsychotics Efficacy and the Traditional Chinese Medicine Body Constitutions in Patients with Schizophrenia. Healthcare (Basel) 2021; 9:healthcare9111480. [PMID: 34828526 PMCID: PMC8622047 DOI: 10.3390/healthcare9111480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Schizophrenia requires lifelong treatment; Second-generation Antipsychotics (SGAs) have become the most prescribed medication for schizophrenia patients. The efficacy of various SGAs treatment may differ in schizophrenia patients with various traditional Chinese medicine (TCM) body constitution (BC) types. Method: This study applied a longitudinal quantitative research design, where a total of 66 participants were recruited. The Positive and Negative Symptom Scale (PANSS) and the Clinical Global Impression (CGI) score were used to evaluate patients’ psychopathology status in hospitalization, and body constitution questionnaires were conducted by face-to-face interviews in the 1st, 3rd, and 6th week of hospitalization. Results: More than 60% of schizophrenia patients who were treated with SGAs were classified to have unbalanced BC types including Yin-Xu, Yang-Xu and Stasis. Generalized estimating equation analysis revealed significant time effects in CGI and PANSS score improvements in both unbalanced and gentleness (balance) BC types, but no significant changes in the group and group-time interaction in the CGI and PANSS scores in different BC type groups. Conclusions: Schizophrenia patients under SGAs treatment had a higher proportion of unbalanced BC types which may lead to poorer physical or mental statuses, such as overweight problems. Health care providers could apply interventions according to patients’ BC types for disease prevention.
Collapse
Affiliation(s)
- Tzu-Pei Yeh
- School of Nursing, China Medical University, Taichung 406040, Taiwan; (T.-P.Y.); (L.-C.H.)
- Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
| | - Li-Chi Huang
- School of Nursing, China Medical University, Taichung 406040, Taiwan; (T.-P.Y.); (L.-C.H.)
- Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
| | - Yu-Fen Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Jui-Fen Cheng
- School of Nursing, China Medical University, Taichung 406040, Taiwan; (T.-P.Y.); (L.-C.H.)
- Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
- Correspondence: ; Tel.: +886-4-22053366 (ext. 7118.)
| |
Collapse
|
18
|
Chang GR, Liu HY, Yang WC, Wang CM, Wu CF, Lin JW, Lin WL, Wang YC, Lin TC, Liao HJ, Hou PH, Chan CH, Lin CF. Clozapine Worsens Glucose Intolerance, Nonalcoholic Fatty Liver Disease, Kidney Damage, and Retinal Injury and Increases Renal Reactive Oxygen Species Production and Chromium Loss in Obese Mice. Int J Mol Sci 2021; 22:ijms22136680. [PMID: 34206460 PMCID: PMC8268139 DOI: 10.3390/ijms22136680] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 12/18/2022] Open
Abstract
Clozapine is widely employed in the treatment of schizophrenia. Compared with that of atypical first-generation antipsychotics, atypical second-generation antipsychotics such as clozapine have less severe side effects and may positively affect obesity and blood glucose level. However, no systematic study of clozapine’s adverse metabolic effects—such as changes in kidney and liver function, body weight, glucose and triglyceride levels, and retinopathy—was conducted. This research investigated how clozapine affects weight, the bodily distribution of chromium, liver damage, fatty liver scores, glucose homeostasis, renal impairment, and retinopathy in mice fed a high fat diet (HFD). We discovered that obese mice treated with clozapine gained more weight and had greater kidney, liver, and retroperitoneal and epididymal fat pad masses; higher daily food efficiency; higher serum or hepatic triglyceride, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, and creatinine levels; and higher hepatic lipid regulation marker expression than did the HFD-fed control mice. Furthermore, the clozapine group mice exhibited insulin resistance, poorer insulin sensitivity, greater glucose intolerance, and less Akt phosphorylation; their GLUT4 expression was lower, they had renal damage, more reactive oxygen species, and IL-1 expression, and, finally, their levels of antioxidative enzymes (superoxide dismutase, glutathione peroxidase, and catalase) were lower. Moreover, clozapine reduced the thickness of retinal cell layers and increased iNOS and NF-κB expression; a net negative chromium balance occurred because more chromium was excreted through urine, and this influenced chromium mobilization, which did not help overcome the hyperglycemia. Our clozapine group had considerably higher fatty liver scores, which was supported by the findings of lowered adiponectin protein levels and increased FASN protein, PNPLA3 protein, FABP4 mRNA, and SREBP1 mRNA levels. We conclude that clozapine can worsen nonalcoholic fatty liver disease, diabetes, and kidney and retinal injury. Therefore, long-term administration of clozapine warrants higher attention.
