Metabolic risk factors of cognitive impairment in young women with major psychiatric disorder

Chuanjun Zhuo; Wei Liu; Ronghuan Jiang; Ranli Li; Haiping Yu; Guangdong Chen; Jianmin Shan; Jingjing Zhu; Ziyao Cai; Chongguang Lin; Langlang Cheng; Yong Xu; Sha Liu; Qinghua Luo; Shili Jin; Chuanxin Liu; Jiayue Chen; Lina Wang; Lei Yang; Qiuyu Zhang; Qianchen Li; Hongjun Tian; Xueqin Song; China multiple organs damage in the mental disorder (CMODMD) Group

doi:10.3389/fpsyt.2022.880031

Metabolic risk factors of cognitive impairment in young women with major psychiatric disorder

Front Psychiatry. 2022 Jul 29:13:880031. doi: 10.3389/fpsyt.2022.880031. eCollection 2022.

Authors

Chuanjun Zhuo^{1

2

3

4

5}, Wei Liu⁶, Ronghuan Jiang⁷, Ranli Li⁸, Haiping Yu⁹, Guangdong Chen⁹, Jianmin Shan⁹, Jingjing Zhu⁹, Ziyao Cai⁹, Chongguang Lin⁹, Langlang Cheng⁹, Yong Xu¹⁰, Sha Liu¹⁰, Qinghua Luo¹¹, Shili Jin¹², Chuanxin Liu¹², Jiayue Chen¹, Lina Wang⁵, Lei Yang¹³, Qiuyu Zhang¹⁴, Qianchen Li¹⁵, Hongjun Tian¹⁶, Xueqin Song^{17

3}; China multiple organs damage in the mental disorder (CMODMD) Group

Affiliations

¹ Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China.
² Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³ Henan Psychiatric Transformational Research Key Laboratory, Zhengzhou University, Zhengzhou, China.
⁴ Multiple Organs Damage in the Mental Disorder (MODMD) Center of Wenzhou Seventh Hospital, Wenzhou, China.
⁵ Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China.
⁶ Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
⁷ Department of Psychiatry, General Hospital of PLA, Beijing, China.
⁸ Key Laboratory of Psychiatric-Neuroimaging-Genetic and Cor-morbidity, Tianjin Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China.
⁹ Inpatient Department of Wenzhou Seventh Peoples Hospital, Wenzhou, China.
¹⁰ Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
¹¹ Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
¹² Inpatient Department, Shandong Daizhuang Hospital, Jining, China.
¹³ Department of Psychiatry, Yanan Fifth Hospital, Yan'An, China.
¹⁴ Department of Psychiatry, Tianjin Anning Hospital, Tianjin, China.
¹⁵ Department of Psychiatry, Hebei Fifth Peoples Hospital, Shijiazhuang, China.
¹⁶ Key Laboratory of Multiple Organ Damage in Patients With Mental Disorder, Tianjin Fourth Center Hospital of Tianjin Medical University, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.
¹⁷ Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Abstract

Background: Cognitive performance improves clinical outcomes of patients with major psychiatric disorder (MPD), but is impaired by hyperglycemia. Psychotropic agents often induce metabolism syndrome (MetS). The identification of modifiable metabolic risk factors of cognitive impairment may enable targeted improvements of patient care.

Objective: To investigate the relationship between MetS and cognitive impairment in young women with MPD, and to explore risk factors.

Methods: We retrospectively studied women of 18-34 years of age receiving psychotropic medications for first-onset schizophrenia (SCH), bipolar disorder (BP), or major depressive disorder (MDD). Data were obtained at four time points: presentation but before psychotropic medication; 4-8 and 8-12 weeks of psychotropic therapy; and enrollment. MATRICS Consensus Cognitive Battery, (MCCB)-based Global Deficit Scores were used to assess cognitive impairment. Multiple logistic analysis was used to calculate risk factors. Multivariate models were used to investigate factors associated with cognitive impairment.

Results: We evaluated 2,864 participants. Cognitive impairment was observed in 61.94% of study participants, and was most prevalent among patients with BP (69.38%). HbA1c within the 8-12 week-treatment interval was the most significant risk factor and highest in BP. Factors in SCH included pre-treatment waist circumference and elevated triglycerides during the 8-12 weeks treatment interval. Cumulative dosages of antipsychotics, antidepressants, and valproate were associated with cognitive impairment in all MPD subgroups, although lithium demonstrated a protect effect (all P < 0.001).

Conclusions: Cognitive impairment was associated with elevated HbA1c and cumulative medication dosages. Pre-treatment waist circumference and triglyceride level at 8-12 weeks were risk factors in SCH. Monitoring these indices may inform treatment revisions to improve clinical outcomes.

Keywords: HbA1c; cognitive impairment; major psychiatric disorder; metabolic syndrome; risk factors.

Copyright © 2022 Zhuo, Liu, Jiang, Li, Yu, Chen, Shan, Zhu, Cai, Lin, Cheng, Xu, Liu, Luo, Jin, Liu, Chen, Wang, Yang, Zhang, Li, Tian, Song and China multiple organs damage in the mental disorder (CMODMD) Group.