Inflammatory, cardio-metabolic and diabetic profiling of chronic schizophrenia.
There is a growing interest in low-grade inflammatory and metabolic alterations in patients with chronic schizophrenia (SCH).



Inflammatory (tumor-necrosis factor-α [TNF-α], interferon-γ [IFN-γ], interleukins [IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10], monocyte chemo-attractant protein-1 [MCP-1]) and growth factors (vascular endothelial growth factor [VEGF], epidermal growth factor [EGF]) were measured in blood serum samples of 105 SCH patients and 148 control subjects (CS). Simultaneously the clinical biomarkers (C-reactive protein [CRP], triglycerides [TG], low-density lipoprotein [LDL-c] and high-density lipoprotein [HDL-c] cholesterol, glycated hemoglobin [HbA1c]) were measured, and body mass index (BMI) was calculated for patients.



Several cyto-/chemokines (IFN-γ, MCP-1, IL-2, IL-6, IL-8 and IL-10) were significantly (P<0.0000001) elevated in SCH patients compared to CS. Odds ratios, obtained from logistic regression analyses, were significantly elevated for IL-2, IL-6, IL-10, INF-γ, and decreased for TNF-α in SCH group. Among the patients, higher IL-2, IL-6, INF-γ and lower MCP-1 levels as well as male gender were together significant (P<0.000001) predictors of higher HbA1c levels, and TG/HDL-c parameter was associated with ratios of INF-γ/IL-10 (P=0.004), and INF-γ/IL-4 (P=0.049), HbA1c (P=0.005), INF-γ (P=0.009), as well as LDL-c (P=0.02) levels.



IL-2, IL-6, IL-10 and IFN-γ were the most significant SCH-related markers among the measured cytokines in our patient group. Furthermore, significant associations between pro-/anti-inflammatory imbalance and HbA1c as well as cardio-metabolic risk marker (TG/HDL-c) were observed, indicating higher risks of diabetes and cardiovascular diseases among SCH patients.
Department of Child and Adolescent Psychiatry, Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia. Electronic address: roman.balotsev@kliinikum.ee.
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Balõtšev
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Koido
Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Vasar
Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Janno
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Kriisa
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Mahlapuu
Psychiatry Department, Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Ljubajev
Department of Child and Adolescent Psychiatry, Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Parksepp
Psychiatry Department, Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Veiksaar
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia; Endocrinology Unit, Internal Medicine Clinic, Tartu University Hospital, Puusepa 8, 50406 Tartu, Estonia.
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Volke
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Lang
Department of the Out-Patient, Psychiatry Clinic of Tartu University Hospital, Raja 31, 50417 Tartu, Estonia.
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Haring
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Zilmer
Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia; Centre of Excellence for Genomics and Translational Medicine, Ravila 19, Tartu 50411, Estonia.
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Vasar
D000328:Adult; D016207:Cytokines / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D004815:Epidermal Growth Factor / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism; D012559:Schizophrenia / Q000150:complications / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
D016207:Cytokines; D042461:Vascular Endothelial Growth Factor A; D004815:Epidermal Growth Factor
Cardio-metabolic risk factors; Cytokines and growth factors; Inflammation; Type-2 diabetes