Collapse
Affiliation(s)
- Geng-Ruei Chang
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 600023, Taiwan; (G.-R.C.); (C.-M.W.); (C.-F.W.); (T.-C.L.); (H.-J.L.)
| | - Hsien-Yueh Liu
- Bachelor Degree Program in Animal Healthcare, Hungkuang University, 6 Section, 1018 Taiwan Boulevard, Shalu District, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.); (W.-L.L.)
| | - Wei-Cheng Yang
- School of Veterinary Medicine, National Taiwan University, 4 Section, 1 Roosevelt Road, Taipei 100046, Taiwan;
| | - Chao-Min Wang
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 600023, Taiwan; (G.-R.C.); (C.-M.W.); (C.-F.W.); (T.-C.L.); (H.-J.L.)
| | - Ching-Fen Wu
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 600023, Taiwan; (G.-R.C.); (C.-M.W.); (C.-F.W.); (T.-C.L.); (H.-J.L.)
| | - Jen-Wei Lin
- Bachelor Degree Program in Animal Healthcare, Hungkuang University, 6 Section, 1018 Taiwan Boulevard, Shalu District, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.); (W.-L.L.)
| | - Wei-Li Lin
- Bachelor Degree Program in Animal Healthcare, Hungkuang University, 6 Section, 1018 Taiwan Boulevard, Shalu District, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.); (W.-L.L.)
- General Education Center, Chaoyang University of Technology, 168 Jifeng Eastern Road, Taichung 413310, Taiwan
| | - Yu-Chen Wang
- Division of Cardiology, Asia University Hospital, 222 Fuxin Road, Wufeng District, Taichung 413505, Taiwan;
- Department of Medical Laboratory Science and Biotechnology, Asia University, 500 Lioufeng Road, Wufeng District, Taichung 413305, Taiwan
- Division of Cardiovascular Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung 404332, Taiwan
- College of Medicine, China Medical University, 91 Hsueh-Shih Road, North District, Taichung 404333, Taiwan
| | - Tzu-Chun Lin
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 600023, Taiwan; (G.-R.C.); (C.-M.W.); (C.-F.W.); (T.-C.L.); (H.-J.L.)
| | - Huei-Jyuan Liao
- Department of Veterinary Medicine, National Chiayi University, 580 Xinmin Road, Chiayi 600023, Taiwan; (G.-R.C.); (C.-M.W.); (C.-F.W.); (T.-C.L.); (H.-J.L.)
| | - Po-Hsun Hou
- Department of Psychiatry, Taichung Veterans General Hospital, 4 Section, 1650 Taiwan Boulevard, Taichung 407219, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, 2 Section, 155 Linong Street, Beitou District, Taipei 112304, Taiwan
- Correspondence: (P.-H.H.); (C.-H.C.); (C.-F.L.); Tel.: +886-4-23592525 (P.-H.H.); +886-975-617071 (C.-H.C.); +886-8-7703202 (C.-F.L.)
| | - Chee-Hong Chan
- Division of Nephrology, Chang Bing Show Chwan Memorial Hospital, 6 Lugong Road, Lukang Township, Changhua 505029, Taiwan
- Correspondence: (P.-H.H.); (C.-H.C.); (C.-F.L.); Tel.: +886-4-23592525 (P.-H.H.); +886-975-617071 (C.-H.C.); +886-8-7703202 (C.-F.L.)
