Anne Marie Greenhalgh1, Leticia Gonzalez-Blanco2, Clemente Garcia-Rizo3, Emilio Fernandez-Egea4, Brian Miller5, Miguel Bernardo Arroyo3, Brian Kirkpatrick6. 1. Department of Psychiatry & Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, United States. 2. Department of Psychiatry, University of Oviedo, & Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. 3. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain. 4. Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon, UK. 5. Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, United States. 6. Department of Psychiatry & Behavioral Sciences, University of Nevada School of Medicine, Reno, NV, United States. Electronic address: bkirkpatrick2@aol.com.
Abstract
BACKGROUND: Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance. AIMS: To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). METHOD: We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects. RESULTS: There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58. CONCLUSIONS: As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.
BACKGROUND: Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance. AIMS: To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). METHOD: We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects. RESULTS: There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58. CONCLUSIONS: As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.
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