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Gao X, Qin Y, Jiao S, Hao J, Zhao J, Wang J, Wen Y, Wang T. Genetic evidence for the causal relations between metabolic syndrome and psychiatric disorders: a Mendelian randomization study. Transl Psychiatry 2024; 14:46. [PMID: 38245519 PMCID: PMC10799927 DOI: 10.1038/s41398-024-02759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Emerging evidence reveals associations between metabolic syndrome (MetS) and psychiatric disorders (PDs), although causality remains uncertain. Consequently, we conducted Mendelian randomization (MR) to systematically evaluate the causality between MetS and PDs. Linkage disequilibrium score regression estimated the heritability of PDs and their genetic correlations with MetS. In primary analyses, the main model employed inverse variance weighting method, with sensitivity analyses using various MR models to ensure robustness. Replication MR analyses, involving cohorts distinct from those in the primary analyses, were performed to validate the generalizability of the findings. Multivariable MR analyses were carried out to account for genetically predicted body mass index (BMI). As a result, genetic correlations of MetS with attention-deficit/hyperactivity disorder(ADHD), anorexia nervosa(ANO), major depressive disorder(MDD), and schizophrenia were identified. Causal effects of MetS on ADHD (OR: 1.59 [95% CI:1.45-1.74]), ANO (OR: 1.42 [95% CI:1.25-1.61]), MDD(OR: 1.23 [95% CI: 1.13-1.33]), and the effects of ADHD (OR: 1.03 [95% CI: 1.02-1.04]) and ANO (OR: 1.01 [95% CI: 1.01-1.02]) on MetS were observed in primary analyses. Results from sensitivity analyses and replication analyses were generally consistent with the primary analyses, confirming the robustness and generalizability of the findings. Associations between MetS and ADHD, as well as ANO persisted after adjusting for BMI, whereas the statistical significance of the association between MetS and MDD was no longer observable. These results contribute to a deeper understanding of the mechanisms underlying PDs, suggesting potential modifiable targets for public prevention and clinical intervention in specific PDs related to metabolic pathways.
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Affiliation(s)
- Xue Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Yi Qin
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Shu Jiao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Junhui Hao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Jian Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen, Guangdong, 518055, China
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jiale Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Yanchao Wen
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030001, China.
- MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China.
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Chen L, Liu Z, Zheng Y. Acute liver failure and aplastic crisis due to anorexia nervosa in an adolescent girl: a case report. J Int Med Res 2023; 51:3000605231214922. [PMID: 38017360 PMCID: PMC10686022 DOI: 10.1177/03000605231214922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/17/2023] [Indexed: 11/30/2023] Open
Abstract
Anorexia nervosa (AN) has a high mortality rate due to the widespread organ dysfunction caused by the underlying severe malnutrition. Malnutrition-induced hepatitis is common among individuals with AN especially as body mass index decreases, while acute liver failure and aplastic crisis related to coagulation disease and encephalopathy rarely occur in AN patients. The supervised increase of caloric intake can quickly improve the elevated aminotransferases caused by starvation and aplastic crisis. This current case report describes a 12-year-old adolescent girl who was admitted with a 3-month history of weight loss. Within 3 months, she had lost 10 kg of weight. The girl was diagnosed with AN, acute liver failure, severe malnutrition with emaciation, electrolyte disorder, bradycardia and aplastic crisis. She was gradually supplemented with vitamins and enteral nutrition to avoid refeeding syndrome. After treatment, her liver function and haematopoietic function returned to normal. In conclusion, acute liver failure and aplastic crisis are rare but potentially life-threatening complications of AN, which could be improved by supervised feeding and timely rehydration. AN should be considered as the potential aetiology of acute liver failure and aplastic crisis.
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Affiliation(s)
- Leilei Chen
- Department of Paediatrics, Yancheng No.1 People’s Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu Province, China
| | - Zhifeng Liu
- Department of Gastroenterology, Nanjing Children’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, Jiangsu Province, China
| | - Yucan Zheng
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
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Bou Khalil R, Risch N, Sleilaty G, Richa S, Seneque M, Lefebvre P, Sultan A, Avignon A, Maimoun L, Renard E, Courtet P, Guillaume S. Neutrophil-to-lymphocyte ratio (NLR) variations in relationship with childhood maltreatment in patients with anorexia nervosa: a retrospective cohort study. Eat Weight Disord 2022; 27:2201-2212. [PMID: 35128621 DOI: 10.1007/s40519-022-01372-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/20/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio). METHODS Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively. RESULTS NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability. CONCLUSION In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization. LEVEL OF EVIDENCE III. Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- R Bou Khalil
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon. .,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
| | - N Risch
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - G Sleilaty
- Clinical Research Center and Department of Cardiac and Thoracic Surgery, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - S Richa
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - M Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - P Lefebvre
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - A Sultan
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France
| | - A Avignon
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, CHU, Montpellier, France
| | - L Maimoun
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, Montpellier, France.,Département de Médecine Nucléaire, Hôpital Lapeyronie, CHU Montpellier, Montpellier, France
| | - E Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Endocrinology, Diabetes, Nutrition, CHU Montpellier, Montpellier, France
| | - P Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
| | - S Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295, Montpellier, France
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