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Morera D, Miller BJ. Meta-analysis of a family history of diabetes in schizophrenia. Schizophr Res 2024; 264:90-94. [PMID: 38118263 DOI: 10.1016/j.schres.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 09/28/2023] [Accepted: 12/05/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVE Type 2 diabetes (T2DM) is common in patients with schizophrenia and non-affective psychosis. These patients also have an increased prevalence of a family history of T2DM. We performed a systematic review and meta-analysis of the association between a family history of T2DM and schizophrenia. METHOD We searched electronic databases from inception until July 2022 for studies of a family history of T2DM or gestational diabetes in patients with schizophrenia and controls. We performed random effects meta-analysis, calculating odds ratios (ORs) and 95 % confidence intervals (CI) and meta-regression analyses. RESULTS Nine studies were included, comprising 2953 patients with non-affective psychosis and 4484 controls. Schizophrenia was associated with an over two-fold increased odds of a family history of T2DM or gestational diabetes (OR = 2.18, 95 % CI 1.61-2.96, p < 0.01). In meta-regression analyses, age, sex, study quality score, and year of publication were all unrelated to the association. CONCLUSION We found that patients with schizophrenia had a 2.2-fold increased odds of a family history of T2DM versus controls. This association may be relevant to both the pathophysiology of schizophrenia and the reported increased risk of development of diabetes with antipsychotic treatment.
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Affiliation(s)
- Daley Morera
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
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Zhang Y, Zhou Y, Cheng Y, Carrillo-Larco RM, Fawad M, Chen S, Xu X. Association of birth and childhood weight with risk of chronic diseases and multimorbidity in adulthood. COMMUNICATIONS MEDICINE 2023; 3:105. [PMID: 37524882 PMCID: PMC10390459 DOI: 10.1038/s43856-023-00335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Little is known about the relationship between early life body size and occurrence of life-course multiple chronic diseases (multimorbidity). We aim to evaluate associations of birth weight, childhood body size, and their changes with the risks of chronic diseases and multimorbidity. METHODS This prospective cohort study included 246,495 UK Biobank participants (aged 40-69 years) who reported birth weight and childhood body size at 10 years old. Birth weight was categorized into low, normal, and high; childhood body size was reported as being thinner, average, or plumper. Multimorbidity was defined as having two or more of 38 chronic conditions retrieved from inpatient hospital data until 31 December, 2020. The Cox regression and quasi-Poisson mixed effects models were used to estimate the associations. RESULTS We show that 57,071 (23.2%) participants develop multimorbidity. Low birth weight (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.26-1.33), high birth weight (HR 1.02, 95% CI > 1.00-1.05), thinner (HR 1.21, 95% CI 1.18-1.23) and plumper body size (HR 1.06, 95% CI 1.04-1.09) are associated with higher risks of multimorbidity. A U-shaped relationship between birth weight and multimorbidity is observed. Changing to be thinner or plumper is associated with multimorbidity and many conditions, compared to changing to be average. CONCLUSIONS Low birth weight, being thinner and changing to have a thinner body size in childhood are associated with higher risks of developing multimorbidity and many chronic conditions in adulthood. Early monitoring and maintaining a normal body size in childhood could have life-course benefits for preventing multimorbidity above and beyond individual conditions.