| | - Chuen-Fu Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, 1 Shuefu Road, Neipu, Pingtung 912301, Taiwan
- Correspondence: (P.-H.H.); (C.-H.C.); (C.-F.L.); Tel.: +886-4-23592525 (P.-H.H.); +886-975-617071 (C.-H.C.); +886-8-7703202 (C.-F.L.)
| |
Collapse
|
19
|
Doxepin Exacerbates Renal Damage, Glucose Intolerance, Nonalcoholic Fatty Liver Disease, and Urinary Chromium Loss in Obese Mice. Pharmaceuticals (Basel) 2021; 14:ph14030267. [PMID: 33809508 PMCID: PMC8001117 DOI: 10.3390/ph14030267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
Doxepin is commonly prescribed for depression and anxiety treatment. Doxepin-related disruptions to metabolism and renal/hepatic adverse effects remain unclear; thus, the underlying mechanism of action warrants further research. Here, we investigated how doxepin affects lipid change, glucose homeostasis, chromium (Cr) distribution, renal impairment, liver damage, and fatty liver scores in C57BL6/J mice subjected to a high-fat diet and 5 mg/kg/day doxepin treatment for eight weeks. We noted that the treated mice had higher body, kidney, liver, retroperitoneal, and epididymal white adipose tissue weights; serum and liver triglyceride, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine levels; daily food efficiency; and liver lipid regulation marker expression. They also demonstrated exacerbated insulin resistance and glucose intolerance with lower Akt phosphorylation, GLUT4 expression, and renal damage as well as higher reactive oxygen species and interleukin 1 and lower catalase, superoxide dismutase, and glutathione peroxidase levels. The treated mice had a net-negative Cr balance due to increased urinary excretion, leading to Cr mobilization, delaying hyperglycemia recovery. Furthermore, they had considerably increased fatty liver scores, paralleling increases in adiponectin, FASN, PNPLA3, FABP4 mRNA, and SREBP1 mRNA levels. In conclusion, doxepin administration potentially worsens renal injury, nonalcoholic fatty liver disease, and diabetes.
Collapse
|
20
|
Ma Q, Yang F, Ma B, Jing W, Liu J, Guo M, Li J, Wang Z, Liu M. Prevalence of nonalcoholic fatty liver disease in mental disorder inpatients in China: an observational study. Hepatol Int 2021; 15:127-136. [PMID: 33512644 PMCID: PMC7886739 DOI: 10.1007/s12072-020-10132-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/26/2020] [Indexed: 12/14/2022]
Abstract
Background and Purpose Non-alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in China. However, the understanding of NAFLD prevalence among Chinese mental disorder inpatients remains insufficient. We aim to investigate the prevalence of NAFLD among mental disorder inpatients in Beijing, China.
Methods In this observational study, we included 66,273 mental disorder inpatients between 2014 and 2018, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Data were obtained from electronic health records of 19 specialized psychiatric hospitals in Beijing. NAFLD was defined by ICD-10 code, excluding other causes of liver disease. We calculated the overall and annual prevalence rates of NAFLD from 2014 to 2018, and compared NAFLD prevalence between sexes, age groups, mental disorders types, antipsychotics use, and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. Subgroup analysis was performed in different mental disorder types. Results The prevalence of NAFLD was 17.63% (95% CI 17.34–17.92%) in mental disorder inpatients, increasing from 16.88% in 2014 to 19.07% in 2018. The NAFLD prevalence in participants with schizophrenia (22.44%) was higher than that in participants with bipolar disorder (17.89%), depressive disorder (12.62%), and other mental disorders (12.99%). Women had similar or even higher NAFLD prevalence than men after 50 years. Men, 50–59 years (aOR = 1.71), schizophrenia (aOR = 1.56), bipolar disorder (aOR = 1.47), antipsychotics use (aOR = 1.46), hypertension (aOR = 1.50), diabetes (aOR = 1.83), dyslipidemia (aOR = 2.50) were risk factors for NAFLD in mental disorder inpatients. Conclusion NAFLD was common among Chinese mental disorder inpatients, and increased over years. The prevalence of NAFLD was higher among men, old women, inpatients with schizophrenia, bipolar disorder, antipsychotics, hypertension, diabetes, and dyslipidemia. Fatty liver disease among mental disorder population warrants the attention of psychiatric specialists and health policy-makers. Supplementary Information The online version contains supplementary material available at 10.1007/s12072-020-10132-z.
