Patients with schizophrenia have 2–3 times higher mortality than the general population and up to 15 years shorter life expectancy. Schizophrenia is a major mental illness with a lifetime prevalence of 1% of the world population, and is amongst the top causes of global disease burden in young adults. If our results are confirmed, acting on this pathway could reduce cardiovascular risk and resultant life-years lost in people with schizophrenia. The presence of non-hypertensive CCR and a dysmetabolic phenotype may contribute to excess cardiovascular risk in schizophrenia. In conclusion, people with schizophrenia showed adipose tissue dysfunction compared to body mass-matched HCs. Despite the cardiac changes, participants with schizophrenia did not demonstrate activation of the hypertensive CCR pathway however, they showed evidence of adipose dysfunction: adiponectin was reduced ( d = −0.69, 95% CI: −1.28, −0.10 p = 0.02), with evidence of activation of downstream pathways, including hypertriglyceridemia, elevated C-reactive protein, fasting glucose, and alkaline phosphatase. Participants with schizophrenia showed increases in cardiac concentricity ( d = 0.71, 95% CI: 0.12, 1.30 p = 0.01), indicative of CCR, but showed no differences in overall content or regional distribution of adipose tissue compared to HCs. Of the 50 participants, 34 (68%) were male.
In this multimodal case–control study, we collected cardiac and whole-body fat magnetic resonance imaging (MRI), clinical measures, and blood levels of several cardiometabolic biomarkers known to potentially cause CCR from individuals with schizophrenia, alongside healthy controls (HCs) matched for age, sex, ethnicity, and body surface area. We aimed to explore the relevance of hypertensive and non-hypertensive pathways to CCR and their potential molecular underpinnings in schizophrenia.
CCR is a predictor of cardiac disease, but the molecular pathways leading to this in schizophrenia are unknown. Patients with schizophrenia show evidence of concentric cardiac remodelling (CCR), defined as an increase in left-ventricular mass over end-diastolic volumes. Cardiovascular diseases are the leading cause of death in schizophrenia.