连接骨骼和大脑：骨代谢失调会加剧双相情感障碍患者的认知障碍
Linking bone and brain: Dysregulated bone metabolism exacerbates cognitive impairment in bipolar disorder.
摘要(中文译文)
基于“骨-脑轴”假说，本研究探讨了未用药双相障碍（BD）患者骨代谢、骨密度（BMD）与认知表现之间的关联，并探讨这些指标能否区分BD患者与健康对照（HCs）。共纳入202例未用药BD患者和161例HCs。采用双能X线吸收法（DEXA）测量腰椎和髋部BMD。评估血清骨转换标志物（骨钙素[OC]、I型前胶原N端前肽[PINP]、I型胶原C端交联肽[CTX-I]）及维生素D。采用可重复成套神经心理状态评估量表（RBANS）和Stroop色词测验评估认知功能。进行了组间比较、相关分析、二元logistic回归以及基于弹性网的分类建模（含交叉验证和SHAP分析）。与HCs相比，BD患者PINP/OC更高，维生素D和多区域BMD更低，认知功能更差（尤其在注意力、记忆和执行功能方面）。CTX-I与认知评分呈负相关，而BMD与语言功能呈正相关。在病例对照框架中，年龄（OR=1.624）和PINP（OR=1.029）是与BD患者和HCs差异显著相关的变量之一，而CTX-I（OR=0.153）和语义流畅性则表现出相反方向的关联。该模型AUC为0.882，认知指标与组间差异的关联最强，其次为年龄和骨代谢标志物。未用药BD患者存在骨代谢异常和多维认知缺陷，支持骨-脑轴在BD相关认知损害中的潜在作用。
Abstract
Based on the "bone-brain axis" hypothesis, this study explored the associations between bone metabolism, bone mineral density (BMD), and cognitive performance in drug-naive patients with bipolar disorder (BD), and explored whether these measures differentiate BD patients from healthy controls (HCs). A total of 202 drug-naïve BD patients and 161 HCs were enrolled. BMD at the lumbar spine and hip was measured via dual-energy X-ray absorptiometry (DEXA). Serum bone turnover markers (osteocalcin [OC], procollagen type I N-terminal propeptide [PINP], C-terminal telopeptide of type I collagen [CTX-I]) and vitamin D were assessed. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Stroop Color-Word Test. Group comparisons, correlation analyses, binary logistic regression, and elastic net-based classification modeling with cross-validation and SHAP analysis were conducted. Compared with HCs, BD patients had higher PINP/OC, lower vitamin D and multi-regional BMD, and poorer cognition (especially in attention, memory, and executive function). CTX-I was negatively correlated with cognitive scores, while BMD was positively associated with language functions. In the case-control framework, age (OR = 1.624) and PINP (OR = 1.029) were among the variables significantly associated with differences between BD patients and HCs, whereas CTX-I (OR = 0.153) and semantic fluency showed associations in the opposite direction. The model yielded an AUC of 0.882, with cognitive measures showing the strongest associations with group differences, alongside age and bone metabolism markers. Drug-naïve BD patients exhibit abnormal bone metabolism and multidimensional cognitive deficits, supporting the potential role of the bone-brain axis in BD-related cognitive impairment.
如何引用
AMA
Jiayang Zhang, Jie Chen, Yan Qiu, Ziwei Teng, Bolun Wang, Xun Hou, et al. Linking bone and brain: Dysregulated bone metabolism exacerbates cognitive impairment in bipolar disorder.. Journal of affective disorders. 2026; doi:10.1016/j.jad.2026.121600.
APA
Jiayang Zhang, Jie Chen, Yan Qiu, Ziwei Teng, Bolun Wang, Xun Hou, et al (2026). Linking bone and brain: Dysregulated bone metabolism exacerbates cognitive impairment in bipolar disorder.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2026.121600
GB/T 7714
Jiayang Zhang, Jie Chen, Yan Qiu, Ziwei Teng, Bolun Wang, Xun Hou, et al. Linking bone and brain: Dysregulated bone metabolism exacerbates cognitive impairment in bipolar disorder.[J]. Journal of affective disorders, 2026 doi:10.1016/j.jad.2026.121600.
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