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Affiliation(s)
- Yue Zhang
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yaguan Zhou
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yangyang Cheng
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Rodrigo M Carrillo-Larco
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Muhammad Fawad
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shu Chen
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, Australia
- School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia
| | - Xiaolin Xu
- School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
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Ursini G, Di Carlo P, Mukherjee S, Chen Q, Han S, Kim J, Deyssenroth M, Marsit CJ, Chen J, Hao K, Punzi G, Weinberger DR. Prioritization of potential causative genes for schizophrenia in placenta. Nat Commun 2023; 14:2613. [PMID: 37188697 PMCID: PMC10185564 DOI: 10.1038/s41467-023-38140-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Our earlier work has shown that genomic risk for schizophrenia converges with early life complications in affecting risk for the disorder and sex-biased neurodevelopmental trajectories. Here, we identify specific genes and potential mechanisms that, in placenta, may mediate such outcomes. We performed TWAS in healthy term placentae (N = 147) to derive candidate placental causal genes that we confirmed with SMR; to search for placenta and schizophrenia-specific associations, we performed an analogous analysis in fetal brain (N = 166) and additional placenta TWAS for other disorders/traits. The analyses in the whole sample and stratifying by sex ultimately highlight 139 placenta and schizophrenia-specific risk genes, many being sex-biased; the candidate molecular mechanisms converge on the nutrient-sensing capabilities of placenta and trophoblast invasiveness. These genes also implicate the Coronavirus-pathogenesis pathway and showed increased expression in placentae from a small sample of SARS-CoV-2-positive pregnancies. Investigating placental risk genes for schizophrenia and candidate mechanisms may lead to opportunities for prevention that would not be suggested by study of the brain alone.
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Affiliation(s)
- Gianluca Ursini
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Pasquale Di Carlo
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Sreya Mukherjee
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Qiang Chen
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Shizhong Han
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Jiyoung Kim
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
| | - Maya Deyssenroth
- Departments of Environmental Medicine and Public Health, Icahn School of Public Health at Mount Sinai, New York, NY, USA
| | - Carmen J Marsit
- Departments of Environmental Health and Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jia Chen
- Departments of Environmental Medicine and Public Health, Icahn School of Public Health at Mount Sinai, New York, NY, USA
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giovanna Punzi
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- McKusick-Nathans Institute, Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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4
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Yang C, Hou X, Ma X, Wu D. Frailty among inpatients with Schizophrenia: Status, influencing factors, and their correlation with quality of life. Front Psychiatry 2022; 13:1067260. [PMID: 36684022 PMCID: PMC9846125 DOI: 10.3389/fpsyt.2022.1067260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aimed to understand frailty and its influencing factors in inpatients with Schizophrenia in Chengdu and to explore correlations between frailty and quality of life. METHODS From May to July 2022, inpatients with Schizophrenia were surveyed using a general information questionnaire, frailty phenotype (FP) scoring, the Self-Rating Depression Scale (SDS), the Mini-Mental State Examination (MMSE), and the SZ Quality of Life Scale (SQLS). Multivariate logistic regression was conducted to assess factors influencing frailty and multivariate linear regression was conducted to assess the factors influencing quality of life. RESULTS A total of 556 hospitalized patients with Schizophrenia were included and divided into three groups according to the degree of frailty, of which 153 cases (27.5%) were without frailty, 348 cases (62.6%) were in early frailty, and 55 cases (9.9%) were in frailty. Univariate analysis of age, history of falls during hospitalization, polypharmacy, compulsory treatment during hospitalization, self-reported health status, activity level, cognitive impairment, depressive symptoms, "psychology and society," "motivation and energy" and "symptoms and side-effects" showed statistically significant differences between the groups. Multinomial logistic regression showed that age, BMI, self-reported health, activity, cognitive impairment, motivation and energy, and symptoms and side-effects were influencing factors for frailty in hospitalized patients with Schizophrenia. Correlation analysis shows that frailty score positively correlated with SQLS score. CONCLUSION We found that frailty was prevalent and that frailty was positively correlated with SQLS scores in inpatients with Schizophrenia. To effectively manage the frailty of hospitalized patients with Schizophrenia, medical staff should pay attention to its influencing factors and quality of life.
