Metabolic syndrome in schizophrenia patients associated with poor premorbid school performance in early adolescence

Nijs, Jessica de; Pet, M. A.

doi:10.1111/acps.12528

Cited by 12 publications

(9 citation statements)

References 44 publications

(50 reference statements)

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“…Besides the profound effects metabolic syndrome and type II diabetes have on premature mortality in schizophrenia, they have also been associated with poor school performance in adolescence (de Nijs and Pet, 2016), sensory gating deficits (Micoulaud-Franchi et al, 2015) and other neurocognitive outcomes (Lindenmayer et al, 2012; Goughari et al, 2015). …”

Section: Schizophrenia Metabolic Syndrome and Type II Diabetesmentioning

confidence: 99%

Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?

et al. 2017

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Growing interest in gut and digestive processes and their potential link to brain and peripheral based inflammation or biobehavioral phenotypes has led to an increasing number of basic and translational scientific reports focused on the role of gut microbiota within the context of neuropsychiatric disorders. However, the effect of dietary modification on specific gut metabolites, in association with immune, metabolic, and psychopathological functioning in schizophrenia spectrum disorders has not been well characterized. The short chain fatty acids (SCFA) acetate, butyrate, and propionate, major metabolites derived from fermentation of dietary fibers by gut microbes, interact with multiple immune and metabolic pathways. The specific pathways that SCFA are thought to target, are dysregulated in cardiovascular disease, type II diabetes, and systemic inflammation. Most notably, these disorders are consistently linked to an attenuated lifespan in schizophrenia. Although, unhealthy dietary intake patterns and increased prevalence of immune and metabolic dysfunction has been observed in people with schizophrenia; dietary interventions have not been well utilized to target immune or metabolic illness. Prior schizophrenia patient trials primarily focused on the effects of gluten free diets. Findings from these studies indicate that a diet avoiding gluten benefits a limited subset of patients, individuals with celiac disease or non-celiac gluten sensitivity. Therefore, alternative dietary and nutritional modifications such as high-fiber, Mediterranean style, diets that enrich the production of SCFA, while being associated with a minimal likelihood of adverse events, may improve immune and cardiovascular outcomes linked to premature mortality in schizophrenia. With a growing literature demonstrating that SCFA can cross the blood brain barrier and target key inflammatory and metabolic pathways, this article highlights enriching dietary intake for SCFA as a potential adjunctive therapy for people with schizophrenia.

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Section: Schizophrenia Metabolic Syndrome and Type II Diabetesmentioning

confidence: 99%

Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?

et al. 2017

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“…Overall, eleven studies (Wysokinski, 2013, Takayanagi et al, 2012, Saatcioglu et al, 2016, Sicras-Mainar et al, 2015, Chen et al, 2013, Chen et al, 2014, Ogawa et al, 2011, de Nijs et al, 2016, Dickinson et al, 2008, Gonzalez, 2015, Pelayo-Teran, 2011 were selected for detailed analysis. Tables 1, 2 and 3 demonstrate a comparison of the included studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…Four studies (Dickinson et al, 2008, Ogawa et al, 2011, Saatcioglu et al, 2016, Takayanagi et al, 2012 specified an upper age limit of 65, one a limit of 50 (de Nijs et al, 2016), and another specified an upper age limit of 42 (Chen et al, 2013).…”

Section: Demographicsmentioning

confidence: 99%

“…Another study (de Nijs et al, 2016) Another study (Dickinson et al, 2008) reported a negative correlation between HbA1c and cognition in patients with concurrent schizophrenia and diabetes (δ=0.26 p=0.01) and an included conference abstract (Gonzalez, 2015) found that FPG was significantly related to cognitive impairment in their preliminary study (no statistical data provided in abstract).…”

Section: Cognitionmentioning

confidence: 99%

“…One might argue that tests of negative symptomatology may share a cross-over with tests showing impairment in cognition, and out of the four included studies that measured the association between cognition and dysglycaemia (Takayanagi et al, 2012, de Nijs et al, 2016, Dickinson et al, 2008, Gonzalez, 2015, all four found an association which remained after controlling for the presence of antipsychotic medication, reporting that severity of glycaemia is related to worse cognitive function. Of note, two of these studies featured the largest sample sizes (Takayanagi et al, 2012, Dickinson et al, 2008 of all the included studies in our analyses, and both presented mean HbA1c values which were not statistically significantly different.…”

