Does severe mental illness predispose to cardiovascular and metabolic disease via an unfavourable adipose storage profile?

与一般人群相比，患有严重精神疾病（重度精神障碍，包括精神分裂症、双相情感障碍和重度抑郁症）的个体患心血管和代谢性疾病（CMD，包括肥胖、2型糖尿病和心血管疾病）的几率和风险更高。社会经济和生活方式因素，以及精神药物和遗传变异都是造成这种过度的原因。最近的研究已经提供了共享生物学的证据，但是将SMI和CMD联系起来的机制仍有待充分阐明。这是必要的，以便对这些患者进行适当的临床风险管理。已经确定了许多导致重度精神分裂症和肥胖表型的遗传变异。肥胖相关的遗传变异根据其对BMI（反映整体肥胖）和WHR（反映中心肥胖）的影响被分类为中性、增加（cmd偶联）和减少（cmd非偶联）。

Individuals with severe mental illness (SMI, including schizophrenia, bipolar disorder, and major depressive disorder) have increased rates and risk of cardiovascular and metabolic diseases (CMD, including obesity, type 2 diabetes and cardiovascular diseases), compared to the general population. Socioeconomic and lifestyle factors as well as psychotropic medication and genetic variation all contribute to this excess. Recent studies have provided evidence of shared biology, however the mechanisms linking SMI and CMD remain to be fully elucidated. This is necessary so that appropriate clinical risk management can be undertaken in these patients. Many genetic variants contributing to SMI and to obesity phenotypes have been identified. Obesity-associated genetic variants have been classified by their effects on BMI (reflecting total obesity) and WHR (reflecting central obesity), as having neutral, increasing (CMD-coupled) and decreasing (CMD-uncoupled)