統合失調症におけるサルコペニアの有病率と多次元的影響：酸化ストレス、機能、および症状重症度との関連

This study aimed to investigate the prevalence of sarcopenia in individuals with schizophrenia and examine its associations with oxidative stress, symptom severity, functioning, and quality of life.

A total of 198 schizophrenia patients aged 18-65 were assessed using the EWGSOP2 criteria for sarcopenia. Participants were classified as sarcopenic if they met criteria for probable, confirmed, or severe sarcopenia. Oxidative stress was evaluated using total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI). Clinical functioning, psychiatric symptoms, and quality of life were assessed using standardized psychometric tools. Multiple linear regression was conducted to identify predictors of oxidative stress parameters.

Sarcopenia was identified in 66.6% of participants, with most meeting criteria for probable sarcopenia. Sarcopenic patients had significantly lower muscle mass, bone mass, basal metabolic rate, handgrip strength, and walking speed, along with poorer quality of life and functional scores. TAC positively correlated with muscle-related parameters and inversely with sarcopenia severity, while OSI showed negative correlations with physical health indicators. Sarcopenic patients also had more severe psychiatric symptoms. Regression analysis revealed that TAC was significantly predicted by BMI, the number of sarcopenia criteria met, PANSS-Total, and WHOQOL-BREF scores (R² = 0.10, p = .011). No significant differences were found in mean TAC, TOS, and OSI between sarcopenic and non-sarcopenic groups.

Sarcopenia is highly prevalent and clinically relevant in individuals with schizophrenia, even at midlife. Routine screening and early interventions targeting physical health and oxidative stress may improve outcomes.