Collapse
Affiliation(s)
- Qiuyue Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing, 100096, China.
| | - Botao Ma
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing, 100096, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing Municipal Commission of Health and Family Planning Policy Research Center, No.277, Zhaodengyu Road, Xicheng District, Beijing, 100034, China
| | - Juan Li
- Beijing Geriatric Hospital, No.118, Wenquan Road, Haidian District, Beijing, 100095, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing, 100096, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
| |
Collapse
|
21
|
Risperidone Exacerbates Glucose Intolerance, Nonalcoholic Fatty Liver Disease, and Renal Impairment in Obese Mice. Int J Mol Sci 2021; 22:ijms22010409. [PMID: 33401717 PMCID: PMC7795724 DOI: 10.3390/ijms22010409] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 12/26/2022] Open
Abstract
Risperidone, a second-generation antipsychotic drug used for schizophrenia treatment with less-severe side effects, has recently been applied in major depressive disorder treatment. The mechanism underlying risperidone-associated metabolic disturbances and liver and renal adverse effects warrants further exploration. This research explores how risperidone influences weight, glucose homeostasis, fatty liver scores, liver damage, and renal impairment in high-fat diet (HFD)-administered C57BL6/J mice. Compared with HFD control mice, risperidone-treated obese mice exhibited increases in body, liver, kidney, and retroperitoneal and epididymal fat pad weights, daily food efficiency, serum triglyceride, blood urea nitrogen, creatinine, hepatic triglyceride, and aspartate aminotransferase, and alanine aminotransferase levels, and hepatic fatty acid regulation marker expression. They also exhibited increased insulin resistance and glucose intolerance but decreased serum insulin levels, Akt phosphorylation, and glucose transporter 4 expression. Moreover, their fatty liver score and liver damage demonstrated considerable increases, corresponding to increases in sterol regulatory element-binding protein 1 mRNA, fatty acid-binding protein 4 mRNA, and patatin-like phospholipid domain containing protein 3 expression. Finally, these mice demonstrated renal impairment, associated with decreases in glutathione peroxidase, superoxide dismutase, and catalase levels. In conclusion, long-term administration of risperidone may exacerbate diabetes syndrome, nonalcoholic fatty liver disease, and kidney injury.
Collapse
|
22
|
Wang TJ, Lee TC, Wu BJ, Yu CH. Nonalcoholic fatty liver disease among long-term hospitalized patients with schizophrenia in a public psychiatric hospital. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_38_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
|
23
|
Zhang J, Tan Y, Chang L, Hammock BD, Hashimoto K. Increased expression of soluble epoxide hydrolase in the brain and liver from patients with major psychiatric disorders: A role of brain - liver axis. J Affect Disord 2020; 270:131-134. [PMID: 32339103 PMCID: PMC7243919 DOI: 10.1016/j.jad.2020.03.070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/21/2020] [Accepted: 03/22/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Soluble epoxide hydrolase (sEH) in the metabolism of polyunsaturated fatty acids might play a role in the pathogenesis of major psychiatric disorders. Here we studied whether expression of sEH protein is altered in the postmortem samples (parietal cortex, and liver) from patients with major psychiatric disorders. METHODS Protein expression of sEH in the parietal cortex and liver from control, major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) groups was measured. RESULTS Levels of sEH in the parietal cortex and liver from MDD, BD, and SZ groups were significantly higher than the control group. Interestingly, there was a positive correlation between sEH protein in the parietal cortex and sEH protein the liver in all groups. LIMITATIONS The small number in each group may limit our interpretation. CONCLUSIONS This study shows that the increased expression of sEH in the brain and liver might play a role in the pathogenesis of major psychiatric disorders, suggesting a role of brain - liver axis in major psychiatric disorders.
