Increasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. Additionally, previous evidence has demonstrated sex differences in many aspects of schizophrenia including clinical characteristics, cytokines, and OxS markers. However, to the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients. A total of 119 FEDN schizophrenia patients and 135 healthy controls were recruited for this study. Serum TNF-α, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) were measured. The Positive and Negative Syndrome Scale (PANSS) was applied to evaluate psychotic symptoms. Two-way ANOVA, partial correlation analysis, and multivariate regression analysis were performed. A sex difference in MDA levels was demonstrated only in healthy controls (F = 7.06, pBonferroni = 0.045) and not seen in patients. Furthermore, only male patients had higher MDA levels than male controls (F = 8.19, pBonferroni = 0.03). Additionally, sex differences were observed in the association of TNF-α and MDA levels with psychotic symptoms (all pBonferroni < 0.05). The interaction of TNF-α and MDA was only associated with general psychopathology symptom in male patients (B = − 0.07, p = 0.02). Our results demonstrate the sex difference in the relationship between TNF-α, MDA, and their interaction with psychopathological symptoms of patients with schizophrenia.

中文翻译：

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首发药物初治精神分裂症TNF-α与氧化应激状态相关性的性别差异

越来越多的证据表明失调的 TNF-α 和氧化应激 (OxS) 有助于精神分裂症的病理生理学。此外，先前的证据表明，精神分裂症的许多方面存在性别差异，包括临床特征、细胞因子和 OxS 标志物。然而，据我们所知，尚无研究调查 TNF-α、OxS 系统及其与精神分裂症患者临床症状的相互作用之间的性别差异，尤其是在首发药物初治 (FEDN) 患者中. 本研究共招募了 119 名 FEDN 精神分裂症患者和 135 名健康对照者。测量血清 TNF-α、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH-Px)、过氧化氢酶 (CAT) 和丙二醛 (MDA)。应用阳性和阴性综合征量表（PANSS）评估精神病症状。进行了双向方差分析、偏相关分析和多变量回归分析。仅在健康对照组（F = 7.06，pBonferroni = 0.045）中证实了 MDA 水平的性别差异，而在患者中未见。此外，只有男性患者的 MDA 水平高于男性对照组（F = 8.19，pBonferroni = 0.03）。此外，在 TNF-α 和 MDA 水平与精神病症状的关联中观察到性别差异（所有 pBonferroni < 0.05）。TNF-α 和 MDA 的相互作用仅与男性患者的一般精神病理学症状相关（B = - 0.07，p = 0.02）。我们的研究结果表明 TNF-α、MDA、