Clinical and inflammatory markers associated with metabolic dysfunction-associated fatty liver disease in a cohort of individuals with chronic schizophrenia (FACE-SZ)
{"title":"Clinical and inflammatory markers associated with metabolic dysfunction-associated fatty liver disease in a cohort of individuals with chronic schizophrenia (FACE-SZ)","authors":"Rudy Tokarski , Susana Barbosa , Baptiste Pignon , Bruno Aouizerate , Christelle Andrieu , Myrtille Andre , Wahid Boukouaci , Delphine Capdevielle , Isabelle Chereau , Clément Dondé , Julie Clauss Kobayashi , J.M. Dorey , Caroline Dubertret , Eric Fakra , Guillaume Fond , Tudy Goze , Sylvain Leignier , Pierre-Michel Llorca , Jasmina Mallet , David Misdrahi , Ophelia Godin","doi":"10.1016/j.jpsychores.2025.112192","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>Recent studies on Metabolic dysfunction-associated fatty liver (MAFLD) in schizophrenia show inconsistent findings, often based on small or specific samples. This study aims to assess the prevalence of MAFLD and its sociodemographic, clinical, and treatment-related risk factors in a large cohort of chronic patients with schizophrenia. A secondary goal is to identify an immuno-inflammatory signature associated with MAFLD.</div></div><div><h3>Methods</h3><div>1009 stable outpatients with schizophrenia were included in the cross-sectional analysis. Individuals with liver disease, hepatitis B/C, or current alcohol use disorder were excluded. MAFLD was screened using the Fatty Liver Index (FLI), with FLI > 60 indicating MAFLD. Risk factors were assessed using multivariate logistic regression, and inflammatory markers were analysed with penalized logistic regression.</div></div><div><h3>Results</h3><div>In a sample of 1009 individuals with schizophrenia, MAFLD prevalence was 36.6 %, higher in men than in women (38.3 % vs 32.0 %, <em>p</em> < 0.0001). Multivariate analysis identified male gender, older age, current smokers, mood stabilizers, antidepressant, clozapine, olanzapine and quetiapine as risk factors for MAFLD. The use of risperidone was associated with a lower risk of MAFLD (0.63 (0.42–0.94). Elevated levels of inflammatory markers such as TNF-α, CRP, and IL-12/IL-23p40 were also linked to a higher likelihood of MAFLD.</div></div><div><h3>Conclusion</h3><div>Although not generalizable to all patients with schizophrenia, this study confirms the high prevalence of MAFLD in individuals with schizophrenia. Psychiatrists should promote healthy lifestyle changes, such as weight control, improved diet, better sleep, and increased physical activity, to improve both physical health and quality of life in these patients.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"195 ","pages":"Article 112192"},"PeriodicalIF":3.5000,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychosomatic Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022399925001564","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Aims
Recent studies on Metabolic dysfunction-associated fatty liver (MAFLD) in schizophrenia show inconsistent findings, often based on small or specific samples. This study aims to assess the prevalence of MAFLD and its sociodemographic, clinical, and treatment-related risk factors in a large cohort of chronic patients with schizophrenia. A secondary goal is to identify an immuno-inflammatory signature associated with MAFLD.
Methods
1009 stable outpatients with schizophrenia were included in the cross-sectional analysis. Individuals with liver disease, hepatitis B/C, or current alcohol use disorder were excluded. MAFLD was screened using the Fatty Liver Index (FLI), with FLI > 60 indicating MAFLD. Risk factors were assessed using multivariate logistic regression, and inflammatory markers were analysed with penalized logistic regression.
Results
In a sample of 1009 individuals with schizophrenia, MAFLD prevalence was 36.6 %, higher in men than in women (38.3 % vs 32.0 %, p < 0.0001). Multivariate analysis identified male gender, older age, current smokers, mood stabilizers, antidepressant, clozapine, olanzapine and quetiapine as risk factors for MAFLD. The use of risperidone was associated with a lower risk of MAFLD (0.63 (0.42–0.94). Elevated levels of inflammatory markers such as TNF-α, CRP, and IL-12/IL-23p40 were also linked to a higher likelihood of MAFLD.
Conclusion
Although not generalizable to all patients with schizophrenia, this study confirms the high prevalence of MAFLD in individuals with schizophrenia. Psychiatrists should promote healthy lifestyle changes, such as weight control, improved diet, better sleep, and increased physical activity, to improve both physical health and quality of life in these patients.
最近关于精神分裂症患者代谢功能障碍相关脂肪肝(MAFLD)的研究显示出不一致的结果,这些研究通常基于小样本或特定样本。本研究旨在评估慢性精神分裂症患者中MAFLD的患病率及其社会人口学、临床和治疗相关的危险因素。第二个目标是确定与MAFLD相关的免疫炎症特征。方法对1009例稳定的精神分裂症门诊患者进行横断面分析。排除了患有肝病、乙型/丙型肝炎或当前酒精使用障碍的个体。使用脂肪肝指数(FLI)筛选MAFLD, FLI >;60表示MAFLD。使用多变量logistic回归评估危险因素,并使用惩罚logistic回归分析炎症标志物。结果1009例精神分裂症患者中,MAFLD患病率为36.6%,男性高于女性(38.3% vs 32.0%, p <;0.0001)。多因素分析发现,男性、年龄较大、当前吸烟者、情绪稳定剂、抗抑郁药、氯氮平、奥氮平和喹硫平是MAFLD的危险因素。使用利培酮与较低的MAFLD风险相关(0.63(0.42-0.94))。炎症标志物如TNF-α、CRP和IL-12/IL-23p40水平升高也与MAFLD的可能性增加有关。结论虽然不能推广到所有精神分裂症患者,但本研究证实了精神分裂症患者中MAFLD的高患病率。精神科医生应该促进健康生活方式的改变,如控制体重、改善饮食、改善睡眠和增加体育活动,以改善这些患者的身体健康和生活质量。
期刊介绍:
The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.