Collapse
Affiliation(s)
- Jiancheng Zhang
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba 260-8670, Japan,Department of Critical Care Medicine (Dr. Zhang), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R. China
| | - Yunfei Tan
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba 260-8670, Japan
| | - Lijia Chang
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba 260-8670, Japan
| | - Bruce D. Hammock
- Department of Entomology and Nematology, and UCD Comprehensive Cancer Center, University of California, Davis, CA 95616, USA
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, 260-8670, Japan.
| |
Collapse
|
24
|
Vázquez-Bourgon J, Ortiz-García de la Foz V, Suarez-Pereira I, Iruzubieta P, Arias-Loste MT, Setién-Suero E, Ayesa-Arriola R, Gómez-Revuelta M, Crespo J, Crespo Facorro B. Cannabis consumption and non-alcoholic fatty liver disease. A three years longitudinal study in first episode non-affective psychosis patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109677. [PMID: 31228640 DOI: 10.1016/j.pnpbp.2019.109677] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/28/2019] [Accepted: 06/17/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Increased incidence of obesity and excess weight lead to an increased incidence of non-alcoholic fatty liver disease (NAFLD). Recent evidence indicates a protective effect of cannabis consumption on weight gain and related metabolic alterations in psychosis patients. Overall, patients are at greater risk of presenting fatty diseases, such as NAFLD, partly due to lipid and glycemic metabolic disturbances. However, there are no previous studies on the likely effect of cannabis on liver steatosis. We aimed to explore if cannabis consumption had an effect on hepatic steatosis, in a sample of first-episode (FEP) non-affective psychosis. MATERIAL AND METHODS A total of 390 patients were evaluated at baseline and after 3 years of initiating the antipsychotic treatment. Anthropometric measurements and liver, lipid, and glycemic parameters were obtained at both time points. All but 6.7% of patients were drug-naïve at entry, and they self-reported their cannabis use at both time points. Liver steatosis and fibrosis were evaluated through validated clinical scores (Fatty Liver Index [FLI], Fibrosis-4 [FIB-4], and NAFLD). RESULTS At 3-year follow-up, cannabis users presented significantly lower FLI scores than non-users (F = 13.874; p < .001). Moreover, cannabis users less frequently met the criteria for liver steatosis than non-users (X2 = 7.97, p = .019). Longitudinally, patients maintaining cannabis consumption after 3 years presented the smallest increment in FLI over time, which was significantly smaller than the increment in FLI presented by discontinuers (p = .022) and never-users (p = .016). No differences were seen in fibrosis scores associated with cannabis. CONCLUSIONS Cannabis consumption may produce a protective effect against liver steatosis in psychosis, probably through the modulation of antipsychotic-induced weight gain.
Collapse
Affiliation(s)
- Javier Vázquez-Bourgon
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| | - Víctor Ortiz-García de la Foz
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain.
| | - Irene Suarez-Pereira
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Neuropsychopharmacology & Psychobiology Research Group, University of Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Edificio "Andrés Segovia", Cádiz, Spain.
| | - Paula Iruzubieta
- Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - María Teresa Arias-Loste
- Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - Esther Setién-Suero
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Crespo
- Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - Benedicto Crespo Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| |
Collapse
|
25
|
Wang CH, Lee TY, Hui KC, Chung MH. Mental disorders and medical comorbidities: Association rule mining approach. Perspect Psychiatr Care 2019; 55:517-526. [PMID: 30734309 DOI: 10.1111/ppc.12362] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/28/2018] [Accepted: 01/20/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study explored the medical comorbidities of mental disorders using association rule mining. DESIGN AND METHODS Patients diagnosed with mental disorders between 2002 and 2010 were identified. An equal number of nonmental disorder subjects were randomly selected and matched with case group by age and gender. FINDINGS Sleep disorders and digestive diseases were frequent comorbidities among mental disorders. The specific medical comorbidities were diabetes mellitus, chronic liver disease, extrapyramidal diseases, disorders of stomach function, general symptoms, sleep disturbance, and family circumstances. PRACTICE IMPLICATIONS The results suggest that education of professional knowledge of comorbid conditions should be provided to nurses for caring patients with mental illnesses.
