주요 정신질환과 대사장애와의 관련성: 미토콘드리아 기능장애를 중심으로

Abstract

Objectives: The association between major psychiatric disorders, including major depressive disorder, bipolar disorder, and schizophrenia, and metabolic disorders has been reported in numerous previous studies. This review aims to examine the potential for mitochondrial dysfunction as a common pathophysiology between psychiatric and metabolic disorders.

Methods: The author searched PubMed for full-text articles published between 2000 and 2024, using keywords related to mitochondrial dysfunction, psychiatric disorders, and metabolic syndrome.

Results: Psychiatric and metabolic disorders shared common mitochondrial dysfunction, including reduced ATP production, oxidative phosphorylation defects, impaired reactive oxygen species balance regulation, and unstable mitochondrial DNA (mtDNA). Key molecular regulators and signaling pathways, such as peroxisome proliferator-activated receptor gamma coactivator, sirtuin 1, adenosine monophosphate-activated protein kinase, and the mammalian target of rapamycin, have played significant roles in the pathophysiology of psychiatric and metabolic disorders. There was also evidence for shared etiologies in these disorders, including alterations in the tryptophan-kynurenine pathway, purinergic signalling, and inflammatory mechanisms. Peripheral markers, including mtDNA copy number, lactate, ATP concentration, and oxidative stress markers, have the potential to provide useful diagnostic and treatment response information. Combining these biomarkers with machine learning-based models has shown the potential to be beneficial not only for disease classification but also for predicting treatment response.

Conclusions: This review shows that mitochondrial dysfunction acts as a common pathophysiological mechanism in psychiatric and metabolic disorders. These research findings suggest the potential for biomarker-based diagnostics, therapeutic interventions targeting mitochondrial health, and the need for an integrated approach to psychiatry and metabolic medicine.