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Affiliation(s)
- Cui Yang
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Xiaofeng Hou
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Xiucheng Ma
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Magnusson Å, Laivuori H, Loft A, Oldereid NB, Pinborg A, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The Association Between High Birth Weight and Long-Term Outcomes-Implications for Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. Front Pediatr 2021; 9:675775. [PMID: 34249812 PMCID: PMC8260985 DOI: 10.3389/fped.2021.675775] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/19/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Studies have shown that the prevalence of children born with high birth weight or large for gestational age (LGA) is increasing. This is true for spontaneous pregnancies; however, children born after frozen embryo transfer (FET) as part of assisted reproductive technology (ART) also have an elevated risk. In recent years, the practice of FET has increased rapidly and while the perinatal and obstetric risks are well-studied, less is known about the long-term health consequences. Objective: The aim of this systematic review was to describe the association between high birth weight and LGA on long-term child outcomes. Data Sources: PubMed, Scopus, and Web of Science were searched up to January 2021. Exposure included high birth weight and LGA. Long-term outcome variables included malignancies, psychiatric disorders, cardiovascular disease, and diabetes. Study Selection: Original studies published in English or Scandinavian languages were included. Studies with a control group were included while studies published as abstracts and case reports were excluded. Data Extraction: The methodological quality, in terms of risk of bias, was assessed by pairs of reviewers. Robins-I (www.methods.cochrane.org) was used for risk of bias assessment in original articles. For systematic reviews, AMSTAR (www.amstar.ca) was used. For certainty of evidence, we used the GRADE system. The systematic review followed PRISMA guidelines. When possible, meta-analyses were performed. Results: The search included 11,767 articles out of which 173 met the inclusion criteria and were included in the qualitative analysis, while 63 were included in quantitative synthesis (meta-analyses). High birth weight and/or LGA was associated with low to moderately elevated risks for certain malignancies in childhood, breast cancer, several psychiatric disorders, hypertension in childhood, and type 1 and 2 diabetes. Conclusions: Although the increased risks for adverse outcome in offspring associated with high birth weight and LGA represent serious health effects in childhood and in adulthood, the size of these effects seems moderate. The identified risk association should, however, be taken into account in decisions concerning fresh and frozen ART cycles and is of general importance in view of the increasing prevalence in high birthweight babies.
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Affiliation(s)
- Åsa Magnusson
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Anne Loft
- Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Anja Pinborg
- Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Max Petzold
- Swedish National Data Service & Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Trondheim, Norway.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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6
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Liuhanen J, Suvisaari J, Kajantie E, Miettunen J, Sarin AP, Järvelin MR, Lönnqvist J, Veijola J, Paunio T. Interaction between compound genetic risk for schizophrenia and high birth weight contributes to social anhedonia and schizophrenia in women. Psychiatry Res 2018; 259:148-153. [PMID: 29049906 DOI: 10.1016/j.psychres.2017.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 08/24/2017] [Accepted: 10/08/2017] [Indexed: 11/16/2022]
Abstract
Schizophrenia is a highly heritable disease, but despite extensive study, its genetic background remains unresolved. The lack of environmental measures in genetic studies may offer some explanation. In recent Finnish studies, high birth weight was found to increase the risk for familial schizophrenia. We examined the interaction between a polygenic risk score for schizophrenia and high birth weight on social anhedonia and schizophrenia in a general population birth cohort. The study sample included 4223 participants from the 1966 Northern Finland Birth Cohort. As a replication sample we used 256 participants from a systematically collected sample of Finnish schizophrenia families. The polygenic risk score comprised of variants published in the large genome-wide meta-analysis for schizophrenia. We found the association between the polygenic risk score and social anhedonia stronger among those with high birth weight, and the same phenomenon was seen for schizophrenia among women, suggesting a gene-environment interaction. Similar results were found within the replication sample. Our results suggest a role for gene-environment interactions in assessing the risk of schizophrenia. Failure to take environmental effects into account may be one of the reasons why identifying significant SNPs for schizophrenia in genome-wide studies has been challenging.
