Obez ve obez olmayan şizofreni spektrum bozukluğu hastalarında kalp damar hastalığı risk faktörleri
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Date
2013
Authors
Açıkgöz, Hacer Ebru
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Publisher
Uludağ Üniversitesi
Abstract
Şizofreni spektrum bozukluğu (ŞSB) hastalarında beklenen yaşam süresi normal popülasyona göre daha kısa olup aterosklerotik kalp damar hastalığı (AKDH), ölüm nedenleri arasında birinci sırada yer almaktadır. AKDH risk faktörlerinden biri olan obezite, bu hastalarda normal populasyona göre daha sık görülmektedir. ŞSB hastalarında kullanılan antipsikotiklerin obeziteye neden olduğu düşünülmektedir. Çalışmalarda AKDH ile ilişkili olduğu düşünülen bazı inflamatuvar belirteçlerin obezitenin ve ŞSB'nin etyopatogenezinde de etkili olduğuna dair veriler elde edilmiştir. Bu çalışmada çeşitli inflamatuvar belirteçlerin düzeylerini karşılaştırarak ŞSB hastalarında AKDH riskininin obezite ile olan ilişkisini incelemeyi amaçladık. Çalışmaya antipsikotik kullanan 40 obez ŞSB (OŞSB) ve 40 obez olmayan ŞSB (OOŞSB) toplam 80 hasta ve 40 obez (OK) ve 40 obez olmayan (OOK) toplam 80 sağlıklı kontrol dahil edildi. Katılımcılardan ayrıntılı anamnez alındı, hasta grubuna psikiyatrik değerlendirme ölçekleri uygulandı. Rutin biyokimyasal parametre düzeyleri otoanalizörde çalışıldı, aterosklerozun inflamatuvar belirteçleri (TNFα, CD40L, MCP-1, PAI-1, P Selektin, IL-6, hsCRP) ELISA metodu ile ölçüldü. Yapılan inceleme sonucunda TNFα, CD40L, MCP-1, PAI-1, P Selektin düzeyleri ŞSB hasta grubunda kontrol grubuna göre yüksek saptanırken, IL-6 düzeyleri hasta grubunda daha düşük bulundu. Altgruplar karşılaştırıldığında hsCRP, OŞSB hasta grubunda OOŞSB hasta grubuna göre, OK grubunda OOK grubuna göre belirgin yüksekti. PAI-1 düzeyleri OK grubunda OOK grubuna göre anlamlı olarak daha düşük, TNFα düzeyleri ise daha yüksek saptandı. P Selektin, MCP-1, TNFα ve CD40L düzeyleri OOŞSB hasta grubunda OOK grubuna göre, OŞSB hasta grubunda OK grubuna göre; IL-6 düzeyleri OOK grubunda OOŞSB grubuna göre, OK grubunda OŞSB grubuna göre anlamlı olarak daha yüksek saptandı. OK grubunda PAI-1 düzeyleri OŞSB grubuna göre daha düşük bulundu. ŞSB hastalarındaki kilo artışının çeşitli inflamatuvar göstergeler üzerindeki etkisini araştırdığımız bu çalışmada P Selektin, IL-6, MCP-1 ve CD40L düzeylerinin hastalık süreciyle ilişkili, PAI-1 ve TNFα seviyelerinin ise hastalık ve obezite ile ilişkili olabileceği ve hsCRP ise sadece obeziteyle ilişkili olabileceği görüşüne varılmıştır.
