061_ Investigating the effect of metabolic syndrome components in cognitive performance of patients with bipolar disorder, schizophrenia and depression
Research Question and Aims
Previous evidence shows that psychiatric illnesses (such as major depression, bipolar disorder and schizophrenia) are characterized by an increased risk of metabolic syndrome (MetS). MetS is a clustering of cardiovascular risk factors characterized by abdominal obesity, high fasting glucose, dyslipemia and hypertension, and it is related to several adverse health outcomes, including an increased risk of developing cognitive impairment. The incidence of MS in these psychiatric conditions is multifactorial, where psychopharmacological treatments (certain mood stabilizers, antipsychotics or antidepressants) and genetics might play a critical role. The use of specific psychotropic medications is associated with an increased risk of cardiometabolic abnormalities. Previous evidence also reports a common genetic background of psychiatric and metabolic disorders.
On the other hand, cognitive impairment is common among patients with these psychiatric conditions during both euthymia and illness episodes. Some studies have suggested that cardiovascular risk factors as blood pressure, cholesterol and elevated triglycerides are important predictors of cognition in individuals with severe mental illnesses, and abdominal obesity is one of the predictors of cognitive impairment and quality of life. Whereas the relationship between cognition and MetS has received more attention in schizophrenia, it has been less studied in bipolar disorder, with conflicting results. This relationship between MetS and cognition might be also mediated by genetic factors.
The relation between cognition and MetS, and the influence of genetics, comorbidities and the effect of pharmacological treatments in severe psychiatric disorders has been little studied. The objective of the study is i) to determine if MetS components could predict cognitive impairment, and ii) if MetS components mediate the relationship of cognition with morbidity, pharmacological treatment, and polygenic risk scores in a sample of different psychiatric conditions.
Analysis will include the PsyCourse samples (schizophrenia, bipolar disorder and major depression patients). Using these data we will investigate the association of variables related to MetS with cognitive variables and the potential role of genetics and medical variables. A descriptive analysis of will be performed for all the target variables, for the cognitive variables we will create composite scores according to each cognitive domain. The whole sample will be divided according to presence/absence of MetS and potential differences between groups with and without MetS with regard to demographic and clinical measures with f-tests for continuous variables and chi-square tests for categorical ones. The differences in cognitive measures will be tested using two-way analyses of covariance (ANCOVAS) with grouping variable Group (BD vs. SCZ vs. MDD) and MetsS (with vs. without) controlling for age and sex.
The association of morbidities (comorbidity/somatic disorder), pharmacological treatments, and polygenic burden (PRScs) for several traits (schizophrenia, bipolar disorder, major depressive disorder, Type-2 Diabetes, MetS, triglyceride levels, cholesterol levels, HDL, LDL, educational attainment) with cognitive performance and MetS variables will be tested using linear models and adequate covariates.
Finally, a mediation analysis will be carried out to check whether the of association of cognitive outcomes and morbidities, pharmacological treatments, and polygenic risk scores are mediated by MetS-related variables. Mediation analyses will be carried out using the R package Mediation.
Raw data on medication
210908_v5.0_psycourse_clin_raw_med_(visit1 to visit4).RData
210908_v5.0_psycourse_con_raw_med_(visit1 to visit4).RData
Genomics data: Raw genotypes (GSA chip) and imputed data from PsyCourse patients.