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Affiliation(s)
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynaecology, Oulu University Central Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Antti-Pekka Sarin
- National Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Biocenter Oulu, University of Oulu, Oulu, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Jouko Lönnqvist
- National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Tiina Paunio
- National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
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7
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Hannon PR, Niermann S, Flaws JA. Acute Exposure to Di(2-Ethylhexyl) Phthalate in Adulthood Causes Adverse Reproductive Outcomes Later in Life and Accelerates Reproductive Aging in Female Mice. Toxicol Sci 2015; 150:97-108. [PMID: 26678702 DOI: 10.1093/toxsci/kfv317] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Humans are ubiquitously exposed to di(2-ethylhexyl) phthalate (DEHP), which is an environmental toxicant incorporated in consumer products. Studies have shown that DEHP targets the ovary to disrupt essential processes required for reproductive and nonreproductive health. Specifically, 10-day exposure to DEHP accelerates primordial follicle recruitment and disrupts estrous cyclicity in adult mice. However, it is unknown if these effects on folliculogenesis and cyclicity following acute DEHP exposure can have permanent effects on reproductive outcomes. Further, the premature depletion of primordial follicles can cause early reproductive senescence, and it is unknown if acute DEHP exposure accelerates reproductive aging. This study tested the hypothesis that acute DEHP exposure causes infertility, disrupts estrous cyclicity, alters hormone levels, and depletes follicle numbers by inducing atresia later in life, leading to accelerated reproductive aging. Adult CD-1 mice were orally dosed with vehicle or DEHP (20 μg/kg/day-500 mg/kg/day) daily for 10 days, and reproductive outcomes were assessed at 6 and 9 months postdosing. Acute DEHP exposure significantly altered estrous cyclicity compared to controls at 6 and 9 months postdosing by increasing the percentage of days the mice were in estrus and metestrus/diestrus, respectively. DEHP also significantly decreased inhibin B levels compared to controls at 9 months postdosing. Further, DEHP significantly increased the BAX/BCL2 ratio in primordial follicles leading to a significant decrease in primordial and total follicle numbers compared to controls at 9 months postdosing. Collectively, the adverse effects present following acute DEHP exposure persist later in life and are consistent with accelerated reproductive aging.
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Affiliation(s)
- Patrick R Hannon
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, 2001 S. Lincoln Ave., Urbana, Illinois 61802
| | - Sarah Niermann
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, 2001 S. Lincoln Ave., Urbana, Illinois 61802
| | - Jodi A Flaws
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, 2001 S. Lincoln Ave., Urbana, Illinois 61802
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Wegelius A, Pankakoski M, Tomppo L, Lehto U, Lönnqvist J, Suvisaari J, Paunio T, Hennah W. An interaction between NDE1 and high birth weight increases schizophrenia susceptibility. Psychiatry Res 2015; 230:194-9. [PMID: 26350705 DOI: 10.1016/j.psychres.2015.08.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/08/2015] [Accepted: 08/30/2015] [Indexed: 01/05/2023]
Abstract
Pre- and perinatal environmental factors have been shown to increase schizophrenia risk particularly when combined with genetic liability. The investigation of specific gene environment interactions in the etiology of psychiatric disorders has gained momentum. We used multivariate GEE regression modeling to investigate the interaction between genes of the DISC1 pathway and birth weight, in relation to schizophrenia susceptibility in a Finnish schizophrenia family cohort. The study sample consisted of 457 subjects with both genotype and birth weight information. Gender and place of birth were adjusted for in the models. We found a significant interaction between birth weight and two NDE1 markers in relation to increased schizophrenia risk: a four SNP haplotype spanning NDE1 (b=1.26, SE=0.5, p=0.012) and one of its constituent SNPs rs4781678 (b=1.33, SE=0.51, p=0.010). Specifically, high birth weight (>4000g) was associated with increased schizophrenia risk among subjects homozygous for the previously identified risk alleles. The study was based on a family study sample with high genetic loading for schizophrenia and thus our findings cannot directly be generalized as representing the general population. Our results suggest that the functions mediated by NDE1 during the early stages of neurodevelopment are susceptible to the additional disruptive effects of pre- and perinatal environmental factors associated with high birth weight, augmenting schizophrenia susceptibility.
