Antipsychotic-induced weight gain and birth weight in psychosis: A fetal programming model

Garriga, Marina; Fernández-Egea, Emilio; Mallorquí, Andrea; Serrano, Lourdes; Oliveira, Cristina; Parellada, Eduard; Kirkpatrick, Brian; Vieta, Eduard; Bernardo, Miquel; García-Rizo, Clemente

doi:10.1016/j.jpsychires.2019.05.004

Cited by 18 publications

(20 citation statements)

References 52 publications

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“…Furthermore, this association was especially present in patients with schizophrenia. Besides the lack of similar studies on affective spectrum disorders and diabetes, these results are in line with previous research on naïve and treatment-resistant patients with schizophrenia, low birth weight and antipsychotic induced weight gain as outcome [45,46]. Cross sectional results have shown an increased obesity due to antipsychotics in those with low birth weight and a treated-resistant psychosis in comparison with naïve patients [45].…”

Section: Discussionsupporting

confidence: 88%

“…Cross sectional results have shown an increased obesity due to antipsychotics in those with low birth weight and a treated-resistant psychosis in comparison with naïve patients [45]. However, when doing prospective follow-up studies, of psychotic patients starting obesogenic antipsychotics (such as olanzapine and clozapine), birth weight did not present the same modifier effect on antipsychotic induced weight gain [46]. After 16–18 weeks of antipsychotics, low birth weight only predicted weight gain in naïve patients starting their first antipsychotic, while these results were not replicated in patients that had been already treated (psychotic treated resistant patients) [46].…”

Section: Discussionmentioning

confidence: 99%

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Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Garriga

Wium‐Andersen

et al. 2019

Eur. psychiatr.

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Background: Birth dimensions have been associated with increased risk of both, severe mental illness and type 2 diabetes in adulthood, however, any influence on their co-occurrence has never been examined. This cohort study examine whether birth weight/ponderal index explain or modify the later association between severe mental illness and risk of type 2 diabetes. Methods: The Metropolit cohort included 10,863 Danish men born in 1953 with information from age at conscription (between1971-84) until February 15th, 2018. Severe mental illness was defined as the exposure and information was retrieved from the national Danish health registries. Information on type 2 diabetes diagnosis or oral antidiabetic prescriptions was also obtained, as they were the outcome of interest. Information on birth weight/ponderal index was available from birth certificates. Cox proportional hazards regression models were used to estimate the associations and interactions were tested. Results: After 47.1 years of follow-up, 848 (7.8%) and 1320 (12.2%) men developed a severe mental illness or diabetes, respectively. Men with severe mental illness presented higher risk of subsequent diabetes (HR = 1.92; 95%CI, 1.61–2.30). This association was stronger in severe mental ill men with low birth weight (HR = 3.58; 95%CI, 2.11–6.07), than in those normal birth weight (HR = 1.79; 95%CI, 1.45–2.20). This effect modification was most evident for men diagnosed with schizophrenia. Conclusions: Birth information on birth weight/ponderal index could be of interest in diabetes screening on severe mental ill populations (especially in schizophrenia) since they might play a critical role in the increased risk of type 2 diabetes following severe mental illness.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Garriga

Wium‐Andersen

et al. 2019

Eur. psychiatr.

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“…Our results mimic the same U-shaped curve (figure 1A), with increased risk for extremely low, low, and extremely high birth weights. While there are no previous studies on the effect of birth weight on diabetes onset in people with schizophrenia, the results align with previous work on birthweight modulation of weight gain in schizophrenia,20 30 a metabolic complication commonly associated with diabetes. Importantly, the present study adds clinical significance, as here we used well-established markers of glucose dysregulation (diabetes or pre-diabetic state).…”

Section: Discussionsupporting

confidence: 85%

“…Adverse scenarios for these adaptations include the widespread availability of calorie-rich food, or perhaps antipsychotic-induced increased appetite and energy intake 19. We have previously reported an inverse correlation between birth weight and increased adiposity in clozapine-treated patients,20 and more recently that birth weight modulates weight gain in drug-naïve patients with first-episode psychosis and after clozapine initiation 21. To date, there are no published studies on whether abnormal birth weight modulates diabetes onset in patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Birth weight, family history of diabetes and diabetes onset in schizophrenia

Fernández-Egea

Walker

Ziauddeen

et al. 2020

BMJ Open Diab Res Care

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IntroductionThe prevalence of diabetes in schizophrenia is twice that in the general population, but there are few reliable predictors of which individuals will develop glucose dysregulation.ObjectiveTo test if abnormal birth weight (either too low or too high) and parental diabetes, both variables that can be ascertained in the clinic, can predict diabetes onset in patients with schizophrenia.Research design and methodsElectronic records of a cohort of 190 clozapine-treated patients (37% treated for more than 20 years) and Cox regression survival analysis (with any type of glucose dysregulation as the event) to account for differences in length of treatment before the event and age at clozapine treatment initiation.ResultsAge at clozapine initiation (Exp(B)=1.098; p<0.001), family history of diabetes (Exp(B)=2.299; p=0.049) and birth weight2 (Exp(B)=0.999; p=0.013) were significant predictors of glucose dysregulation onset, while gender was not (Exp(B)=0.1.350; p=0.517). Among individuals with 10 years of follow-up, 80% of those with both abnormal birth weight and a family history of diabetes developed diabetes compared with 56% with only abnormal birth weight, 40% with only a family history of diabetes and 20% in those with neither.ConclusionsSince 48% of cases had at least one risk factor and 6% had both risk factors, there is a substantial proportion of patients for whom preventive strategies could be implemented.

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“…Also, we found that high BMI was inversely correlated to education levels, which is consistent with previous studies 2 , 55 , 56 . In addition, most of the previous studies demonstrated that atypical antipsychotic treatment may lead to increased obesity in schizophrenia 57 , 58 . In this study, however, we did not find that BMI was significantly associated with clozapine/olanzapine treatment.…”

Section: Discussionmentioning

confidence: 99%

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

Huang

et al. 2020

Sci Rep

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Obesity is common comorbidity in patients with schizophrenia. Previous studies have reported that homocysteine (Hcy) is increased in schizophrenia. However, no study has reported the association between BMI and Hcy levels in schizophrenia. This cross-sectional naturalistic study aimed to evaluate the relationship between BMI, Hcy and clinical symptoms in Chinese Han patients with chronic schizophrenia. Clinical and anthropometric data as well as plasma Hcy level and glycolipid parameters were collected. Psychopathology was measured with the Positive and Negative Syndrome Scale (PANSS). Our results showed that compared with the low BMI group, the high BMI group had a higher PANSS general psychopathology subscore, higher levels of blood glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol (all p < 0.05). Hcy levels were negatively associated with BMI in patients (p < 0.001). Hcy level, the PANSS general psychopathology subscale, total cholesterol and education (all p < 0.05) were the influencing factors of high BMI. Our study suggest that Hcy level may be associated with BMI in patients with schizophrenia. Moreover, patients with high BMI show more severe clinical symptoms and higher glucose and lipid levels.

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Antipsychotic-induced weight gain and birth weight in psychosis: A fetal programming model

Cited by 18 publications

References 52 publications

Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Birth weight, family history of diabetes and diabetes onset in schizophrenia

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

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