Collapse
Affiliation(s)
- Chia-Hui Wang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Yin Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - King-Cheung Hui
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
26
|
Xu H, Zhuang X. Atypical antipsychotics-induced metabolic syndrome and nonalcoholic fatty liver disease: a critical review. Neuropsychiatr Dis Treat 2019; 15:2087-2099. [PMID: 31413575 PMCID: PMC6659786 DOI: 10.2147/ndt.s208061] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/02/2019] [Indexed: 02/05/2023] Open
Abstract
The atypical antipsychotics (AAPs) have been used as first-line drugs in psychiatric practice for a wide range of psychotic disorders, including schizophrenia and bipolar mania. While effectively exerting therapeutic effects on positive and negative symptoms, as well as cognitive impairments in schizophrenia patients, these drugs are less likely to induce extrapyramidal symptoms compared to typical antipsychotics. However, the increasing application of them has raised questions on their tolerability and adverse effects over the endocrine, metabolic, and cardiovascular axes. Specifically, AAPs are associated to different extents, with weight gain, metabolic syndrome (MetS), and nonalcoholic fatty liver disease (NAFLD). This article summarized clinical evidence showing the metabolic side effects of AAPs in patients with schizophrenia, and experimental evidence of AAPs-induced metabolic side effects observed in animals and cell culture studies. In addition, it discussed potential mechanisms involved in the APPs-induced MetS and NAFLD.
Collapse
Affiliation(s)
- Haiyun Xu
- The Mental Health Center, Shantou University Medical College, Shantou, People’s Republic of China
- Correspondence: Haiyun XuThe Mental Health Center, Shantou University Medical College, Shantou 515041, People’s Republic of ChinaEmail
| | - Xiaoyin Zhuang
- The Mental Health Center, Shantou University Medical College, Shantou, People’s Republic of China
| |
Collapse
|
27
|
Yang B, Ren Q, Zhang JC, Chen QX, Hashimoto K. Altered expression of BDNF, BDNF pro-peptide and their precursor proBDNF in brain and liver tissues from psychiatric disorders: rethinking the brain-liver axis. Transl Psychiatry 2017; 7:e1128. [PMID: 28509900 PMCID: PMC5534963 DOI: 10.1038/tp.2017.95] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/22/2017] [Accepted: 03/28/2017] [Indexed: 12/11/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) has a role in the pathophysiology of psychiatric disorders. The precursor proBDNF is converted to mature BDNF and BDNF pro-peptide, the N-terminal fragment of proBDNF; however, the precise function of these proteins in psychiatric disorders is unknown. We sought to determine whether expression of these proteins is altered in the brain and peripheral tissues from patients with psychiatric disorders. We measured protein expression of proBDNF, mature BDNF and BDNF pro-peptide in the parietal cortex, cerebellum, liver and spleen from control, major depressive disorder (MDD), schizophrenia (SZ) and bipolar disorder (BD) groups. The levels of mature BDNF in the parietal cortex from MDD, SZ and BD groups were significantly lower than the control group, whereas the levels of BDNF pro-peptide in this area were significantly higher than controls. In contrast, the levels of proBDNF and BDNF pro-peptide in the cerebellum of MDD, SZ and BD groups were significantly lower than controls. Moreover, the levels of mature BDNF from the livers of MDD, SZ and BD groups were significantly higher than the control group. The levels of mature BDNF in the spleen did not differ among the four groups. Interestingly, there was a negative correlation between mature BDNF in the parietal cortex and mature BDNF in the liver in all the subjects. These findings suggest that abnormalities in the production of mature BDNF and BDNF pro-peptide in the brain and liver might have a role in the pathophysiology of psychiatric disorders, indicating a brain-liver axis in psychiatric disorders.
Collapse
Affiliation(s)
- B Yang
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Q Ren
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - J-c Zhang
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Q-X Chen
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - K Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
| |
Collapse
|