Changes in Body Fat and Related Biochemical Parameters Associated With Atypical Antipsychotic Drug Treatment in Schizophrenia Patients With or Without Metabolic Syndrome

Abstract

Background: Metabolic syndrome (MetS) is a common problem in schizophrenia patients and associated with increased mortality due to cardiovascular disease. Second-generation antipsychotics (SGAs) play an important role in facilitating MetS.Objective: The study aimed to assess weight changes and alterations of indicators of body fat composition and lipid-glucose metabolism induced by reinitiating atypical antipsychotics in patients with schizophrenia when with or without MetS.Methods: After giving informed consent, newly admitted patients with a clinical diagnosis of schizophrenia (ICD-10: F20) and an age between 18 and 55 years were included. MetS was diagnosed according to International Diabetes Federation (IDF) criteria. At entry and after 6 weeks of treatment, anthropometry and biochemical analysis were carried out. Total and visceral fats were measured with the use of non-invasive bioimpedance analysis and subcutaneous fat with calculation of total adipose tissue with the use of caliperometry. Based on biochemical assessments low density (LDL) and very low-density lipoproteins (VLDL), atherogenic index and Homeostatic Model Assessment of Insulin Resistance (IR-HOMA) were calculated. Statistical analysis was conducted using Wilcoxon signed-rank test, Mann-Whitney U-test, and chi-squared test. Differences were considered statistically significant at p < 0.05.Results: A total of 114 patients (59M/55F) with schizophrenia were examined; they were divided into two groups with (n = 43; 37.7%) and without (n = 71; 62.3%) MetS. After a 6-week SGA treatment, only the total fat fold, waist circumference, triglyceride level, and atherogenic index underwent statistically significant changes in patients with MetS. In those without MetS, statistically significant changes across all fat indicators were noted. Also, a significant increase in blood glucose and HOMA-IR parameters, triglyceride, and VLDL levels and atherogenic index was observed in this group.Discussion: The study illustrates the benefits of estimating both anthropometric and biochemical parameters shortly after (re)installing treatment of schizophrenia in order to minimize the risk of MetS development.

Amino Acid and Acylcarnitine Levels in Chronic Patients with Schizophrenia: A Preliminary Study

“…Individuals with schizophrenia are known to have an increased risk of diabetes mellitus, metabolic syndrome, and other metabolic abnormalities [31]. In this case, schizophrenia itself may be a risk factor for metabolic syndrome, and also antipsychotic drugs, particularly secondgeneration antipsychotics, may contribute the risk [32]. Recently, it has been demonstrated that the level of acylcarnitines in patients with schizophrenia differs depending on the presence of metabolic syndrome [33].…”

Body Fat Parameters, Glucose and Lipid Profiles, and Thyroid Hormone Levels in Schizophrenia Patients with or without Metabolic Syndrome

“…Patients with schizophrenia and MetS had a significantly larger fat component, including both visceral and subcutaneous fat, compared with patients with schizophrenia without MetS ( Table 3 ) which is expected, considering that abdominal obesity is the main diagnostic criterion for MetS by IDF criteria. Previous studies have shown that patients with chronic schizophrenia, even with normal body weight, have higher levels of visceral fat than healthy people do [ 18 ]; therefore, it might be suggested that monitoring the fat component in patients with schizophrenia treated with antipsychotics is an essential part of all management tactics for patients with this severe mental disorder to prevent the development of MetS [ 44 ].…”

Adipocytokines and Metabolic Syndrome in Patients with Schizophrenia

“…MetS is associated with an increased risk for type 2 diabetes and cardiovascular pathology and, therefore, with high mortality rates among patients with schizophrenia [ 2 , 3 , 4 ]. In a recent study, our group showed an increase in body fat composition after six weeks of therapy using second-generation antipsychotics (SGAs) with a magnitude that depended upon the presence of MetS [ 5 ]. The endocrine functions of adipose tissue are widely known for their ability to produce bioactive peptides and cytokines, or so-called “adipokines,” which regulate metabolism and inflammation and may decrease the insulin sensitivity of tissues [ 6 , 7 , 8 , 9 ].…”