Abstract: Background: Low-grade inflammation has been repeatedly associated with both excess weight and psychosis.
However, no previous studies have addressed the direct effect of body mass index (BMI) on basal serum cytokines
in individuals with first-episode psychosis (FEP).
Objectives: The aim of this study is to analyze the effect of BMI on basal serum cytokine levels in FEP patients and
control subjects, separating the total sample into two groups: normal-weight and overweight individuals.
Methods: This is a prospective and open-label study. We selected 75 FEP patients and 75 healthy controls with
similar characteristics to patients according to the following variables: sex, age, and cannabis and tobacco
consumption. Both controls and patients were separated into two groups according to their BMI: subjects with a
BMI under 25 were considered as normal weight and those with a BMI equal to or more than 25 were considered
as overweight. Serum levels of 21 cytokines/chemokines were measured at baseline using the Human High
Sensitivity T Cell Magnetic Bead Panel protocol from the Milliplex® Map Kit. We compared the basal serum levels of
the 21 cytokines between control and patient groups according to their BMI.
Results: In the normal-weight group, IL-8 was the only cytokine that was higher in patients than in the control
group (p = 0.001), whereas in the overweight group, serum levels of two pro-inflammatory cytokines (IL-6, p = 0.000;
IL-1?, p = 0.003), two chemokines (IL-8, p = 0.001; MIP-1?, p = 0.001), four Th-1 and Th-2 cytokines (IL-13, p = 0.009;
IL-2, p = 0.001; IL-7, p = 0.001; IL-12p70, p = 0.010), and one Type-3 cytokine (IL-23, p = 0.010) were higher in patients
than in controls.
Conclusions: Most differences in the basal serum cytokine levels between patients and healthy volunteers were
found in the overweight group. These findings suggest that excess weight can alter the homeostasis of the
immune system and therefore may have an additive pro-inflammatory effect on the one produced by psychosis in
the central nervous system.
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