血清胆红素与2型糖尿病风险之间的关系：来自精神分裂症队列的发现

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-04-04 DOI:10.1016/j.schres.2025.03.039

Kuan Liu , Hao-Wen Chen , Shi-Ao Wang , Chen-Yu Zhang , Bi-Fei Cao , Xiao-Chun Zhang , Shan-Yuan Gu , Qi Zhong , Yan-Fei Wei , Yong-Qi Liang , Wei-Dong Fan , Zheng-Yun Xu , Kai-Yue Liao , Zi-Xuan Zhao , Xian-Bo Wu

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引用次数: 0

摘要

精神分裂症（SCZ）患者血清胆红素水平与2型糖尿病（T2DM）之间的关系尚不清楚。本研究调查了总胆红素、结合胆红素和非结合胆红素（TB、CB和UCB）与T2DM风险之间的关系，同时探讨了炎症途径的潜在作用。方法选取广州市白云静康医院862例SCZ患者作为研究对象。Cox比例风险模型评估基线胆红素和T2DM风险，而因果中介分析探讨炎症标志物。潜在类别轨迹模型和逻辑回归模型评估了胆红素多时间点轨迹与T2DM患病率之间的关系。结果在中位3.19年的随访中，诊断出63例T2DM。每增加1 μmol/L， TB、CB和UCB的校正风险比分别为0.88 （95% CI: 0.82 ~ 0.95）、0.71（0.57 ~ 0.89）和0.86（0.78 ~ 0.95）。与最低分位数相比，TB、CB和UCB的最高分位数分别与T2DM风险降低63%、74%和63%相关。淋巴细胞计数介导的TB（8.77%）、CB（11.68%）和UCB (8.34%)；CRP介导的TB（3.33%）和UCB（4.60%）合并T2DM。持续较高的TB和UCB水平与较低的T2DM患病率相关（OR分别为0.22和0.30）。结论胆红素水平升高与SCZ患者T2DM风险降低相关，淋巴细胞计数和CRP在胆红素与T2DM的关系中起部分介导作用。持续高水平的结核病和UCB与较低的2型糖尿病患病率有关。这些发现表明，中度升高的血清胆红素可能降低SCZ患者的2型糖尿病风险。

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Association between serum bilirubin and type 2 diabetes mellitus risk: Findings from a schizophrenia cohort

Background

The relationship between serum bilirubin levels and type 2 diabetes mellitus (T2DM) in individuals with schizophrenia (SCZ) remains poorly understood. This study investigated associations between total, conjugated, and unconjugated bilirubin (TB, CB, and UCB) and T2DM risk, while exploring the potential role of inflammatory pathways.

Methods

The study included 862 SCZ patients from Baiyun Jingkang Hospital, Guangzhou, the People's Republic of China. Cox proportional hazards model assessed baseline bilirubin and T2DM risk, while causal mediation analysis explored inflammatory markers. Latent class trajectory model and logistic regression model evaluated the association between multi-timepoint trajectories of bilirubin and T2DM prevalence.

Results

Over a median 3.19-year follow-up, 63 T2DM cases were diagnosed. Adjusted hazard ratios per 1 μmol/L increase were 0.88 (95 % CI: 0.82–0.95) for TB, 0.71 (0.57–0.89) for CB, and 0.86 (0.78–0.95) for UCB. Compared to the lowest tertile, the highest tertiles of TB, CB, and UCB were associated with 63 %, 74 %, and 63 % reduced T2DM risks, respectively. Lymphocyte count mediated TB (8.77 %), CB (11.68 %), and UCB (8.34 %); CRP mediated TB (3.33 %) and UCB (4.60 %) with T2DM. Persistently high TB and UCB levels were associated with lower T2DM prevalence (OR = 0.22 and 0.30, respectively).

Conclusion

Elevated bilirubin levels are associated with reduced T2DM risk in SCZ patients, with lymphocyte count and CRP partially mediating the bilirubin-T2DM relationship. And persistently high levels of TB and UCB linked to a lower prevalence of T2DM. These findings suggest that moderately elevated serum bilirubin may reduce T2DM risk among SCZ patients.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.