Abstract：
BACKGROUND: Increasing evidence suggests an association between schizophrenia and atherosclerosis. We conducted a systematic review and meta-analysis of cell adhesion molecules, critically involved in early atherosclerosis, in schizophrenia.
METHODS: We searched electronic databases from inception to 11 November 2023 for case-control studies assessing vascular cell, VCAM-1, intercellular, ICAM-1, platelet endothelial cell, PECAM-1, neural cell, NCAM, and Down syndrome cell, DSCAM, adhesion molecules, selectins (E-, L-, and P-selectin), integrins, and cadherins in patients with schizophrenia and healthy controls. Risk of bias and certainty of evidence were assessed using the JBI checklist and GRADE, respectively.
RESULTS: In 19 eligible studies, there were non-significant between-group differences in the concentrations of cell adhesion molecules, barring higher P-selectin in patients with schizophrenia (standard mean difference, SMD = 2.05, 95 % CI 0.72 to 3.38, p = 0.003; I2 = 97.2 %, p<0.001; very low certainty of evidence). Limited or no information was available regarding PECAM-1, DSCAM, ESAM, integrins, and cadherins. In meta-regression and subgroup analysis, there were significant associations between the SMD of ICAM-1 and matrix used (plasma or serum) and pharmacological treatment of schizophrenia, and between the SMD of VCAM-1 and pharmacological treatment, but not with other study and patient characteristics.
CONCLUSIONS: The results of our systematic review and meta-analysis do not support a significant role of immunoglobulin-like adhesion molecules, selectins, integrins, or cadherins in mediating the associations between schizophrenia, atherosclerosis, and cardiovascular disease. Further studies are warranted to investigate these associations in patients with different cardiovascular risk and the effects of antipsychotic treatments on cell adhesion molecules and surrogate markers of atherosclerosis (PROSPERO registration number: CRD42023463916).
METHODS: We searched electronic databases from inception to 11 November 2023 for case-control studies assessing vascular cell, VCAM-1, intercellular, ICAM-1, platelet endothelial cell, PECAM-1, neural cell, NCAM, and Down syndrome cell, DSCAM, adhesion molecules, selectins (E-, L-, and P-selectin), integrins, and cadherins in patients with schizophrenia and healthy controls. Risk of bias and certainty of evidence were assessed using the JBI checklist and GRADE, respectively.
RESULTS: In 19 eligible studies, there were non-significant between-group differences in the concentrations of cell adhesion molecules, barring higher P-selectin in patients with schizophrenia (standard mean difference, SMD = 2.05, 95 % CI 0.72 to 3.38, p = 0.003; I2 = 97.2 %, p<0.001; very low certainty of evidence). Limited or no information was available regarding PECAM-1, DSCAM, ESAM, integrins, and cadherins. In meta-regression and subgroup analysis, there were significant associations between the SMD of ICAM-1 and matrix used (plasma or serum) and pharmacological treatment of schizophrenia, and between the SMD of VCAM-1 and pharmacological treatment, but not with other study and patient characteristics.
CONCLUSIONS: The results of our systematic review and meta-analysis do not support a significant role of immunoglobulin-like adhesion molecules, selectins, integrins, or cadherins in mediating the associations between schizophrenia, atherosclerosis, and cardiovascular disease. Further studies are warranted to investigate these associations in patients with different cardiovascular risk and the effects of antipsychotic treatments on cell adhesion molecules and surrogate markers of atherosclerosis (PROSPERO registration number: CRD42023463916).
摘要：
背景：越来越多的证据表明精神分裂症与动脉粥样硬化之间存在关联。我们对细胞粘附分子进行了系统评价和荟萃分析，严重参与早期动脉粥样硬化，在精神分裂症中。
方法：我们从开始到2023年11月11日搜索了电子数据库，用于评估血管细胞的病例对照研究，VCAM-1，细胞间，ICAM-1,血小板内皮细胞,PECAM-1神经细胞,NCAM,和唐氏综合症细胞，DSCAM,粘附分子,选择素(E-,L-,和P-选择素)，整合素,精神分裂症患者和健康对照者的钙黏着蛋白。使用JBI核对表和等级评估偏倚风险和证据的确定性，分别。
结果：在19项符合条件的研究中，细胞粘附分子的浓度在组间无显著差异，除非精神分裂症患者的P-选择素较高(标准平均差，SMD=2.05，95%CI0.72至3.38，p=0.003；I2=97.2%，p<0.001；证据的确定性非常低)。关于PECAM-1、DSCAM、ESAM,整合素,和钙黏着蛋白。在荟萃回归和亚组分析中，ICAM-1的SMD与使用的基质（血浆或血清）和精神分裂症的药物治疗之间存在显着关联，在VCAM-1的SMD和药物治疗之间，但不具有其他研究和患者特征。
结论：我们的系统评价和荟萃分析的结果不支持免疫球蛋白样粘附分子的重要作用，选择素,整合素,或者钙黏着蛋白在调节精神分裂症之间的联系，动脉粥样硬化,和心血管疾病。需要进一步的研究来研究不同心血管风险患者的这些相关性以及抗精神病药物治疗对细胞粘附分子和动脉粥样硬化替代标志物的影响（PROSPERO注册号：CRD42023463916）。
方法：我们从开始到2023年11月11日搜索了电子数据库，用于评估血管细胞的病例对照研究，VCAM-1，细胞间，ICAM-1,血小板内皮细胞,PECAM-1神经细胞,NCAM,和唐氏综合症细胞，DSCAM,粘附分子,选择素(E-,L-,和P-选择素)，整合素,精神分裂症患者和健康对照者的钙黏着蛋白。使用JBI核对表和等级评估偏倚风险和证据的确定性，分别。
结果：在19项符合条件的研究中，细胞粘附分子的浓度在组间无显著差异，除非精神分裂症患者的P-选择素较高(标准平均差，SMD=2.05，95%CI0.72至3.38，p=0.003；I2=97.2%，p<0.001；证据的确定性非常低)。关于PECAM-1、DSCAM、ESAM,整合素,和钙黏着蛋白。在荟萃回归和亚组分析中，ICAM-1的SMD与使用的基质（血浆或血清）和精神分裂症的药物治疗之间存在显着关联，在VCAM-1的SMD和药物治疗之间，但不具有其他研究和患者特征。
结论：我们的系统评价和荟萃分析的结果不支持免疫球蛋白样粘附分子的重要作用，选择素,整合素,或者钙黏着蛋白在调节精神分裂症之间的联系，动脉粥样硬化,和心血管疾病。需要进一步的研究来研究不同心血管风险患者的这些相关性以及抗精神病药物治疗对细胞粘附分子和动脉粥样硬化替代标志物的影响（PROSPERO注册号：CRD42023463916）。
