Sex Differences in the Relationship Between Schizophrenia and the Development of Cardiovascular Disease

Cardiovascular comorbidities in Chinese inpatients with schizophrenia spectrum disorders

Cardiovascular diseases (CVDs) are the leading cause of premature mortality in patients with schizophrenia spectrum disorders (SSDs). However, the detailed categorization of these conditions remains insufficiently explored. This study aims to identify CVDs comorbidity patterns among inpatients with SSDs and to investigate associated factors. Electronic medical records (EMRs) data from three neuropsychiatric hospitals (2015-2023) in China was conducted. Comorbidity patterns were revealed through latent class analysis (LCA), and multinomial logit analysis were utilized to evaluate the effect of factors on these patterns, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Among the 2830 inpatients with SSD, four distinct comorbidity patterns were identified based on their dominant characteristics: low-risk CVDs (47.86%), primary hypertension (30.15%), heart failure (12.99%), and cardiac valve and vascular disorders (8.99%). Compared to the low-risk CVD group, male patients demonstrated a higher probability of primary hypertension (OR = 1.15) and heart failure (OR = 5.36). Significant associations were observed between comorbid CVDs and the use of typical antipsychotics, atypical antipsychotics, anxiolytics and sedatives, antidepressants, and mood stabilizers. Notably, perphenazine (OR = 22.06) and chlorpromazine hydrochloride (OR = 7.09) were strongly linked to comorbid heart failure. Among Chinese patients with SSDs, four distinct CVD comorbidity patterns were identified, with hypertension and heart failure displaying strong specificity. Variations in demographic characteristics and psychotropic medication use provide valuable insights for treatment and management.

Meta-analyses of epigenetic age acceleration and GrimAge components of schizophrenia or first-episode psychosis

Schizophrenia is a common chronic psychiatric disorder that causes age-related dysfunction. The life expectancy in patients with schizophrenia is ≥10 years shorter than that in the general population because of the higher risk of other diseases, such as cardiovascular diseases. Aging studies based on DNA methylation status have received considerable attention. Several epigenetic age accelerations and predicted values of aging-related proteins (GrimAge and GrimAge2 components) have been analyzed in multiple diseases. However, no studies have investigated up to GrimAge and GrimAge2 components between patients with schizophrenia and controls. Therefore, we aimed to conduct multiple regression analyses to investigate the association between schizophrenia and epigenetic age accelerations and GrimAge and GrimAge2 components in seven cohorts. Furthermore, we included patients with first-episode psychosis whose illness duration was often shorter than schizophrenia in our analysis. We integrated these results with meta-analyses, noting the acceleration of GrimAge, GrimAge2, and DunedinPACE, and increase in adrenomedullin, beta-2 microglobulin, cystatin C, and plasminogen activation inhibitor-1 levels, in patients with schizophrenia or first-episode psychosis. These results corroborated the finding that patients with schizophrenia had an increased risk of diabetes, cardiovascular disease, and cognitive dysfunction from a biological perspective. Patients with schizophrenia and first-episode psychosis showed differences in the results when compared with controls. Such analyses may lead to the development of novel therapeutic targets to patients with schizophrenia or relevant diseases from the perspective of aging in the future.