TY - JOUR
T1 - Glucometabolic hormones and cardiovascular risk markers in antipsychotic-treated patients
AU - Ebdrup, Bjørn H
AU - Knop, Filip K
AU - Madsen, Anna
AU - Mortensen, Henrik B
AU - Søgaard, Birgitte
AU - Holst, Jens Juul
AU - Szecsi, Pal B
AU - Lublin, Henrik
N1 - © Copyright 2014 Physicians Postgraduate Press, Inc.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Objective: Treatment with antipsychotic drugs is widely associated with metabolic side effects such as weight gain and disturbed glucose metabolism, but the pathophysiologic mechanisms are unclear. Method: Fifty nondiabetic (fasting plasma glucose ≤ 7.0 mmol/L), antipsychotic-treated male patients (ICD-10 diagnosis code F20, F21, F22, F25, F28, or F60; mean±SD age = 33.0±6.7 years; body mass index [BMI; kg/ m2] = 26.0±4.7; waist circumference = 95.9±13.3 cm; glycated hemoglobin A1c [HbA1c] = 5.7%±0.3%) and 93 age- and waist circumference-matched healthy male controls (age = 33±7.3 years; BMI = 26.1±3.9; waist circumference = 94.6±11.9 cm; HbA1c = 5.7%±0.3%) participated in this cross-sectional study. Blood was sampled in the fasting state and 90 minutes after ingestion of a standardized liquid meal (2,268 kJ). The primary outcomes were glucometabolic hormones and cardiovascular risk markers. Data were collected between March 2008 and February 2010. Results: Compared to healthy controls, patients were characterized by elevated fasting levels of proinsulin, C-peptide, and glucose-dependent insulinotropic polypeptide (GIP) (P < .05) and higher postprandial levels of insulin, proinsulin, C-peptide, and GIP (P ≤ .02). Also, patients exhibited elevated plasma levels of C-reactive protein and signs of dyslipidemia. Fasting plasma levels of insulin, glucagon, glucagon-like peptide-1 (GLP-1), ghrelin, leptin, adiponectin, tumor necrosis factor-α, plasminogen activator inhibitor-1, and interleukin-6 and postprandial levels of glucagon, GLP-1, ghrelin, leptin, and adiponectin did not differ between groups. Conclusions: Presenting with an insulin resistant-like pattern, including beta cell hypersecretion and elevated GIP levels, nondiabetic antipsychotic-treated patients display emerging signs of dysmetabolism and a compromised cardiovascular risk profile. The appetite-regulating hormones GLP-1 and ghrelin appear not to be influenced by antipsychotic treatment. Our findings provide new clinical insight into the pathophysiology associated with metabolic side effects of antipsychotic treatment and put emphasis on the importance of implementing metabolic screening into psychiatric practice.
AB - Objective: Treatment with antipsychotic drugs is widely associated with metabolic side effects such as weight gain and disturbed glucose metabolism, but the pathophysiologic mechanisms are unclear. Method: Fifty nondiabetic (fasting plasma glucose ≤ 7.0 mmol/L), antipsychotic-treated male patients (ICD-10 diagnosis code F20, F21, F22, F25, F28, or F60; mean±SD age = 33.0±6.7 years; body mass index [BMI; kg/ m2] = 26.0±4.7; waist circumference = 95.9±13.3 cm; glycated hemoglobin A1c [HbA1c] = 5.7%±0.3%) and 93 age- and waist circumference-matched healthy male controls (age = 33±7.3 years; BMI = 26.1±3.9; waist circumference = 94.6±11.9 cm; HbA1c = 5.7%±0.3%) participated in this cross-sectional study. Blood was sampled in the fasting state and 90 minutes after ingestion of a standardized liquid meal (2,268 kJ). The primary outcomes were glucometabolic hormones and cardiovascular risk markers. Data were collected between March 2008 and February 2010. Results: Compared to healthy controls, patients were characterized by elevated fasting levels of proinsulin, C-peptide, and glucose-dependent insulinotropic polypeptide (GIP) (P < .05) and higher postprandial levels of insulin, proinsulin, C-peptide, and GIP (P ≤ .02). Also, patients exhibited elevated plasma levels of C-reactive protein and signs of dyslipidemia. Fasting plasma levels of insulin, glucagon, glucagon-like peptide-1 (GLP-1), ghrelin, leptin, adiponectin, tumor necrosis factor-α, plasminogen activator inhibitor-1, and interleukin-6 and postprandial levels of glucagon, GLP-1, ghrelin, leptin, and adiponectin did not differ between groups. Conclusions: Presenting with an insulin resistant-like pattern, including beta cell hypersecretion and elevated GIP levels, nondiabetic antipsychotic-treated patients display emerging signs of dysmetabolism and a compromised cardiovascular risk profile. The appetite-regulating hormones GLP-1 and ghrelin appear not to be influenced by antipsychotic treatment. Our findings provide new clinical insight into the pathophysiology associated with metabolic side effects of antipsychotic treatment and put emphasis on the importance of implementing metabolic screening into psychiatric practice.
KW - Adiponectin
KW - Adolescent
KW - Adult
KW - Antipsychotic Agents
KW - C-Peptide
KW - C-Reactive Protein
KW - Cardiovascular Diseases
KW - Case-Control Studies
KW - Cross-Sectional Studies
KW - Gastric Inhibitory Polypeptide
KW - Gastrointestinal Hormones
KW - Ghrelin
KW - Glucagon
KW - Glucose Metabolism Disorders
KW - Humans
KW - Insulin
KW - Interleukin-6
KW - Leptin
KW - Male
KW - Middle Aged
KW - Plasminogen Activator Inhibitor 1
KW - Proinsulin
KW - Risk Factors
KW - Tumor Necrosis Factor-alpha
KW - Young Adult
U2 - 10.4088/jcp.13m08820
DO - 10.4088/jcp.13m08820
M3 - Journal article
C2 - 25295432
SN - 0160-6689
VL - 75
SP - e899-905
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 9
ER -