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Affiliation(s)
- Asko Wegelius
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
| | - Maiju Pankakoski
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland
| | - Liisa Tomppo
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ulriika Lehto
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland
| | - Jouko Lönnqvist
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Tampere, Finland
| | - Tiina Paunio
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland; Development of Work and Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - William Hennah
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
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Torniainen M, Wegelius A, Tuulio-Henriksson A, Lönnqvist J, Suvisaari J. Both low birthweight and high birthweight are associated with cognitive impairment in persons with schizophrenia and their first-degree relatives. Psychol Med 2013; 43:2361-2367. [PMID: 23360614 DOI: 10.1017/s0033291713000032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Both low birthweight and high birthweight have been associated with an increased risk for schizophrenia and cognitive impairments in the general population. We assessed the association between birthweight and cognitive performance in persons with schizophrenia and their unaffected first-degree relatives. METHOD We investigated a population-based family sample comprising persons with schizophrenia (n = 142) and their unaffected first-degree relatives (n = 277). Both patients and relatives were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) and a comprehensive neuropsychological test battery was administered. Information on birthweight was obtained from obstetric records. We used generalized estimating equation (GEE) models to investigate the effect of birthweight, as a continuous variable, on cognitive functioning, adjusting for within-family correlation and relevant covariates. RESULTS Both low birthweight and high birthweight were associated with lower performance in visuospatial reasoning, processing speed, set-shifting and verbal and visual working memory among persons with schizophrenia and their unaffected first-degree relatives compared to individuals with birthweight in the intermediate range. The group × birthweight interactions were non-significant. CONCLUSIONS Both low birthweight and high birthweight are associated with deficits in cognition later in life. Schizophrenia does not seem to modify the relationship between birthweight and cognition in families with schizophrenia.
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Affiliation(s)
- M Torniainen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
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10
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Nielsen PR, Mortensen PB, Dalman C, Henriksen TB, Pedersen MG, Pedersen CB, Agerbo E. Fetal growth and schizophrenia: a nested case-control and case-sibling study. Schizophr Bull 2013; 39:1337-42. [PMID: 23236080 PMCID: PMC3796081 DOI: 10.1093/schbul/sbs148] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The association between low birth weight and schizophrenia has been suggested by many studies. Small for gestational age (SGA) is a measure used as a proxy for intrauterine growth restriction. We aim to examine if children who are born SGA are at increased risk of developing schizophrenia and whether an association may be explained by factors shared among siblings. We linked 3 population-based registers: the Danish National Medical Birth Register, the Danish Psychiatric Central Register, and the Danish Civil Registration register to identify all persons born between 1978 and 2000. A nested case-control study and a case-sibling study design were used. There were 4650 cases of schizophrenia. Incidence rate ratios (IRRs) were estimated using conditional logistic regression. SGA was defined as the lowest 10th birth weight percentile for a given sex and gestational age. SGA was associated with an IRR of 1.23 (95% CI: 1.11-1.37) for schizophrenia in the case-control study. An IRR of 1.28 (95% CI: 0.97-1.68) was found in the case-sibling study. There is a modest association between SGA and schizophrenia. Our results indicate that this association is due to an independent effect of factors associated with low birth weight for gestational age per se, rather than other factors shared by siblings.