Patients with Schizophrenia Spectrum Disorder (SSD) have a shorter life expectancy than the general population and in these patients atherosclerotic cardiovascular disease (ACVD), ranks first among the causes of death. Obesity is one of the risk factors for ACVD, and it is more frequent in SSD patients than in the normal population. Antipsychotics, used in SSD patients, are thought to contribute to the obesity. Studies have revealed that the inflammatory markers which are thought to be associated ACVD risk, have been effective in pathogenesis of obesity. In this study, we aimed to investigate the relationship between obesity and risk of the ACVD, comparing the inflammatory markers associated with obesity and ACVD in SSD patients. 40 obese SSD (OSSD), 40 non-obese SSD (NOSSD) patients using antipsychotic treatment (total 80 patients), and 40 obese (OC) and also 40 non-obese (NOC) healthy control subjects (in total 80 healthy control) were included in this study. Detailed history of the participants was questioned, and psychiatric rating scales were performed in the patient group. Biochemical parameters were measured in autoanalyser and inflammatory markers of atherosclerosis (TNFα, CD40L, MCP-1, PAI-1, P selectin, IL-6, hsCRP) were measured by ELISA method. As a result of the analysis, TNFα, CD40L, MCP-1, PAI-1, P-selectin levels were higher in the SSD patient group, whereas IL-6 levels were significantly lower in SSD patient group compared to the control group. When we compared the subgroups, hsCRP levels were significantly higher in OSSD patients group than NOSSD patients group, and higher in OC group than NOC group. PAI-1 levels were significantly lower, TNFα levels were significantly higher than OC group those of NOC group. P Selectin, MCP-1, TNFα and CD40L levels were significantly higher than the NOC group in patients with NOSSD, higher than OC in patient OSSD. IL-6 levels were also significantly higher in NOC group compared with NOSSD group, in OC group compared with OSSD group. PAI-1 levels were significantly lower than those of OSSD group in the OC group. The study which investigated by us the effect on weight gain of various inflammatory markers on SSD patients, we concluded that P-Selectin, IL-6, MCP-1 and CD40L levels may be related to disease process, PAI-1 and TNFα levels may be associated with the disease and obesity, and hsCRP may be related to only obesity.
Patients with Schizophrenia Spectrum Disorder (SSD) have a shorter life expectancy than the general population and in these patients atherosclerotic cardiovascular disease (ACVD), ranks first among the causes of death. Obesity is one of the risk factors for ACVD, and it is more frequent in SSD patients than in the normal population. Antipsychotics, used in SSD patients, are thought to contribute to the obesity. Studies have revealed that the inflammatory markers which are thought to be associated ACVD risk, have been effective in pathogenesis of obesity. In this study, we aimed to investigate the relationship between obesity and risk of the ACVD, comparing the inflammatory markers associated with obesity and ACVD in SSD patients. 40 obese SSD (OSSD), 40 non-obese SSD (NOSSD) patients using antipsychotic treatment (total 80 patients), and 40 obese (OC) and also 40 non-obese (NOC) healthy control subjects (in total 80 healthy control) were included in this study. Detailed history of the participants was questioned, and psychiatric rating scales were performed in the patient group. Biochemical parameters were measured in autoanalyser and inflammatory markers of atherosclerosis (TNFα, CD40L, MCP-1, PAI-1, P selectin, IL-6, hsCRP) were measured by ELISA method. As a result of the analysis, TNFα, CD40L, MCP-1, PAI-1, P-selectin levels were higher in the SSD patient group, whereas IL-6 levels were significantly lower in SSD patient group compared to the control group. When we compared the subgroups, hsCRP levels were significantly higher in OSSD patients group than NOSSD patients group, and higher in OC group than NOC group. PAI-1 levels were significantly lower, TNFα levels were significantly higher than OC group those of NOC group. P Selectin, MCP-1, TNFα and CD40L levels were significantly higher than the NOC group in patients with NOSSD, higher than OC in patient OSSD. IL-6 levels were also significantly higher in NOC group compared with NOSSD group, in OC group compared with OSSD group. PAI-1 levels were significantly lower than those of OSSD group in the OC group. The study which investigated by us the effect on weight gain of various inflammatory markers on SSD patients, we concluded that P-Selectin, IL-6, MCP-1 and CD40L levels may be related to disease process, PAI-1 and TNFα levels may be associated with the disease and obesity, and hsCRP may be related to only obesity.
Description
Keywords
Şizofreni spektrum bozukluğu, Obezite, İnflamasyon, Antipsikotik, Aterosklerotik kalp damar hastalığı, Schizophrenia spectrum disorder, Obesity, Inflammation, Antipsychotic, Atherosclerotic vascular disease
Citation
Açıkgöz, H. E. (2013). Obez ve obez olmayan şizofreni spektrum bozukluğu hastalarında kalp damar hastalığı risk faktörleri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.