Increased dyslipidemia in schizophrenic outpatients using new generation antipsychotics

Leitão-Azevedo, Carmen Lúcia; Guimarães, Lísia Rejane; Abreu, Martha Guerra Belmonte de; Gama, Clarissa Severino; Lobato, Maria Inês Rodrigues; Belmonte-de-Abreu, Paulo Silva

doi:10.1590/s1516-44462006005000016

Cited by 18 publications

(8 citation statements)

References 10 publications

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“…However, one previous study, which assessed some metabolic disturbances associated with MS in schizophrenic outpatients in use of antipsychotics found a high percentage of overweight patients, and increased prevalence of dyslipidemia. 26 Considering that the prevalence rates of DM and obesity in Brazil 27,28 are lower than those in United States, 19,27 we can estimate that the prevalence of MS in our country is inferior to the prevalence of MS (23.7%) found in that country. Thus, the prevalence of MS found in this study (29.4%) is probably higher than that of the general population.…”

Section: Discussionmentioning

confidence: 65%

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Teixeira¹,

Rocha²

2007

Rev. Bras. Psiquiatr.

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A b s t r a c t Objective: Metabolic syndrome is a highly prevalent disorder among the general population. Studies show an even higher prevalence among psychiatric patients. The objective of this study is to assess the prevalence of metabolic syndrome among inpatients of a psychiatric ward of a general hospital in Brazil and correlate it with their respective psychiatric diagnoses and with the antipsychotics and mood stabilizers used. Method: 170 inpatients (mean age: 45.6 years) were evaluated according to the National Cholesterol Education Program criteria for metabolic syndrome, with a modification of the criteria for blood pressure and fasting glucose. Results: The prevalence found was 29.4%, being higher in women (43.6% versus 20.8%, p = 0.002). The prevalence stratified by psychiatric diagnostic was 48.1% for depression, 38.3% for bipolar disorder, 31.8% for schizophrenia and schizoaffective disorder, 5.1% for alcoholism, and 23.1% for "other mental disorders". The prevalence for alcoholism was significantly lower than the prevalence rates associated with other diagnostic categories (p = 0.035). After using the multivariate analysis, female gender and use of lithium remained as factors associated with a diagnosis of metabolic syndrome. Conclusions: The prevalence found was 29.4%. Gender (female) and use of lithium were factors significantly associated with the diagnosis of metabolic syndrome.Descriptors: Metabolic syndrome X; Mental disorders; Schizophrenia; Bipolar disorder; Depression Resumo Objetivo: A síndrome metabólica é um transtorno de alta prevalência na população em geral. Estudos demonstram prevalência ainda maior em pacientes psiquiátricos. O objetivo deste trabalho é avaliar a prevalência de síndrome metabólica em pacientes internados em uma enfermaria psiquiátrica de um hospital geral no Brasil e correlacioná-la com os diagnósticos psiquiátricos e com o uso de medicamentos antipsicóticos e moduladores do humor. Método: Cento e setenta pacientes (idade média: 45,6 anos) foram avaliados de acordo com os critérios do National Cholesterol Education Program para síndrome metabólica, modificados nos critérios pressão arterial e glicemia de jejum. Resultados: A prevalência encontrada foi de 29,4%, sendo mais elevada em mulheres (43,6% versus 20,8%, p = 0,002). A prevalência estratificada por diagnóstico psiquiátrico foi de 48,1% para depressão, 38,3% para transtorno bipolar, 31,8% para esquizofrenia e transtornos esquizoafetivos, 5,1% para alcoolismo e 23,1% para "outros transtornos mentais". A prevalência para alcoolismo foi significativamente menor, se comparada às prevalências associadas às demais categorias diagnósticas (p = 0,035). Após análise multivariada, o sexo feminino e o uso de lítio permaneceram como fatores associados ao diagnóstico de síndrome metabólica. Conclusão: A prevalência de síndrome metabólica encontrada foi de 29,4%. O sexo feminino e o uso de lítio foram fatores significativamente associados ao diagnóstico de síndrome metabólica.

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Section: Discussionmentioning

confidence: 65%

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Teixeira¹,

Rocha²

2007

Rev. Bras. Psiquiatr.

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“…A cross-sectional study of 62 patients with schizophrenia found that increased BMI was associated with dyslipidemia [Kato et al 2005]. Furthermore, Leitão-Azevedo and colleagues showed a significant decrease in HDL cholesterol levels in patients treated with clozapine compared with those treated with first-generation antipsychotics [Leitão-Azevedo et al 2006]. Likewise, for the other metabolic parameters (LDL cholesterol and triglycerides), the study failed to show significant difference between the treatments.…”