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Affiliation(s)
- Philip Rising Nielsen
- To whom correspondence should be addressed; National Centre for Register-Based Research, Aarhus University, Taasingegade 1, DK-8000 Aarhus C, Denmark; tel: +45-8716-5753, fax: +45-8716-4601, e-mail:
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11
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Lee M, Rebora P, Valsecchi MG, Czene K, Reilly M. A unified model for estimating and testing familial aggregation. Stat Med 2013; 32:5353-65. [DOI: 10.1002/sim.6025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 09/24/2013] [Accepted: 09/30/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Myeongjee Lee
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; 17177 Stockholm Sweden
| | - Paola Rebora
- Center of Biostatistics for Clinical Epidemiology, Department of Health Science; University of Milano-Bicocca; Monza Italy
| | - Maria Grazia Valsecchi
- Center of Biostatistics for Clinical Epidemiology, Department of Health Science; University of Milano-Bicocca; Monza Italy
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; 17177 Stockholm Sweden
| | - Marie Reilly
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; 17177 Stockholm Sweden
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Suvisaari JM, Taxell-Lassas V, Pankakoski M, Haukka JK, Lönnqvist JK, Häkkinen LT. Obstetric complications as risk factors for schizophrenia spectrum psychoses in offspring of mothers with psychotic disorder. Schizophr Bull 2013; 39:1056-66. [PMID: 23002182 PMCID: PMC3756781 DOI: 10.1093/schbul/sbs109] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Obstetric complications have predicted future development of schizophrenia in previous studies, but they are also more common in mothers with schizophrenia. The aims of this study were to compare the occurrence of obstetric complications in children of mothers with schizophrenia spectrum psychoses and control children, and to investigate whether obstetric complications predicted children's psychiatric morbidity. METHOD The Helsinki High-Risk (HR) Study monitors females born between 1916 and 1948 and treated for schizophrenia spectrum disorders in Helsinki psychiatric hospitals, their offspring born between 1941 and 1977, and controls. We examined information on obstetric complications and neonatal health of 271 HR and 242 control offspring. We compared the frequency of obstetric complications and neonatal health problems in the HR group vs controls and in HR children who later developed psychotic disorders vs healthy HR children. A Cox regression model was used to assess whether problems in pregnancy or delivery predicted psychiatric morbidity within the HR group. RESULTS Few differences between HR and control offspring were found in obstetric complications. Within the HR group, infections (hazard rate ratio [HRR] 3.73, 95% CI 1.27-11.01), hypertension during pregnancy (HRR 4.10, 95% CI 1.15-14.58), and placental abnormalities (HRR 4.09, 95% CI 1.59-10.49) were associated with elevated risk of schizophrenia spectrum psychoses. CONCLUSIONS Common medical problems during pregnancy were associated with increased risk of schizophrenia spectrum psychoses in offspring of mothers with schizophrenia spectrum psychoses. These results underline the role of the prenatal period in the development of schizophrenia and the importance of careful monitoring of pregnancies of mothers with psychotic disorder.
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Affiliation(s)
- Jaana M. Suvisaari
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland;,These authors contributed equally to the manuscript.,To whom correspondence should be addressed; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, FIN-00271 Helsinki, Finland; tel: +358-295248539, fax: +358-295247155,
| | - Virpi Taxell-Lassas
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland;,These authors contributed equally to the manuscript
| | - Maiju Pankakoski
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Jari K. Haukka
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Jouko K. Lönnqvist
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Laura T. Häkkinen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland;,Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Assessment of cardiovascular disease risk in patients with schizophrenia spectrum disorders in German psychiatric hospitals: results of the pharmacoepidemiologic CATS study. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1283-8. [PMID: 23515714 DOI: 10.1007/s00127-013-0676-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 03/02/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE Patients with severe mental illness are at high risk for metabolic and cardiac disorders. Thus, monitoring of cardiovascular risks is imperative and schedules for screening for lipids, glucose, body mass index (BMI), waist-hip ratio and blood pressure have been developed. We intended to analyze screening for metabolic disorders in German patients with schizophrenia spectrum disorders in routine psychiatric care. METHODS We included 674 patients with any F2 diagnosis in out- and inpatient settings and analyzed metabolic screening procedures as practiced under conditions of usual care. RESULTS Except BMI (54 %), all other values were documented only in a minority of patients: waist circumference (23 %), cholesterol (28 %), fasting glucose (19 %), triglycerides (25 %) and blood pressure (37 %). We found evidence for less than perfect quality of blood pressure measures. The group of patients who met the individual metabolic syndrome ATP III criteria was comparable to the US CATIE trial. CONCLUSIONS We conclude that frequency and quality of metabolic monitoring in German in- and outpatients settings are not in accordance with the respective recommendations. Similar to previous reports we found evidence for a high prevalence of metabolic disturbances in German patients with schizophrenia spectrum disorders.
