Do Leptin Play a Role in Metabolism–Related Psychopathological Symptoms?

Abstract

Objectives: Leptin is a crucial regulator of energy balance and is associated with obesity. In recent years, it has also been recognized as involved in the psychopathological mechanism. Our study aimed to elucidate the relationships between serum leptin levels, body mass index (BMI), and psychopathology symptoms in patients with schizophrenia.Methods: A cross-sectional assessment of 324 inpatients with schizophrenia was conducted. Schizophrenia symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). Serum leptin levels were assessed by the Enzyme-Linked Immunosorbent Assay (ELISA).Results: Significant differences in sex, BMI, and negative symptom subscale (PANSS-N) scores were found between the groups with high and low leptin levels in the study. Leptin levels were positively correlated with BMI (B = 2.322, t = 9.557, P < 0.001) and negatively correlated with PANSS-N scores (B = −0.303, t = −2.784, P = 0.006).Conclusions: Our results suggest that the increase in leptin levels is responsible for antipsychotic-induced weight gain and improved psychopathological symptoms.

Association of higher plasma leptin levels with HOMA-IR index, high sensitivity C-reactive protein and glycolipid metabolism in patients with chronic schizophrenia: A multi-center cross-sectional study

“…As we know, leptin can be involved in regulating the body's eating behavior, which in turn regulates the level of glucolipid metabolism ( 30 ). Previous literature have shown that increased leptin levels were significantly associated with BMI, body weight ( 7 ), increased waist circumference, and energy intake in psychosis ( 31 , 32 ). Follow-up studies have also found that the clinical symptoms of schizophrenic patients improved after taking antipsychotic drugs, but BMI increased and was associated with increased leptin levels, significantly ( 33 , 34 ).…”

“…Although Current evidence demonstrated that high levels of leptin were an indirect consequence of weight gain during pharmacotherapy ( 7 , 47 ), individualized dietary patterns should be developed in clinical treatment and medications should be selected that have less impact on patients' metabolic indicators.…”

“…Because of the severe weight gain effect of clozapine or olanzapine during medication treatment, patients on clozapine or olanzapine treatment grouped separately, and those taking the rest of the drugs (aripiprazole, amisulpride, ziprasidone, risperidone, quetiapine etc.,) were classified as weak weight gain drug (WWGD) group ( 26 ). Patients were divided into a higher leptin level group (≥ P 75 ) and a lower leptin level group (< P 75 ) based on the quartiles of their plasma leptin levels ( 7 , 27 ).…”

“…Leptin is a class of proteins (16 KD in length) encoded by obesity genes, synthesized and secreted mainly by adipocytes, with biological effects such as reducing appetite, promoting glucose utilization, increasing energy expenditure, and improving insulin sensitivity, also known as anti-obesity hormones ( 4 ). Previous studies have pointed out that plasma leptin levels were increased in schizophrenia patients ( 5 ) and that leptin was closely related to weight gain ( 6 , 7 ), abnormal glucose metabolism and dyslipidemia ( 5 ) in patients.…”

Crosstalk between Schizophrenia and Metabolic Syndrome: The Role of Oxytocinergic Dysfunction

“…However, previous studies noticed an elevation in serum leptin levels among persons with schizophrenia treated with antipsychotics [85], and the evidence suggested that the hyperleptinemic state could be more of a consequence than a cause of antipsychotic-induced weight gain [86]. As it has been proven that leptin levels are positively correlated with the body mass index [87], it is believed that hyperleptinemia that is associated with adipose tissue in persons with obesity without expected appetite reduction may indicate a leptin resistance status [88], a similar concept to insulin resistance in persons with diabetes mellitus. Ghrelin, an orexigenic hormone, increases food intake, modulates glucose homeostasis, decreases brown adipose tissue thermogenesis, and increases reward-seeking behaviors [89], consequently contributing to weight gain and metabolic syndrome.…”