Obesity, dyslipidemia and brain age in first-episode psychosis.
INTRODUCTION
Obesity and dyslipidemia may negatively affect brain health and are frequent medical comorbidities of schizophrenia and related disorders. Despite the high burden of metabolic disorders, little is known about their effects on brain structure in psychosis. We investigated, whether obesity or dyslipidemia contributed to brain alterations in first-episode psychosis (FEP).


METHODS
120 participants with FEP, who were undergoing their first psychiatric hospitalization, had <24 months of untreated psychosis and were 18-35 years old and 114 controls within the same age range participated in the study. We acquired 3T brain structural MRI, fasting lipids and body mass index. We used machine learning trained on an independent sample of 504 controls to estimate the individual brain age of study participants and calculated the BrainAGE score by subtracting the chronological from the estimated brain age.


RESULTS
In a multiple regression model, the diagnosis of FEP (B = 1.15, SE B = 0.31, p < 0.001) and obesity/overweight (B = 0.92, SE B = 0.35, p = 0.008) were each additively associated with BrainAGE scores (R2 = 0.22, F(3, 230) = 21.92, p < 0.001). BrainAGE scores were highest in participants with FEP and obesity/overweight (3.83 years, 95%CI = 2.35-5.31) and lowest in normal weight controls (-0.27 years, 95%CI = -1.22-0.69). LDL-cholesterol, HDL-cholesterol or triglycerides were not associated with BrainAGE scores.


CONCLUSIONS
Overweight/obesity may be an independent risk factor for diffuse brain alterations manifesting as advanced brain age already early in the course of psychosis. These findings raise the possibility that targeting metabolic health and intervening already at the level of overweight/obesity could slow brain ageing in FEP.
['Kolenic|Marian|M|', 'Franke|Katja|K|', 'Hlinka|Jaroslav|J|', 'Matejka|Martin|M|', 'Capkova|Jana|J|', 'Pausova|Zdenka|Z|', 'Uher|Rudolf|R|', 'Alda|Martin|M|', 'Spaniel|Filip|F|', 'Hajek|Tomas|T|']
D000293:Adolescent D000328:Adult D000367:Age Factors D001921:Brain D015897:Comorbidity D050171:Dyslipidemias D005260:Female D006801:Humans D000069550:Machine Learning D008279:Magnetic Resonance Imaging D008297:Male D009765:Obesity D050177:Overweight D010363:Pattern Recognition, Automated D011618:Psychotic Disorders D012307:Risk Factors D012559:Schizophrenia D055815:Young Adult
Obesity Dyslipidemia First-episode psychosis Schizophrenia BrainAGE score Overweight