Hypobetalipoproteinemia Associated With Aggression and Schizophrenia

Hypobetalipoproteinemia is more prevalent among those with schizophrenia, hetero-aggression, and autism than among the healthy public, according to a study recently published in Lipids in Health and Disease. This substantiates the empirical link between low plasma concentrations of low-density lipoproteins-cholesterol (LDL-C) and aggressive, impulsive behavior.

This retrospective study included 837 adults from the Nantes University Hospital’s Psychiatry department (HYPOPSY; ClinicalTrials.gov identifier: NCT02889614). Data were recorded during the year 2014, and the ICD-10 classification was used for related psychiatric disorders among the study population. Data on age, sex, physical features, psychiatric features, and biochemical features were collected for each individual in the study population. Mann-Whitney tests and Fisher tests were used to examine associations between LDL-cholesterol status and demographic, psychiatric, biological, and physical features.

Among the participants, there were 20 diagnosed cases of hypobetalipoproteinemia (defined as plasma LDL-C ≤50 mg/dL) with a mean LDL-C level of 42 (SD 7) mg/dL. This comprised a 2.39% prevalence among the study population, compared with 0.57% in the general public. There were higher rates among those with hypobetalipoproteinemia of hetero-aggression (25% vs 7%; P =.015), pervasive and specific developmental disorders (10% vs <1%; P =.022), and schizophrenia (40% vs 20%; P =.044) than those without hypobetalipoproteinemia.

Researchers concluded that the “HYPOPSY study found a ≈4 fold higher prevalence of [hypobetalipoproteinemia] in patients hospitalized in the Psychiatry department than in a general healthy population. More specifically, some statistically significant associations were found between low LDL-C concentrations and schizophrenia, autism and hetero-aggression. These data reinforce the hypothesis for a link between genetically low LDL-C levels and violent behavior or impulsivity. However, additional prospective studies need to be conducted in this Psychiatric population to confirm the higher prevalence of [familial hypobetalipoproteinemia] and to perform more extensive genotype-phenotype comparisons.”

Disclosure: Bertrand Cariou has received research funding from Sanofi, Regeneron, and Pfizer. He has received honoraria from Amgen, MSD (Merck & Co.), Regeneron, and Sanofi outside of this work.

Reference

Cariou B, Challet-Bouju G, Bernard C, et al. Prevalence of hypobetalipoproteinemia and related psychiatric characteristics in a psychiatric population: results from the retrospective HYPOPSY Study. Lipids Health Dis. 2018;17(1):249.