Brain, Behavior, & Immunity - Health (Jul 2022)

Immuno-metabolic profile of patients with psychotic disorders and metabolic syndrome. Results from the FACE-SZ cohort

  • Marianne Foiselle,
  • Susana Barbosa,
  • Ophélia Godin,
  • Ching-Lien Wu,
  • Wahid Boukouaci,
  • Myrtille Andre,
  • Bruno Aouizerate,
  • Fabrice Berna,
  • Caroline Barau,
  • Delphine Capdevielle,
  • Pierre Vidailhet,
  • Isabelle Chereau,
  • Laetitia Davidovic,
  • Jean-Michel Dorey,
  • Caroline Dubertret,
  • Julien Dubreucq,
  • Catherine Faget,
  • Guillaume Fond,
  • Sylvain Leigner,
  • Pierre-Michel Llorca,
  • Jasmina Mallet,
  • David Misdrahi,
  • Emanuela Martinuzzi,
  • Christine Passerieux,
  • Romain Rey,
  • Baptiste Pignon,
  • Mathieu Urbach,
  • Franck Schürhoff,
  • Nicolas Glaichenhaus,
  • Marion Leboyer,
  • Ryad Tamouza,
  • F. Berna,
  • E. Haffen,
  • M. Leboyer,
  • P.M. Llorca,
  • F. Schürhoff,
  • V. Barteau,
  • S. Bensalem,
  • O. Godin,
  • H. Laouamri,
  • K. Souryis,
  • M. Leboyer,
  • I. Offerlin-Meyer,
  • B. Pignon,
  • F. Schürhoff,
  • A. Szöke,
  • B. Aouizerate,
  • A. Deloge,
  • D. Misdrahi,
  • E. Vilà,
  • O. Blanc,
  • I. Chéreau,
  • H. Denizot,
  • R.M. Honciuc,
  • D. Lacelle,
  • P.M. Llorca,
  • S. Pires,
  • C. Dubertret,
  • J. Mallet,
  • C. Portalier,
  • J. Dubreucq,
  • C. Fluttaz,
  • F. Gabayet,
  • C. Roman,
  • G. Chesnoy-Servanin,
  • T. D'Amato,
  • J.M. Dorey,
  • R. Rey,
  • A. Vehier,
  • C. Lançon,
  • C. Faget,
  • E. Metairie,
  • P. Peri,
  • F. Vaillant,
  • L. Boyer,
  • G. Fond,
  • F. Berna,
  • P. Vidailhet,
  • A. Zinetti-Bertschy,
  • D. Capdevielle,
  • H. Yazbek,
  • S. Esselin,
  • M. Jarroir,
  • C. Passerieux,
  • M. Urbach

Journal volume & issue
Vol. 22
p. 100436

Abstract

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Background: Metabolic syndrome (MetS) is a highly prevalent and harmful medical disorder often comorbid with psychosis where it can contribute to cardiovascular complications. As immune dysfunction is a key shared component of both MetS and schizophrenia (SZ), this study investigated the relationship between immune alterations and MetS in patients with SZ, whilst controlling the impact of confounding clinical characteristics including psychiatric symptoms and comorbidities, history of childhood maltreatment and psychotropic treatments. Method: A total of 310 patients meeting DSM-IV criteria for SZ or schizoaffective disorders (SZA), with or without MetS, were systematically assessed and included in the FondaMental Advanced Centers of Expertise for Schizophrenia (FACE-SZ) cohort. Detailed clinical characteristics of patients, including psychotic symptomatology, psychiatric comorbidities and history of childhood maltreatment were recorded and the serum levels of 18 cytokines were measured. A penalized regression method was performed to analyze associations between inflammation and MetS, whilst controlling for confounding factors. Results: Of the total sample, 25% of patients had MetS. Eight cytokines were above the lower limit of detection (LLOD) in more than 90% of the samples and retained in downstream analysis. Using a conservative Variable Inclusion Probability (VIP) of 75%, we found that elevated levels of interleukin (IL)-6, IL-7, IL-12/23 p40 and IL-16 and lower levels of tumor necrosis factor (TNF)-α were associated with MetS. As for clinical variables, age, sex, body mass index (BMI), diagnosis of SZ (not SZA), age at the first episode of psychosis (FEP), alcohol abuse, current tobacco smoking, and treatment with antidepressants and anxiolytics were all associated with MetS. Conclusion: We have identified five cytokines associated with MetS in SZ suggesting that patients with psychotic disorders and MetS are characterized by a specific “immuno-metabolic” profile. This may help to design tailored treatments for this subgroup of patients with both psychotic disorders and MetS, taking one more step towards precision medicine in psychiatry.

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