Desheng Zhai1, Taizhen Cui2, Yahui Xu3, Yihang Feng2, Xin Wang4, Yuxin Yang5, Songji Li2, Dushuang Zhou2, Gaopan Dong2, Ying Zhao6, Yunlei Yang7, Ruiling Zhang8. 1. The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China; School of Public Health, Xinxiang Medical University, Xinxiang 453003, China. 2. School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China. 3. The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China. 4. McLean Hospital & Harvard Medical School, 115 Mill St., Belmont, MA 02478, USA. 5. The First Affiliated Hospital, Xinxiang Medical University, Weihui 453100, China. 6. School of Pharmacy, Xinxiang Medical University, Xinxiang 453003, China. Electronic address: zhaoyingxxmc@163.com. 7. Department of Neuroscience and Physiology, State University of New York Upstate Medical University, Syracuse, NY 13210, USA. Electronic address: yangyun@upstate.edu. 8. The Second Affiliated Hospital, Xinxiang Medical University, Xinxiang 453003, China. Electronic address: zhangruilingxx@163.com.
Abstract
OBJECTIVE: It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. METHODS: We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. RESULTS: Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. CONCLUSION: These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.
OBJECTIVE: It is well established that schizophreniapatients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. METHODS: We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. RESULTS: Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. CONCLUSION: These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.
Authors: Maria Fe Barcones; Karina Soledad MacDowell; Borja García-Bueno; Miquel Bioque; Leticia Gutiérrez-Galve; Ana González-Pinto; Maria José Parellada; Julio Bobes; Miguel Bernardo; Antonio Lobo; Juan Carlos Leza Journal: Int J Neuropsychopharmacol Date: 2018-05-01 Impact factor: 5.176