Perry, Benjamin Ian, Upthegrove, Rachel, Thompson, Andrew David, Marwaha, Steven, Zammet, Stanley, Singh, Swaran P. and Khandaker, Golam (2019) Dysglycaemia, inflammation and psychosis : findings from the UK ALSPAC birth cohort. Schizophrenia Bulletin, 45 (2). pp. 330-338. doi:10.1093/schbul/sby040 ISSN 1745-1701.

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Abstract

Background

Psychosis is associated with both dysglycaemia and low-grade inflammation, but population-based studies investigating the interplay between these factors are scarce.

Aims

(1) To explore the direction of association between markers of dysglycaemia, inflammation and psychotic experiences (PEs); and (2) To explore whether dysglycaemia moderates and/or mediates the association between inflammation and PEs.

Method

Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were modeled using logistic and linear regression to examine cross-sectional and longitudinal associations between markers of dysglycaemia (ages 9 and 18), interleukin-6 (IL-6) (age 9), and PEs (ages 12 and 18). We tested for an interaction between dysglycaemia and IL-6 on risk of PEs at age 18, and tested whether dysglycaemia mediated the relationship between IL-6 and PEs.

Results

Based on 2627 participants, at age 18, insulin resistance (IR) was associated with PEs (adjusted OR = 2.32; 95% CI, 1.37–3.97). IR was associated with IL-6 both cross-sectionally and longitudinally. Interaction analyses under a multiplicative model showed that IR moderated the association between IL-6 at age 9 and PEs at age 18 (adjusted OR for interaction term = 2.18; 95% C.I., 1.06–4.49). Mediation analysis did not support a model of IR mediating the relationship between IL-6 and PEs.

Implications

IR is associated with PEs in young people even before the onset of clinical psychosis. Metabolic alterations may interact with childhood inflammation to increase risk of PEs. The findings have implications for clinical practice and future research.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Psychoses -- Research, Inflammation
Journal or Publication Title:	Schizophrenia Bulletin
Publisher:	Oxford University Press
ISSN:	1745-1701
Official Date:	March 2019
Dates:	Date Event March 2019 Published 9 April 2018 Available 15 March 2018 Accepted
Volume:	45
Number:	2
Page Range:	pp. 330-338
DOI:	10.1093/schbul/sby040
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	16 March 2018
Date of first compliant Open Access:	11 June 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED [NIHR] National Institute for Health Research http://dx.doi.org/10.13039/501100000272 201486/Z/16/Z Wellcome Trust http://dx.doi.org/10.13039/100010269 80354 Academy of Medical Sciences http://dx.doi.org/10.13039/501100000691 UNSPECIFIED University Hospitals Coventry and Warwickshire NHS Trust http://viaf.org/viaf/152707181 UNSPECIFIED [MRC] Medical Research Council http://dx.doi.org/10.13039/501100000265 102215/2/13/2) Wellcome Trust http://dx.doi.org/10.13039/100010269 UNSPECIFIED University of Bristol http://dx.doi.org/10.13039/501100000883
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