Section: Main Findingsmentioning

confidence: 99%

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Associated illness severity in schizophrenia and diabetes mellitus: A systematic review

Perry

Salimkumar

Green

et al. 2017

Psychiatry Research

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(2017) Associated illness severity in schizophrenia and diabetes mellitus : a systematic review. Psychiatry research. Permanent WRAP URL:http://wrap.warwick.ac.uk/89163 Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. ResultsEleven observational studies were included in the analysis. Ten presented evidence in support of an association between schizophrenia severity and dysglycaemia. This association appeared particularly strong regarding negative symptomatology and impaired cognitive function, between which there may be some overlap. Studies examining positive symptomatology returned mixed results. ConclusionWhilst study design varied amongst the included studies, the results suggest that further work examining the effect of hyperglycaemia on schizophrenia severity may be relevant, particularly longitudinal studies assessing negative symptomatology and cognitive function. To the authors' knowledge, this is the first systematic review conducted to address this question.

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Association Between Cardiovascular Risk Factors and Cognitive Impairment in People With Schizophrenia

et al. 2021

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IMPORTANCE Schizophrenia is associated with cognitive dysfunction and cardiovascular risk factors, including metabolic syndrome (MetS) and its constituent criteria. Cognitive dysfunction and cardiovascular risk factors can worsen cognition in the general population and may contribute to cognitive impairment in schizophrenia. OBJECTIVETo study the association between cognitive dysfunction and cardiovascular risk factors and cognitive impairment in individuals with schizophrenia.DATA SOURCES A search was conducted of Embase, Scopus, MEDLINE, PubMed, and Cochrane databases from inception to February 25, 2020, using terms that included synonyms of schizophrenia AND metabolic adversities AND cognitive function. Conference proceedings, clinical trial registries, and reference lists of relevant publications were also searched.STUDY SELECTION Studies were included that (1) examined cognitive functioning in patients with schizophrenia or schizoaffective disorder; (2) investigated the association of cardiovascular disease risk factors, including MetS, diabetes, obesity, overweight, obesity or overweight, hypertension, dyslipidemia, and insulin resistance with outcomes; and (3) compared cognitive performance of patients with schizophrenia/schizoaffective disorder between those with vs without cardiovascular disease risk factors.DATA EXTRACTION AND SYNTHESIS Extraction of data was conducted by 2 to 3 independent reviewers per article. Data were meta-analyzed using a random-effects model. MAIN OUTCOMES AND MEASURESThe primary outcome was global cognition, defined as a test score using clinically validated measures of overall cognitive functioning.RESULTS Twenty-seven studies involving 10 174 individuals with schizophrenia were included. Significantly greater global cognitive deficits were present in patients with schizophrenia who had MetS (13 studies; n = 2800; effect size [ES] = 0.31; 95% CI, 0.13-0.50; P = .001), diabetes (8 studies; n = 2976; ES = 0.32; 95% CI, 0.23-0.42; P < .001), or hypertension (5 studies; n = 1899; ES = 0.21; 95% CI, 0.11-0.31; P < .001); nonsignificantly greater deficits were present in patients with obesity (8 studies; n = 2779; P = .20), overweight (8 studies; n = 2825; P = .41), and insulin resistance (1 study; n = 193; P = .18). Worse performance in specific cognitive domains was associated with cognitive dysfunction and cardiovascular risk factors regarding 5 domains in patients with diabetes (ES range, 0.23 [95% CI, 0.12-0.33] to 0.40 [95% CI, 0.20-0.61]) and 4 domains with MetS (ES range, 0.15 [95% CI, 0.03-0.28] to 0.40 [95% CI, 0.20-0.61]) and hypertension (ES range, 0.15 [95% CI, 0.04-0.26] to 0.27 [95% CI, 0.15-0.39]). CONCLUSIONS AND RELEVANCEIn this systematic review and meta-analysis, MetS, diabetes, and hypertension were significantly associated with global cognitive impairment in people with schizophrenia.

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Metabolic syndrome in schizophrenia patients associated with poor premorbid school performance in early adolescence

Cited by 12 publications

References 44 publications

Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?

Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?

Associated illness severity in schizophrenia and diabetes mellitus: A systematic review

Association Between Cardiovascular Risk Factors and Cognitive Impairment in People With Schizophrenia

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