High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

Julie R. Larsen; Camilla K. Svensson; Louise Vedtofte; Mathilde Lund Jakobsen; Hans Søe Jespersen; Michelle I. Jakobsen; Kamuran Koyuncu; Ole Schjerning; Jimmi Nielsen; Claus T. Ekstrøm; Jens J. Holst; Christoph U Correll; Tina Vilsbøll; Anders Fink-Jensen

doi:10.1017/S1092852918001311

High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

Julie R. Larsen, Camilla K. Svensson, Louise Vedtofte, Mathilde Lund Jakobsen, Hans Søe Jespersen, Michelle I. Jakobsen, Kamuran Koyuncu, Ole Schjerning, Jimmi Nielsen, Claus T. Ekstrøm, Jens J. Holst, Christoph U Correll, Tina Vilsbøll, Anders Fink-Jensen

6 Citationer (Scopus)

Abstract

Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m². Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.

Originalsprog	Engelsk
Tidsskrift	CNS Spectrums
Vol/bind	24
Udgave nummer	4
Sider (fra-til)	441-452
Antal sider	12
ISSN	1092-8529
DOI	https://doi.org/10.1017/S1092852918001311
Status	Udgivet - 1 aug. 2019

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10.1017/S1092852918001311

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Larsen, J. R., Svensson, C. K., Vedtofte, L., Jakobsen, M. L., Jespersen, H. S., Jakobsen, M. I., Koyuncu, K., Schjerning, O., Nielsen, J., Ekstrøm, C. T., Holst, J. J., Correll, C. U., Vilsbøll, T., & Fink-Jensen, A. (2019). High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine. CNS Spectrums, 24(4), 441-452. https://doi.org/10.1017/S1092852918001311

Larsen, JR, Svensson, CK, Vedtofte, L, Jakobsen, ML, Jespersen, HS, Jakobsen, MI, Koyuncu, K, Schjerning, O, Nielsen, J, Ekstrøm, CT , Holst, JJ, Correll, CU, Vilsbøll, T & Fink-Jensen, A 2019, 'High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine', CNS Spectrums, bind 24, nr. 4, s. 441-452. https://doi.org/10.1017/S1092852918001311

@article{eddd331ba6664c8fa4835d8f9e9a67cb,

title = "High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine",

abstract = "Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.",

author = "Larsen, {Julie R.} and Svensson, {Camilla K.} and Louise Vedtofte and Jakobsen, {Mathilde Lund} and Jespersen, {Hans S{\o}e} and Jakobsen, {Michelle I.} and Kamuran Koyuncu and Ole Schjerning and Jimmi Nielsen and Ekstr{\o}m, {Claus T.} and Holst, {Jens J.} and Correll, {Christoph U} and Tina Vilsb{\o}ll and Anders Fink-Jensen",

year = "2019",

month = aug,

day = "1",

doi = "10.1017/S1092852918001311",

language = "English",

volume = "24",

pages = "441--452",

journal = "CNS Spectrums",

issn = "1092-8529",

publisher = "Cambridge University Press",

number = "4",

}

TY - JOUR

T1 - High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

AU - Larsen, Julie R.

AU - Svensson, Camilla K.

AU - Vedtofte, Louise

AU - Jakobsen, Mathilde Lund

AU - Jespersen, Hans Søe

AU - Jakobsen, Michelle I.

AU - Koyuncu, Kamuran

AU - Schjerning, Ole

AU - Nielsen, Jimmi

AU - Ekstrøm, Claus T.

AU - Holst, Jens J.

AU - Correll, Christoph U

AU - Vilsbøll, Tina

AU - Fink-Jensen, Anders

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.

AB - Objective: To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes. Methods: A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c. Results: Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes. Conclusion: Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.

U2 - 10.1017/S1092852918001311

DO - 10.1017/S1092852918001311

M3 - Journal article

C2 - 30596361

SN - 1092-8529

VL - 24

SP - 441

EP - 452

JO - CNS Spectrums

JF - CNS Spectrums

IS - 4

ER -

High prevalence of prediabetes and metabolic abnormalities in overweight or obese schizophrenia patients treated with clozapine or olanzapine

Abstract

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