Trajectories of Inflammation in Youth and Risk of Mental and Cardiometabolic Disorders in Adulthood.

IF 22.5 1区 医学 Q1 PSYCHIATRY
Edward R Palmer, Isabel Morales-Muñoz, Benjamin I Perry, Steven Marwaha, Ella Warwick, Jack C Rogers, Rachel Upthegrove
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引用次数: 0

Abstract

Importance: Research suggests that low-grade, nonresolving inflammation may predate adult mental and physical illness. However, evidence to date is largely cross-sectional or focuses on single disorder outcomes.

Objectives: To examine trajectories of inflammation as measured by C-reactive protein (CRP) levels in a large sample of children and adolescents, and to explore associations between different identified trajectories and mental and related cardiometabolic health outcomes in early adulthood.

Design, setting, and participants: In a longitudinal cohort study using data from the large UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), latent class growth analysis (LCGA) was used to explore different trajectories of inflammation, with logistic regression exploring association with mental and physical health outcomes. Participants with measurable CRP data and associated mental and cardiometabolic health outcomes recorded were included in the analysis. Data analysis was performed from May 1, 2023, to March 30, 2024.

Exposures: Inflammation was assessed via CRP levels at ages 9, 15, and 17 years. LCGA was used to identify different trajectories of inflammation.

Main outcomes and measures: Outcomes assessed at age 24 years included psychotic disorders, depressive disorders, anxiety disorders, hypomania, and, as a measure of insulin resistance, Homeostasis Model Assessment (HOMA2) score.

Results: A total of 6556 participants (3303 [50.4%] female) were included. Three classes of inflammation were identified: persistently low CRP levels (reference class, n = 6109); persistently raised CRP levels, peaking at age 9 years (early peak, n = 197); and persistently raised CRP levels, peaking at age 17 years (late peak, n = 250). Participants in the early peak group were associated with a higher risk of psychotic disorder (odds ratio [OR], 4.60; 95% CI, 1.81-11.70; P = .008), a higher risk of severe depression (OR, 4.37; 95% CI, 1.64-11.63; P = .02), and higher HOMA2 scores (β = 0.05; 95% CI, 0.01-0.62, P = .04) compared with participants with persistently low CRP. The late peak group was not associated with any outcomes at age 24 years.

Conclusions and relevance: Low-grade systemic inflammation peaking in midchildhood was associated with specific mental and cardiometabolic disorders in young adulthood. These findings suggest that low-grade persistent inflammation in early life may be an important shared common factor for mental-physical comorbidity and so could be relevant to future efforts of patient stratification and risk profiling.

青少年时期的炎症轨迹与成年后精神和心脏代谢紊乱的风险。
重要性:研究表明,低水平、非缓解性炎症可能会在成年后先于精神和身体疾病发生。然而,迄今为止的证据大多是横断面的,或侧重于单一疾病的结果:研究大量儿童和青少年样本中通过 C 反应蛋白(CRP)水平测量的炎症轨迹,并探讨不同的已识别轨迹与成年早期精神和相关心脏代谢健康结果之间的关联:在一项纵向队列研究中,我们使用了来自英国大型父母与子女埃文纵向研究(ALSPAC)的数据,通过潜类增长分析(LCGA)来探索不同的炎症轨迹,并通过逻辑回归来探索与心理和身体健康结果之间的关联。分析纳入了具有可测量的 CRP 数据以及相关心理和心脏代谢健康结果记录的参与者。数据分析时间为 2023 年 5 月 1 日至 2024 年 3 月 30 日:炎症通过 9 岁、15 岁和 17 岁时的 CRP 水平进行评估。LCGA用于识别不同的炎症轨迹:24岁时评估的结果包括精神病性障碍、抑郁性障碍、焦虑性障碍、躁狂症,以及作为胰岛素抵抗测量指标的稳态模型评估(HOMA2)得分:共纳入了 6556 名参与者(3303 人[50.4%]为女性)。炎症分为三类:CRP水平持续偏低(参考类,n = 6109);CRP水平持续升高,在9岁时达到峰值(早期峰值,n = 197);CRP水平持续升高,在17岁时达到峰值(晚期峰值,n = 250)。与 CRP 持续偏低的参与者相比,早期峰值组的参与者患精神病性障碍的风险更高(几率比 [OR],4.60;95% CI,1.81-11.70;P = .008),患严重抑郁症的风险更高(OR,4.37;95% CI,1.64-11.63;P = .02),HOMA2 评分更高(β = 0.05;95% CI,0.01-0.62,P = .04)。晚高峰组与24岁时的任何结果都无关:在儿童期达到峰值的低水平全身性炎症与青年期的特定精神和心脏代谢紊乱有关。这些研究结果表明,生命早期的低度持续炎症可能是导致精神和身体并发症的重要共同因素,因此可能与未来的患者分层和风险分析工作相关。
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来源期刊
JAMA Psychiatry
JAMA Psychiatry PSYCHIATRY-
CiteScore
30.60
自引率
1.90%
发文量
233
期刊介绍: JAMA Psychiatry is a global, peer-reviewed journal catering to clinicians, scholars, and research scientists in psychiatry, mental health, behavioral science, and related fields. The Archives of Neurology & Psychiatry originated in 1919, splitting into two journals in 1959: Archives of Neurology and Archives of General Psychiatry. In 2013, these evolved into JAMA Neurology and JAMA Psychiatry, respectively. JAMA Psychiatry is affiliated with the JAMA Network, a group of peer-reviewed medical and specialty publications.
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