Abstract
Fatty acid (FA) metabolism is essential in the pathogenesis of schizophrenia, yet prospective evidence linking plasma FAs to schizophrenia risk remains limited. This study aims to investigate the association between plasma FAs and the risk of schizophrenia, and to identify key potential mediators involved in this relationship. This study used plasma FAs data, including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs), from 273,458 schizophrenia-free participants in the UK Biobank. Cox regression models assessed schizophrenia risk based on FA quartiles or 1-SD increments. Mediation analyses were conducted to identify potential intermediate factors underlying these associations. Our results showed that SFAs [HR per 1-SD: 1.11 (95 % CI: 1.05-1.16)] were positively associated with schizophrenia risk, while PUFAs [HR per 1-SD: 0.94 (95 % CI: 0.92-0.97)], particularly n-6 PUFAs [HR per 1-SD: 0.94 (95 % CI: 0.92-0.97)] and linoleic acid (LA) [HR per 1-SD: 0.94 (95 % CI: 0.91-0.97)], exhibited a protective association. Furthermore, C-reactive protein (CRP) was identified as a mediator in the effects of these associations. In conclusion, plasma SFAs may be involved in increasing the risk of schizophrenia, whereas PUFAs, particularly n-6 PUFAs and LA, may have protective effects. Moreover, the observed mediating role of CRP suggests that inflammation could potentially link FAs to schizophrenia.</p>