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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Increased Silent Brain Infarction Accompanied With High Prevalence of Diabetes and Dyslipidemia in Psychiatric
Tetsuto Kanzaki1, Yoriyasu Uju1, Keisuke Sekine1
1Department of Clinical Medicine (Drs Kanzaki and Mimori) and Department of Biostatistics (Dr Takizawa), Faculty of Pharmacy, Chiba Institute of Science, Choshi City; Department of Psychiatry (Drs Uju, Sekine, Ishii, Yoshimi, Yasui, Yasukawa, Sato, Okamoto, Hisaoka, Miura, Kusanishi, Murakami, Nakano, Mizuta, Hayakawa, and Tsukada) and Department of Internal Medicine (Dr Mishima), Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa City; and Amine Pharma Research Institute, Innovation Plaza at Chiba University, Chiba City (Dr Igarashi), Japan.
Insights
Psychiatric patients in Japan show a higher prevalence of silent brain infarction, linked to diabetes and low HDL cholesterol. This highlights the increased risk of cerebrovascular disease in this population.
Area of Science:
- Neuroscience
- Cardiovascular Medicine
- Psychiatry
Background:
- Patients with schizophrenia face elevated risks of atherosclerotic diseases, influenced by lifestyle factors and antipsychotic medications.
- Cerebrovascular diseases like stroke and coronary heart disease are significant causes of mortality in Japan.
- Understanding the prevalence of cerebrovascular disease in psychiatric inpatients is crucial for targeted interventions.
Purpose of the Study:
- To investigate the prevalence of cerebrovascular disease in Japanese psychiatric inpatients using brain magnetic resonance imaging (MRI).
- To assess the association between metabolic and physical health status and cerebrovascular disease in this population.
Main Methods:
- A cross-sectional study involving 152 hospitalized psychiatric patients (mean age 50-57 years) at Kohnodai Hospital, Japan.
- Patients diagnosed with schizophrenia (69.1%), mood disorders (18.4%), or other mental disorders (12.5%) underwent physical and metabolic assessments, including glucose and lipid levels, and brain MRI within one week of admission.
- Data collected included physical status, serum fasting plasma glucose, hemoglobin A1c, HDL cholesterol, total cholesterol, and triglyceride levels.
Main Results:
- The study group exhibited a significantly high prevalence of diabetes and low high-density lipoprotein (HDL) cholesterolemia in both sexes.
- Elevated serum fasting plasma glucose and hemoglobin A1c levels were observed, alongside significantly low serum HDL cholesterol and total cholesterol.
- Silent brain infarction was detected at a higher rate in psychiatric inpatients compared to healthy controls.
Conclusions:
- Psychiatric inpatients in Japan demonstrate an increased prevalence of silent brain infarction.
- This finding is associated with higher rates of diabetes and low HDL cholesterol among the study participants.
- These results underscore the heightened risk of cerebrovascular complications in individuals with mental disorders.
Objective:
Patients with schizophrenia have increased risk of atherosclerotic diseases. It is already known that lifestyle-related disorders and the use of antipsychotics are closely related with the progression of atherosclerosis in psychiatric patients. Stroke as well as coronary heart disease play an important role in the cause of death in Asia and Japan. Thus, we studied the prevalence of cerebrovascular disease in psychiatric inpatients in Japan using brain magnetic resonance imaging (MRI).
Method:
This cross-sectional study was performed from January 2012 to December 2013. Study participants were 152 hospitalized patients (61 men and 91 women) in the Department of Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa City, Japan. Mean ages were 50.0 and 57.1 years old for men and women, respectively. The diagnoses (DSM-IV-TR criteria) of participants were schizophrenia (69.1%), mood disorder (18.4%), and other mental disorders (12.5%). We checked physical status, metabolic status of glucose and lipid levels, and brain MRI within 1 week of admission.
Results:
The study group showed a significantly high prevalence of diabetes and low high-density lipoprotein (HDL) cholesterolemia in both sexes (n = 61 in men, n = 91 in women, P < .05). In the study group, serum fasting plasma glucose and hemoglobin A1c levels were significantly high (n = 152, P < .05), but serum HDL cholesterol and total cholesterol were significantly low in both sexes (n = 61 in men, n = 90 in women, P < .05), and triglycerides were low in men (n = 61, P < .05). Silent brain infarction was recognized at a higher rate (n = 98, P < .05) compared with healthy controls.
Conclusions:
Participants in this study had an increased ratio of silent brain infarction compared with Japanese healthy controls, accompanied with higher ratios of diabetes and low HDL cholesterol.
