Assessing causal links between metabolic traits, inflammation and schizophrenia: a univariable and multivariable, bidirectional Mendelian-randomization study.


Journal

International journal of epidemiology
ISSN: 1464-3685
Titre abrégé: Int J Epidemiol
Pays: England
ID NLM: 7802871

Informations de publication

Date de publication:
01 10 2019
Historique:
accepted: 07 08 2019
pubmed: 11 9 2019
medline: 21 4 2020
entrez: 11 9 2019
Statut: ppublish

Résumé

Blood immunoreactive biomarkers, such as C-reactive protein (CRP), and metabolic abnormalities have been associated with schizophrenia. Studies comprehensively and bidirectionally probing possible causal links between such blood constituents and liability to schizophrenia are lacking. To disentangle putative causal links between CRP blood levels and schizophrenia in both directions, we conducted multiple univariable Mendelian-randomization (MR) analyses, ranging from fixed-effect to inverse variance-weighted (IVW), weighted-median, MR Egger and generalized summary-data-based Mendelian-randomization (GSMR) models. To prioritize metabolic risk factors for schizophrenia, a novel multivariable approach was applied: multivariable Mendelian-randomization-Bayesian model averaging (MR-BMA). All forward univariable MR analyses consistently showed that CRP has a protective effect on schizophrenia, whereas reverse MR analyses consistently suggested absent causal effects of schizophrenia liability on CRP blood levels. Using MR-BMA, as the top protective factors for schizophrenia we prioritized leucine and as the prime risk-factor triglycerides in medium very-low-density lipoprotein (VLDL). The five best-performing MR-BMA models provided one additional risk factor: triglycerides in large VLDL; and two additional protective factors: citrate and lactate. Our results add to a growing body of literature hinting at metabolic changes-in particular of triglycerides-independently of medication status in schizophrenia. We also highlight the absent effects of genetic liability to schizophrenia on CRP levels.

Sections du résumé

BACKGROUND
Blood immunoreactive biomarkers, such as C-reactive protein (CRP), and metabolic abnormalities have been associated with schizophrenia. Studies comprehensively and bidirectionally probing possible causal links between such blood constituents and liability to schizophrenia are lacking.
METHODS
To disentangle putative causal links between CRP blood levels and schizophrenia in both directions, we conducted multiple univariable Mendelian-randomization (MR) analyses, ranging from fixed-effect to inverse variance-weighted (IVW), weighted-median, MR Egger and generalized summary-data-based Mendelian-randomization (GSMR) models. To prioritize metabolic risk factors for schizophrenia, a novel multivariable approach was applied: multivariable Mendelian-randomization-Bayesian model averaging (MR-BMA).
RESULTS
All forward univariable MR analyses consistently showed that CRP has a protective effect on schizophrenia, whereas reverse MR analyses consistently suggested absent causal effects of schizophrenia liability on CRP blood levels. Using MR-BMA, as the top protective factors for schizophrenia we prioritized leucine and as the prime risk-factor triglycerides in medium very-low-density lipoprotein (VLDL). The five best-performing MR-BMA models provided one additional risk factor: triglycerides in large VLDL; and two additional protective factors: citrate and lactate.
CONCLUSIONS
Our results add to a growing body of literature hinting at metabolic changes-in particular of triglycerides-independently of medication status in schizophrenia. We also highlight the absent effects of genetic liability to schizophrenia on CRP levels.

Identifiants

pubmed: 31504541
pii: 5557835
doi: 10.1093/ije/dyz176
pmc: PMC7070229
doi:

Substances chimiques

Biomarkers 0
Lipids 0
Lipoproteins, VLDL 0
Triglycerides 0
very low density lipoprotein triglyceride 0
C-Reactive Protein 9007-41-4
Leucine GMW67QNF9C

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1505-1514

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© The Author(s) 2019; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

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Auteurs

Bochao D Lin (BD)

Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
Department of Preventive Medicine, Institute of Biomedical Informatics, Bioinformatics Center, School of Basic Medical Sciences, Henan University, Kaifeng, China.
Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

Anne Alkema (A)

Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

Triinu Peters (T)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Janneke Zinkstok (J)

Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

Lars Libuda (L)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Johannes Hebebrand (J)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Jochen Antel (J)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Anke Hinney (A)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Wiepke Cahn (W)

Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

Roger Adan (R)

Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.

Jurjen J Luykx (JJ)

Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
GGNet Mental Health, Apeldoorn, The Netherlands.

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