title: Microvascular dysfunction in schizophrenia: a case-control study.
abstract: BACKGROUND
  Schizophrenia is a mental illness associated with cardiovascular disease at a younger age than in the general population. Endothelial dysfunction has predictive value for future cardiovascular events; however, the impact of a diagnosis of schizophrenia on this marker is unknown.
  
  
  OBJECTIVE
  We tested the hypothesis that subjects with schizophrenia have impaired endothelial function.
  
  
  METHODS
  A total of 102 subjects (34.5±7.5 years) participated in this study. This sample consisted of 51 subjects with a diagnosis of schizophrenia and 51 healthy subjects, who were matched for age (P=0.442), sex (P>0.999), and smoking status (P=0.842). Peripheral artery microvascular and conduit vessel endothelial function was measured using hyperemic velocity time integral (VTI), pulse arterial tonometry (PAT), and flow-mediated dilation (FMD).
  
  
  RESULTS
  Significantly lower values of VTI were noted in subjects with schizophrenia (104.9±33.0 vs. 129.1±33.8 cm, P<0.001), whereas FMD (P=0.933) and PAT (P=0.862) did not differ between the two groups. A multivariable-linear-regression analysis, built on data from univariate and partial correlations, showed that only schizophrenia, sex, lipid-lowering medications, antihypertensive medications, and low-density lipoprotein (LDL)-cholesterol were predictive of attenuated VTI, whereas age, ethnicity, family history of cardiovascular disease, smoking status, systolic blood pressure, waist circumference, HDL-cholesterol, triglycerides, C-reactive protein, and homeostatic model assessment-insulin resistance (HOMA-IR), antidiabetic medications, antidepressant medications, mood stabilizers, benzodiazepines, and anticholinergic medications did not predict VTI in this model (adjusted R (2)=0.248).
  
  
  CONCLUSIONS
  Our findings suggest that a diagnosis of schizophrenia is associated with impaired microvascular function as indicated by lower values of VTI, irrespective of many other clinical characteristics. It might be an early indicator of cardiovascular risk in schizophrenia, and might help to identify high-risk individuals.
authors.affiliation: Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Martin W
authors.identifier: 0000-0003-3946-3718
authors.initials: MW
authors.lastname: Vetter
authors.affiliation: Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada.
authors.forename: Billie-Jean
authors.initials: BJ
authors.lastname: Martin
authors.affiliation: Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada.
authors.forename: Marinda
authors.initials: M
authors.lastname: Fung
authors.affiliation: Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada.
authors.forename: Milada
authors.initials: M
authors.lastname: Pajevic
authors.affiliation: Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary , Calgery, AB, Canada.
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Anderson
authors.affiliation: Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgery, AB, Canada.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Raedler