精神分裂症合并NAFLD患者血清甲状腺激素水平与精神症状的相关性

Correlation between serum levels of thyroid hormones and psychiatric symptoms in schizophrenia patients with NAFLD

目的:探讨合并非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的精神分裂症(schizophrenia,SCH)患者甲状腺激素水平与精神症状的相关性。方法:随机筛选2019年1月—2022年4月在南通市第四人民医院精神科住院的SCH患者161例,依据肝脏超声检查结果分为NAFLD组77例和无NAFLD组(对照组)84例。记录两组研究对象的年龄、性别、住院次数、疾病分型等临床资料并检测血清甲状腺激素水平,以阳性与阴性症状量表精神症状量表(positive and negative syndrome scale,PANSS)评估患者精神症状。采用t检验、χ^(2)检验、U检验及Pearson相关性分析等比较两组指标的差异性。结果:NAFLD组总甲状腺素(total thytoxine,TT4)、游离甲状腺素(free thyroxine,FT4)水平显著低于对照组(t=-2.022、-2.106,P<0.05)。PANSS量表分值显示,NAFLD组阴性症状(N总分)显著高于对照组(t=2.118,P<0.05)。Pearson相关性分析结果显示,总体SCH患者TT4与阳性症状(P总分)、一般精神症状(G总分)及PANSS量表总分呈正相关(r=0.158、0.191、0.160,P<0.05),FT4与P总分呈正相关(r=0.159,P<0.05)。NAFLD组TT4与G总分呈正相关(r=0.245,P<0.05)。对照组促甲状腺激素(thyroid stimulating hormone,TSH)与阴性症状(N总分)呈正相关(r=0.262,P<0.05)。结论:SCH患者体内血清甲状腺激素水平与精神症状相关,合并NAFLD的SCH患者TT4水平低于无NAFLD的SCH患者,且合并NAFLD的SCH患者体内血清TT4水平与一般精神症状有关,而无NAFLD合并的SCH患者TSH水平与阴性症状有关。

Objective:To evaluate the relationship between serum levels of thyroid hormones and psychiatric symptoms in schizophrenia patients with nonalcoholic fatty liver disease(NAFLD).Methods:161 SCH patients admitted to the Psychiatry Department of Nantong Fourth People′s Hospital from January 2019 to April 2022 were collected and divided into NAFLD group(77 cases)and no NAFLD group(control group,84 cases)according to the results of liver ultrasonography.The clinical evaluation included age,sex,number of hospitalizations,disease types and the serum levels of thyroid hormones were recorded,and psychiatric symptoms were assessed by positive and negative syndrome scale(PANSS).The differences between the two groups were analyzed by t-test,χ^(2) test,U test and the Pearson correlation analysis were used to assess the differences between the two groups of indicators.Results:The levels of total thytoxine(TT4)and free thyroxine(FT4)in NAFLD group were significantly lower than those in control group(t=-2.022,-2.106,P<0.05).PANSS scale score showed that negative symptoms(total N score)in NAFLD group were significantly higher than those in control group(t=2.118,P<0.05).Pearson correlation analysis showed that TT4 was positively correlated with positive symptoms(P total score),general psychiatric symptoms(G total score)and PANSS total score(r=0.158,0.191,0.160,P<0.05).FT4 was positively correlated with the P total score(r=0.159,P<0.05).TT4 in NAFLD group was positively correlated with the total G total score(r=0.245,P<0.05).In the control group,thyroid stimulating hormone(TSH)was positively correlated with negative symptoms(N total score)(r=0.262,P<0.05).Conclusions:Serum levels of thyroid hormone in SCH patients were correlated with psychiatric symptoms.TT4 levels in SCH patients with NAFLD were lower than those in SCH patients without NAFLD.TT4 levels in SCH patients with NAFLD were correlated with general psychiatric symptoms,while TSH levels in SCH patients without NAFLD were correlated with negative symptoms.