急性期精神分裂症患者血清胆汁酸谱与认知功能的相关性

Correlation between serum bile acid profile and cognitive functionin patients with acute schizophrenia

目的 探讨外周血胆汁酸对精神分裂症患者认知功能的影响。方法 用靶向代谢组学分析23例精神分裂症患者(精神分裂症组)和23例健康志愿者(健康对照组)血清中初级和次级胆汁酸代谢物水平。采用MATRICS公认认知成套测验量表(MCCB)测试所有被试者5个维度的认知功能。结果 精神分裂症患者在信息处理速度、工作记忆、推理及问题解决能力、视觉学习能力等多个维度的认知功能均有受损。与健康对照组相比,精神分裂症组血清中胆酸(CA)和鹅去氧胆酸(CDCA)的含量显著降低,而甘氨胆酸(GCA)的含量显著升高,去氧胆酸(DCA)/CA的比值(3.04 vs. 1.16)更高。校正了年龄、性别、身体质量指数后,信息处理速度、工作记忆、推理和问题解决和视觉学习能力与血清中牛磺胆酸(TCA)、GCA、甘氨鹅去氧胆酸(GCDCA)、CDCA等初级胆汁酸的含量呈显著负相关。结论 精神分裂症患者的胆汁酸谱出现明显紊乱,CA、CDCA等起神经保护作用的胆汁酸减少和具有细胞毒性的胆汁酸GCA增多可能造成精神分裂症患者认知水平下降。

Objective To investigate the effect of peripheral blood bile acids on the cognitive function of schizophrenia patients.Methods Targeted metabolomics was adopted to analyze the total level of primary and secondary serum bile acid metabolites collected from 23 schizophrenia patients and 23 health control individuals.The MATRICS Consensus Cognitive Battery(MCCB)was adopted to evaluate the subjects’cognitive function in five dimensions.Results We found that the schizophrenia patients had impaired cognitive functions in multiple dimensions including speed of processing,working memory,reasoning and problem solving,and visual learning.Compared with the health control group,serum levels of cholic acid(CA)and chenodeoxycholic acid(CDCA)were significantly lower in patients with schizophrenia,while serum level of glycocholic acid(GCA)was significantly higher,and the ratio of deoxycholic acid(DCA)to CA was higher(3.04 vs.1.16).Speed of processing,working memory,reasoning and problem solving,and visual learning abilities were significantly negatively correlated with serum levels of multiple primary bile acids including taurocholic acid(TCA),GCA,glycochenodeoxycholic acid(GCDCA)and taurochenodeoxycholic acid(TCDCA),after adjustments of age,sex,and body mass index.Conclusion The bile acid profile of schizophrenia patients is obvious,and the decrease in neuroprotective bile acids(namely,CA and CDCA)and the up-regulation of cytotoxic bile acid(i.e.,GCA)may impair the cognitive function of schizophrenia patients.