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Interaction between parental psychosis and risk factors during pregnancy and birth for schizophrenia - the Northern Finland 1966 Birth Cohort study. Schizophr Res 2013; 145:56-62. [PMID: 23375940 DOI: 10.1016/j.schres.2012.12.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 11/16/2012] [Accepted: 12/17/2012] [Indexed: 02/04/2023]
Abstract
Our aim was to investigate the association between parental psychosis and potential risk factors for schizophrenia and their interaction. We evaluated whether the factors during pregnancy and birth have a different effect among subjects with and without a history of parental psychosis and whether parental psychosis may even explain their effects on the risk of schizophrenia. The sample comprised 10,526 individuals from the Northern Finland 1966 Birth Cohort. A total of 150 (1.4%) cohort members had schizophrenia by the age of 44 years, of them 18 (12.0%) had a parent with a history of psychosis. In non-psychotic cohort members, this figure was 495 (4.8%). In the parental psychosis group, significant early biological risk factors for schizophrenia included high birth weight (hazard ratio, HR 11.4; 95% confidence interval 3.3-39.7) and length (HR 4.1; 1.3-12.5), high birth weight in relation to gestational age (HR 3.2; 1.1-9.0), and high maternal age (HR 2.6.; 1.0-6.7). High birth weight and length and high maternal education had a significant interaction with parental psychosis. The presence of any biological risk factor increased the risk of schizophrenia significantly only among the parental psychosis group (HR 4.0; 1.5-10.5), whereas the presence of any psychosocial risk factor had no interaction with parental psychosis. Parental psychosis can act as an effect modifier on early risk factors for schizophrenia. Evaluation of the mechanisms behind the risk factors should, therefore, include consideration of the parental history of psychosis.
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An association between both low and high birth weight and increased disorganized and negative symptom severity in schizophrenia and other psychoses. Psychiatry Res 2013; 205:18-24. [PMID: 22985549 DOI: 10.1016/j.psychres.2012.08.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 08/16/2012] [Accepted: 08/25/2012] [Indexed: 11/21/2022]
Abstract
Longitudinal cohort studies have implicated an association between both low and high birth weight and increased schizophrenia risk. In this study, we investigated the effect of birth weight on the symptom severity of psychotic disorders including schizophrenia in a Finnish schizophrenia family study sample. We used a multivariate GEE (General Estimating Equation) regression model to investigate the association of birth weight and symptom severity in 282 subjects with a primary psychotic disorder, 178 of whom had a diagnosis of schizophrenia. The Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) were used as a measure of symptom severity. Sex, place of birth and year of birth were adjusted for in the model. Both low and high birth weight were associated with more severe symptoms with respect to bizarre behaviour, affective flattening and attentional impairment. In addition, low birth weight was associated with more severe symptoms with respect to positive formal thought. Our findings suggest that both low and high birth weight can influence the symptom severity of psychotic disorders. Our results implicate an association between both low and high birth weight and disorganized and negative symptoms.
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Long-term influence of normal variation in neonatal characteristics on human brain development. Proc Natl Acad Sci U S A 2012; 109:20089-94. [PMID: 23169628 DOI: 10.1073/pnas.1208180109] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
It is now recognized that a number of cognitive, behavioral, and mental health outcomes across the lifespan can be traced to fetal development. Although the direct mediation is unknown, the substantial variance in fetal growth, most commonly indexed by birth weight, may affect lifespan brain development. We investigated effects of normal variance in birth weight on MRI-derived measures of brain development in 628 healthy children, adolescents, and young adults in the large-scale multicenter Pediatric Imaging, Neurocognition, and Genetics study. This heterogeneous sample was recruited through geographically dispersed sites in the United States. The influence of birth weight on cortical thickness, surface area, and striatal and total brain volumes was investigated, controlling for variance in age, sex, household income, and genetic ancestry factors. Birth weight was found to exert robust positive effects on regional cortical surface area in multiple regions as well as total brain and caudate volumes. These effects were continuous across birth weight ranges and ages and were not confined to subsets of the sample. The findings show that (i) aspects of later child and adolescent brain development are influenced at birth and (ii) relatively small differences in birth weight across groups and conditions typically compared in neuropsychiatric research (e.g., Attention Deficit Hyperactivity Disorder, schizophrenia, and personality disorders) may influence group differences observed in brain parameters of interest at a later stage in life. These findings should serve to increase our attention to early influences.
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