首发未用药精神分裂症患者血清核心蛋白多糖、胰岛素抵抗与炎性因子及认知损伤的关系分析

Analysis of the relationship among serum core proteoglycan,insulin resistance and inflammatory factors,cognitive impairment in patients with first-episode untreated schizophrenia.

目的评估首发未用药精神分裂症患者血清核心蛋白多糖(DCN)、胰岛素抵抗与炎性因子及认知损伤的关系。方法选取90例首发未用药精神分裂症患者作为研究组,同期进行体检的90名健康者为对照组,检测两组血清DCN水平、白细胞介素-6(IL-6)水平和肿瘤坏死因子α(TNF-α)水平。采用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,采用阳性和阴性综合征量表(PANSS)对患者精神病理症状进行评估,采用MATRICS共识认知成套测验(MCCB)对患者的认知功能进行评估。结果研究组血清DCN水平低于对照组,而血清IL-6、TNF-α水平和HOMA-IR高于对照组(P<0.05)。血清DCN阳性患者的IL-6、TNF-α水平和PANSS评分低于阴性患者(P<0.05),而MCCB评分高于阴性患者(P<0.05)。胰岛素抵抗患者的IL-6、TNF-α水平和PANSS评分均高于非抵抗患者(P<0.05),而MCCB评分低于胰岛素非抵抗患者。血清DCN水平与IL-6、TNF-α和PANSS评分均呈负相关(P<0.05),而与MCCB评分呈正相关(P<0.05);HOMA-IR与IL-6、TNF-α和PANSS评分均呈正相关(P<0.05),而与MCCB评分呈负相关(P<0.05)。结论首发未用药精神分裂症患者血清DCN、TNF-α、IL-6水平以及HOMA-IR异常,且患者血清DCN水平、胰岛素抵抗与炎性因子水平和认知损伤相关,血清DCN水平和胰岛素抵抗在精神分裂症患者的治疗和预后预测中具有一定临床价值。

Objective To evaluate the relationship among serum core proteoglycan(DCN),insulin resistance,inflammatory factors and cognitive impairment in patients with first-episode untreated schizophrenia.Methods A total of 90 patients with first-episode untreated schizophrenia in study group and 90 healthy controls in control group were selected and their serum DCN,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were detected.Insulin resistance was assessed by Homeostasis Model Assessment-Insulin Resistance Index(HOMA-IR).The Positive and Negative Syndrome Scale(PANSS)was used to evaluate the psychopathological symptoms.The cognitive function of patients was evaluated by the MATRICS Consensus Cognitive Battery(MCCB).Results In study group,the serum DCN level was significantly lower and serum TNF-αand IL-6 levels and HOMA-IR were all significantly higher than those in control group(P<0.05).Compared with the patients with negative serum DCN,the patients with positive serum DCN had lower levels of TNF-αand IL-6 as well as lower PANSS scores(P<0.05),and higher MCCB scores(P<0.05).Compared with non-insulin resistant patients,insulin resistant patients had higher levels of TNF-αand IL-6 as well as higher PANSS scores(P<0.05),and lower MCCB scores(P<0.05).Serum DCN level was negatively correlated with IL-6,TNF-αand PANSS score(P<0.05),while it was positively correlated with MCCB score(P<0.05).HOMA-IR was positively correlated with IL-6,TNF-αand PANSS score(P<0.05),while it was negatively correlated with MCCB score(P<0.05).Conclusion Serum DCN,TNF-α,IL-6 levels and HOMA-IR in patients with first-episode untreated schizophrenia are abnormal,and serum DCN level and insulin resistance are correlated with inflammatory factor levels and cognitive impairment.The detection of serum DCN and insulin resistance has a certain clinical value in the treatment and prognosis prediction of schizophrenic patients.