摘要

目的 本研究旨在评估青少年精神分裂症谱系障碍（SSD）患者的皮肤烟酸潮红反应表现及其在临床诊断中的价值，并探讨该反应与临床症状的多维关联。

方法 纳入58例10–19岁青少年SSD患者及80例健康对照；采用多浓度烟酸贴片系统测量皮肤潮红反应；使用广义线性混合效应模型分析组间差异；构建LASSO回归模型评估其诊断效能；并通过稀疏典型相关分析探索皮肤烟酸潮红反应与临床症状的多变量关联。

结果 在60、20及6.67 mM烟酸刺激下，SSD组皮肤烟酸潮红反应显著减弱（PFDR<0.05）；基于皮肤烟酸潮红反应构建的LASSO模型在测试集的AUC为0.86（95% CI: 0.73-0.96）；稀疏典型相关分析揭示一个显著关联模式（r=0.557, PFDR=0.039）：烟酸反应钝化与更严重的非自杀性自伤（载荷=-0.531）及躁狂症状（载荷=-0.292）相关，且与较轻的整体精神病性症状（载荷=0.703）及焦虑症状（载荷=0.317）相关。

结论 皮肤烟酸潮红反应钝化是青少年精神分裂症谱系障碍（SSD）的潜在早期辅助诊断标志物。皮肤烟酸潮红反应钝化与精神病性症状、躁狂、自伤行为及焦虑症状相关，可为评估青少年SSD临床症状提供重要线索。

关键词：青少年；精神分裂症谱系障碍；皮肤烟酸潮红反应；稀疏典型相关分析

ABSTRACT

Objective To evaluate the niacin skin flushing response in adolescents with schizophrenia spectrum disorders (SSD), assess its diagnostic value, and explore its association with clinical symptoms.

Methods 58 adolescents (ages 10-19) with SSD and 80 healthy controls were enrolled. Niacin skin flushing was measured using a multi-concentration patch test system. Group differences were analyzed using generalized linear mixed models. The diagnostic efficacy was assessed with a LASSO regression model, and sparse canonical correlation analysis explored its associations with clinical symptoms.

Results Attenuated niacin skin flushing responses were found at 60, 20, and 6.67 mM concentrations in the adolescent SSD group (PFDR < 0.05). The LASSO model achieved an AUC of 0.86 (95% CI: 0.73-0.96). Sparse canonical correlation analysis revealed a significant pattern (r = 0.557, PFDR = 0.039): attenuated niacin skin flushing response was correlated with more prominent non-suicidal self-injury (load = -0.531) and manic symptoms (load = -0.292), while correlated with lighter psychotic symptom severity (load = 0.703) and anxiety (load = 0.317).

Conclusion   Attenuation of the skin niacin flushing response may serve as an early adjunctive diagnostic marker for adolescent SSD. The reduced niacin flushing response is associated with psychotic symptoms, mania, self-injurious behaviors, and anxiety, and may provide valuable insights for evaluating the clinical status of adolescents with SSD.

Key words: Adolescent；Schizophrenia spectrum disorder；Niacin skin flushing response; Sparse canonical correlation analysis