A total number of 29 untreated patients with first episode psychosis, 30 chronic schizophrenia and 29 randomly selected weight- and body mass index-matched healthy volunteers were included. The Diagnostic and Statistical Manual of Mental Disorders 4th edition, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale were applied to the patient groups. The enzyme-linked immunosorbent assay method was used to measure plasma apelin, visfatin and resistin levels.
There was no difference in age, marital status, occupation, and BMI between the groups. Plasma apelin levels were significantly higher in first episode psychosis group than chronic schizophrenia and control group. There was no statistically significant difference in plasma visfatin levels between the groups: first episode psychosis group, chronic schizophrenia and control group. Plasma resistin levels were higher in both first episode psychosis group and chronic schizophrenia group than the control group. There was no statistically significant correlation between plasma apelin and resistin levels and total PANSS scores in the group of patients.
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To our knowledge, this study is the first which investigates the plasma apelin, visfatin and resistin levels in patients with first episode psychosis and chronic schizophrenia. Based on the results of this study, apelin and resistin may be related with some central nervous system pathologies, including the severity of a psychiatric disorder.
It is known that inflammatory process plays a role in the etiology of schizophrenia. In this study, we aimed to investigate the possible relationship between first episode psychosis, chronic schizophrenia and plasma concentrations of apelin, visfatin and resistin in the inflammatory process.
This study included a total of 29 untreated patients with first episode psychosis, 30 chronic schizophrenia and 29 randomly selected weight- and body mass index-matched healthy volunteers admitted to Mustafa Kemal University, Faculty of Medicine, Training and Research Hospital, Psychiatry outpatient clinic were included. Three groups were formed for the study. The first group consisted of patients with non-effective drug-naive first episode psychosis. Second group consisted of patients with chronic schizophrenia. And the third group was healthy control group. Diagnoses of the patients were made in accordance with the Diagnostic and Statistical Manual of Mental Disorders 4th edition schizophrenia diagnosis criteria. The patients with the first attack who take antipsychotics and patients with affective psychosis were excluded from the study. Individuals with any other chronic disease such as diabetes mellitus, hypertension, hyperlipidemia, or neurological disorders, who were under 18 years of age and those over 65 years of age and pregnant women in the menstrual cycle were excluded from the study. People with any additional psychiatric condition were excluded; also those with mental retardation and those with organic brain damage were not included in the study. For the control group, people with any psychiatric or medical condition were excluded from the study. Before enrollment, the relationship between plasma apelin, visfatin and resistin levels and socio-demographic characteristics was examined. A written informed consent was obtained from each participant. The study protocol was research ethics approval was obtained from the Ethics Committee of the Medical School of Mustafa Kemal University (no. 201335). The study was conducted in accordance with the principles of the Declaration of Helsinki.
Statistically significant differences were found between the groups for apelin levels (p = 0.026; χ2 = 7.338). According to pairwise comparisons; apelin levels of the first episode psychosis patients were significantly higher than the chronic schizophrenia and control group patients (p = 0.034; p = 0.012, respectively). There was no significant difference in apelin levels between the chronic schizophrenia and control group patients (p = 0.644). There was no statistically significant difference in visfatin levels between the groups (p = 0.109; F = 2.272). In the comparison of resistin levels between the groups, a high level of statistically significant differences was found (p = 0.007; χ2 = 10.000). According to pairwise comparison; resistin levels of the first episode psychosis and chronic schizophrenia groups were significantly higher than the controls (p = 0.003; p = 0.016, respectively). There was no statistically significant difference in resistin levels between the first episode psychosis and chronic schizophrenia patients (p = 0.490). It was shown in Table 2.
There was no statistically significant difference in sociodemographic variables in terms of the mean plasma apelin, visfatin and resistin levels between three groups. Plasma apelin, visfatin and resistin levels of three groups were not statistically significantly associated with BMI and smoking (p > 0.05). There was no statistically significant relationship between the Total PANSS score and plasma apelin, visfatin, resistin levels in patients with first episode psychosis and chronic schizophrenia (p > 0.05).
The most substantial finding in our study is that we found high plasma resistin levels in both first episode psychosis and chronic schizophrenia patients. This, in line with the literature, suggests a role of resistin in inflammatuar process in both acute and chronic phase of psychosis. According to our findings, resistin may be a component of inflammatuar process both acute and chronic stress. In humans, resistin appears to be an inflammatory molecule primarily expressed in monocytic cells, from which it is secreted. The correlation between resistin with inflammatory markers (e.g., IL-6, TNF-α) is especially considerable given the observation that resistin is produced by macrophages in response to inflammatory cytokines [7,40]. Resistin has been implicated in the pathogenesis of several inflammatory central nervous system disorders [40]. Recently studies suggested that there is an association between inflammatory agents produced by adipose tissue and risk of depression [7]. Some studies have reported a positive correlation between resistin levels in the blood and atypical, melancholic subtypes of major depressive disorders [41,42]. This association may be related to the reduction in intrasynaptic concentration of monoamines by resistin via inhibition of release of norepinephrine and dopamine in the hypothalamus [43]. It has been suggested that resistin is involved in the pathogenesis of bipolar disorder. A recent study reported increased levels of resistin in patients with bipolar disorder, the specific role of resistin in the pathogenesis of the illness is still unknown [44]. Some studies reported reduced concentration of resistin have been observed in patients with anorexia nervosa [45], autism spectrum disorders [46] and obsessive compulsive disorder [47]. In a study by Balotsev et al. [48] was found ferritin and resistin levels of drug naive first episode psychosis patients were significantly higher than the chronic schizophrenic patients. It was shown that after seven months of antipsychotic drug treatment in first episode psychosis patients the strongest decline was established for ferritin, followed by resistin. This study supports our findings on relation between resistin and psychosis.
Nonetheless, there are some limitations to this study. This is a cross-sectional study with a small sample size. There is not sufficient data about the first episode psychosis and chronic schizophrenia as a study which compares these molecules (apelin, visfatin, and resistin) have not been done. Levels of other inflammatory markers (e.g., ferritin, IL-6, TNF-α) could be examined, together with apelin, visfatin and resistin.
In conclusion, to our knowledge, this study is the first which investigates the plasma apelin, visfatin and resistin levels in patients with first episode psychosis. Based on the results of this study, apelin and resistin may be related with some central nervous system pathologies, including the severity of a psychiatric disorder. However, further large-scale studies are required to establish a conclusion.
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Statistically significant differences were found between the groups for apelin levels (p = 0.026; χ2 = 7.338). According to pairwise comparisons; apelin levels of the first episode psychosis patients were significantly higher than the chronic schizophrenia and control group patients (p = 0.034; p = 0.012, respectively). There was no significant difference in apelin levels between the chronic schizophrenia and control group patients (p = 0.644). There was no statistically significant difference in visfatin levels between the groups (p = 0.109; F = 2.272). In the comparison of resistin levels between the groups, a high level of statistically significant differences was found (p = 0.007; χ2 = 10.000). According to pairwise comparison; resistin levels of the first episode psychosis and chronic schizophrenia groups were significantly higher than the controls (p = 0.003; p = 0.016, respectively). There was no statistically significant difference in resistin levels between the first episode psychosis and chronic schizophrenia patients (p = 0.490). It was shown in Table 2. 2ff7e9595c
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