Section: Discussionmentioning

confidence: 99%

Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up

Balbão

Hallak

Nunes

et al. 2013

Therapeutic Advances in Psychopharmacology

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Objective: Olanzapine is an atypical antipsychotic drug used to treat schizophrenia. Some of the adverse effects related to its use are obesity, hyperlipidemia, type 2 diabetes and hypertension, which may result in development of metabolic syndrome. This study aimed to investigate a possible increase in some anthropometric and biochemical parameters, and the existence of any correlation between them in Brazilian patients with schizophrenia treated with olanzapine in the mid term. Methods: Thirty subjects with schizophrenia were evaluated, 16 women and 14 men, aged between 18 and 47 years. All patients underwent blood collection and anthropometric measurements at four different times during 12 months of follow up; thus each patient was his or her own control. Results: Evaluation of some anthropometric measurements showed significant differences when comparing the mean values obtained in each of the different data collection times (p < 0.05). However, the biochemical indicators of development of metabolic syndrome measured in our study did not show the same rate of increment, with only the total cholesterol and glucose levels presenting statistically significant changes (p < 0.05), but without the same magnitude of weight change. Conclusion:We conclude that medium-term treatment with olanzapine promoted a substantial weight gain and increased visceral fat, while the metabolic profile did not show the same magnitude of change, suggesting a dissociation between weight gain and blood parameters, despite the severe weight gain observed among subjects evaluated.

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“…9 The excessive cardiovascular mortality associated with SZ and BD is attributed in part to an increased risk of the modifiable atherosclerotic risk factors: obesity, smoking, diabetes, hypertension and dyslipidaemia. [10][11][12] Inflammation is a mechanism that plays a part not only in atherosclerosis but also in different neuropsychiatric disorders, where it is involved in complex and reciprocal interactions with neurotrophins and oxidative stress. Considering these interactions, a Systemic Toxicity Index for mood episodes has recently been proposed to study neurotrophins, oxidative stress markers and inflammatory markers.…”

Section: Introductionmentioning

confidence: 99%

Serum levels of IL-6, IL-10 and TNF-α in patients with bipolar disorder and schizophrenia: differences in pro- and anti-inflammatory balance

Kunz¹,

Ceresér²,

Goi³

et al. 2011

Rev. Bras. Psiquiatr.

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Objective: Previous reports suggest that cytokines act as potential mediators of the interaction between the immune and neuroendocrine systems, and that a proinflammatory state may be associated with bipolar disorder and schizophrenia. The aim is to compare cytokine levels in both disorders. Method: Twenty euthymic bipolar disorder patients, 53 chronic stabilized schizophrenia patients and 80 healthy controls were recruited. Subjects were all non-smokers and non-obese. Cytokines TNF-α, IL-6, and IL-10 were examined by sandwich ELISA. Results: IL-6 levels were increased in schizophrenia patients when compared to controls (p < 0.0001) and euthymic bipolar disorder patients (p < 0.0001). IL-6 levels were no different in controls compared to euthymic bipolar disorder patients (p = 0.357). IL-10 was lower in controls compared to schizophrenia patients (p = 0.001) or to bipolar disorder patients (p = 0.004). There was no significant difference in TNF-α serum levels among the groups (p = 0.284). Gender-based classification did not significantly alter these findings, and no correlation was found between the antipsychotic dose administered and cytokine levels in patients with schizophrenia. Discussion: These findings evidence a chronic immune activation in schizophrenia. Bipolar disorder seems to present an episode-related inflammatory syndrome. Increased anti-inflammatory factor IL-10 in bipolar disorder and schizophrenia suggests different patterns of inflammatory balance between these two disorders. Results further support the need to investigate cytokines as possible biomarkers of disease activity or treatment response.Descriptors: Bipolar disorder; Schizophrenia; Interleukin-6; Interleukin-10; Tumor necrosis factor-alpha (p = 0,284 Resumo Objetivo: Pesquisas sugerem as citocinas como potenciais mediadores da interação entre os sistemas imune e neuroendócrino, e que existe um estado pró-inflamatório associado com transtorno bipolar e esquizofrenia. O objetivo deste estudo é comparar os níveis de citocinas entre os dois distúrbios. Método: Vinte pacientes com transtorno bipolar eutímicos, 53 pacientes com esquizofrenia crônica estabilizados e 80 controles saudáveis foram recrutados. Todos os indivíduos eram não-fumantes e não-obesos. As citocinas TNF-α, IL-6 e IL-10 foram examinadas por ELISA sanduíche. Resultados: A IL-6 estava aumentada nos pacientes com esquizofrenia quando comparados aos controles (p < 0,0001) e aos pacientes bipolares eutímicos (p < 0,0001). Os níveis de IL-6 não foram diferentes nos controles em comparação com pacientes com transtorno bipolar eutímicos (p = 0,357). Os níveis de IL-10 foram menores nos controles quando comparados aos pacientes com esquizofrenia (p = 0,001) ou aos bipolares (p = 0,004). Não houve diferença significativa nos níveis séricos de TNF-α entre os grupos

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Increased dyslipidemia in schizophrenic outpatients using new generation antipsychotics

Cited by 18 publications

References 10 publications

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up

Serum levels of IL-6, IL-10 and TNF-α in patients with bipolar disorder and schizophrenia: differences in pro- and anti-inflammatory balance

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Increased dyslipidemia in schizophrenic outpatients using new generation antipsychotics

Cited by 18 publications

References 10 publications

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up

Serum levels of IL-6, IL-10 and TNF-&#945; in patients with bipolar disorder and schizophrenia: differences in pro- and anti-inflammatory balance

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Product

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Serum levels of IL-6, IL-10 and TNF-α in patients with bipolar disorder and schizophrenia: differences in pro- and anti-inflammatory balance