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Original article
Disponible online el 6 de Julio de 2023
Biomarkers as proxies for cognitive reserve: The role of high density lipoprotein cholesterol in first episode of psychosis
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1
Rebeca Magdaleno Herreroa,b, Nancy Murillo-Garcíaa,b, Ángel Yorca-Ruiza,b, Karl Neergaarda, Benedicto Crespo-Facorroc,d,e, Rosa Ayesa-Arriolaa,e,
Autor para correspondencia
rayesa@humv.es

Corresponding author.
, PAFIP Group
a Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
b Doctoral School University of Cantabria (EDUC), Santander, Spain
c Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
d Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain
e Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Table 1. Comparisons between FEP patients and healthy controls on sociodemographic data, CR proxies and levels of biological parameters.
Table 2. Linear regression models pertaining to FEP patients with SBP and HDL levels as dependent variables.
Table 3. Linear regression models pertaining to HC with SBP and HDL levels as the dependent variables.
Table 4. Total variance explained by comparing classic and biological CR in patients and controls.
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Abstract
Introduction

The proxies used to compose cognitive reserve (CR) for patients of a first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to peripheral pathways of the central nervous system, yet despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR. Meanwhile, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL), cause worse global functioning and cognitive impairment. For these reasons, the present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP.

Materials and methods

We included 668 FEP patients and 217 healthy controls. Participants were assessed for sociodemographic information, years of education, employment status, premorbid IQ and biological parameters: waist circumference, hypertension, and levels of HDL, triglycerides, and glucose.

Results

The findings suggest that the years of education proxy showed correlational and higher relationship with HDL levels for both FEP patients (r=0.23, b=0.185) and controls (r=0.31, b=0.342). We found that the CR index composed of years of education and HDL levels showed a higher explanatory power for the phenomenon than the classic CR index composed of years of education, employment status and premorbid IQ.

Conclusions

This article proposes an objective and quantifiable method to measure CR that is more the multifactorial nature of FEP.

Keywords:
Cognitive reserve
First episodes of psychosis
High-density lipoproteins
Years of education
Systolic blood pressure

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