Body Composition Status And Risk Prediction Model For Concomitant Metabolic Disorders In Patients With First-episode Schizophrenia

BackgroundSchizophrenia is a group of severe mental disorders of unknown etiology,characterized by significant abnormalities in cognitive,emotional,and other aspects of mental activity,leading to significant social dysfunction.Research has found that the risk of metabolic disorders in patients with schizophrenia is significantly higher than that of the general population,which increases the incidence of cardiovascular diseases and reduces treatment compliance.The body composition analyzer can measure various indicators,such as visceral fat content,skeletal muscle content,waist to hip ratio,etc.,which can reflect the metabolic status of patients effectively.In recent years,many studies have begun to use body composition analysis indicators to predict the incidence of cardiovascular diseases and metabolic disorders.However,few studies use body composition analysis techniques to explore the metabolic status of first-episode schizophrenia patients and predict the risk of accompanying metabolic disorders.Objective(1)To observe the body composition differences among first-episode schizophrenia patients(FSZ),first-degree relatives(FDR)and healthy controls(HC)through bioelectrical impedance analysis(BIA),and to explore the body composition indicators related to high-risk factors of schizophrenia.(2)To longitudinally observe the changes of body composition and metabolic components of first-episode schizophrenia patients treated with olanzapine within six months.To explore the characteristics of body composition related to the development of metabolic abnormalities in SCZ,then establish a medical model to predict whether metabolic abnormalities will occur in first-episode schizophrenia patients after treatment with olanzapine alone.Methods(1)In this study,67 first-episode schizophrenia outpatients and 95 first-degree relatives were enrolled;112 healthy volunteers were selected as the control group.Collect their general information and use a body composition analyzer to measure body composition data for statistical analysis.(2)Collect general information,body composition and metabolic composition data and other indicators of 36 first-episode schizophrenia outpatient patients who have never used psychiatric medication and never experienced metabolic abnormalities before.Patients were divided into a normal metabolism group and an abnormal metabolism group based on whether they developed obesity,hyperglycemia,hyperlipidemia,or hypertension after six months of treatment with olanzapine alone.Establish a risk prediction model using body composition data at baseline from two groups of patients.Results(1)There were significant statistical differences in log TBW,log ICW,logprotein,logmineral,log SLM,log FFM,log SMM,log BMR,log BCM,and TBW/FFM between FDR and HC groups;The ECW/TBW of HC group was significantly lower than that of FSZ and FDR groups;The phase angle of FSZ group was significantly lower than that of HC group.Gender had no significant impact on body composition in these three groups.The lean tissue composition in HC group was significantly higher than that in FDR group;The ECW/TBW of HC group was significantly lower than that of FSZ and FDR groups.(2)At the baseline level,BFM,BMI,PBF,WHR,VFA,AC,AMC,FFMI,FMI,and SMI indicators in the normal metabolism(NM)group were significantly lower than those in the abnormal metabolism(AM)group;TG,hs-CRP,SBP,and waist WC in the NM group were significantly lower than those in the AM group.Half a year later,the indexes of BFM,BMI,PBF,WHR,VFA,AC,AMC,FFMI,FMI,and phase angle in the NM group were significantly lower than those in the AM group;the hs-CRP,SBP,and WC in the NM group were significantly lower than those in the AM group,while the HDL-C was higher than those in the AM group.The changes of VFA,BCM,TBW/FFM in the NM group were significantly lower than those in the AM group during half a year;the changes of HDL-C values in the two groups were significantly different.(3)Using the ROC curve for testing.The prediction model has good fitting effect and high predictive value.Conclusion(1)There were differences in body composition among FSZ,FDR,and HC groups.Lean tissue composition and ECW/TBW may be related to high-risk factors for schizophrenia.(2)Changes in body composition(especially visceral fat area)related to adipose tissue and blood lipids in schizophrenia patients are closely related to metabolic disorders after treatment with olanzapine.(3)The medical model established using the body composition has a good predictive value for predicting whether first-episode schizophrenia patients will develop metabolic abnormalities after treatment with olanzapine.