Objective: It is known that mortality rates in schizophrenic patients with cardiovascular diseases are twice as high as other diseases. Some of the research has revealed that the risks of cardiovascular disease were dependent on adhesion molecules. The main adhesion molecules are intracellular adhesive molecule (ICAM-1), vascular cell adhesive molecule (VCAM-1) and E-selectin. The aim of this study was to determine whether or not ICAM-1, V-CAM-1 and E-selectin levels, which are considered as possible biological determinants in the prognosis and progression of atherosclerosis, change with treatment in schizophrenic patients with respect to controls.
Method: In the Erenköy Research and Training Hospital for Neuropsychiatry, 50 patients who were diagnosed with first episode schizophrenia according to the DSM-IV-TR diagnostic criteria and had never received antipsychotic treatment and a control group consisting of 50 healthy volunteers were enrolled the study. At the beginning of the study (n=50) and after the third month (n=39), ICAM, VCAM, E-selectin, Fasting Blood Glucose, Total Cholesterol, LDL Cholesterol, HDL Cholesterol and Triglyceride levels were checked in the plasma of each patient and compared with each other. For the control group, the same biochemical parameters were investigated only at the beginning of the study. In order to assess the termination of the acute episode, the patient group was given the Positive Symptoms Assessment Scale (SAPS) and Negative Symptoms Assessment Scale (SANS) in the beginning and at the end of the third month.
Results: In the first episode schizophrenic patients, the average age was 30.14±7.50 years. In the patients, the beginning ICAM-1 levels were lower than the control group (t= 3.41, p=0.001) and increased during treatment (t=-6.73 p<0.001), while VCAM-1 and E-selectin levels were similar to the control group (t=-1.23, p=0.223; t=-0.32 p=0.750, respectively). In addition, after treatment the VCAM-1 level was determined to be lower than the pretreatment level (t=7.17, p<0.001). Whereas the averages of Fasting Blood Glucose, Total Cholesterol, LDL Cholesterol, HDL Cholesterol and Triglycerides were similar in the control and patient groups, a significant increase was observed in the triglyceride levels of the schizophrenic patients after treatment (t=-3.19, p=0.003). According to the statistics, a significant positive correlation was found between ICAM and triglyceride values (r= 0.351, p<0.001).
Conclusion: When compared with the control group, it was observed that the levels of cellular adhesion molecules of individuals with first episode schizophrenia were not different, except for ICAM-1. Whereas according to the information retrieved from levels determined in plasma during treatment, cellular adhesion molecules act differently. It was observed that the antipsychotics used for treatment had an effect on increasing ICAM-1 and decreasing VCAM-1. It is possible that the number of patients was not enough, the disease does not have a homogenous structure, and some other unknown confounding factors could be present. Our findings need to be replicated by other clinical groups in larger studies.