Low prevalence of lipid metabolism abnormalities in APOE ε2-genotype and male patients 60 years or older with schizophrenia

Abstract

BackgroundSchizophrenia is a serious mental disorder largely manageable with atypical antipsychotics; however, these drugs have been associated with glucose/lipid metabolism issues such as diabetes and hyperlipidaemia. Apolipoprotein E (APOE) is the most abundant apolipoprotein, and APOE genotypes have been correlated with lipid metabolism phenotypes in an age-dependent manner. Studies examining the relationship between the APOE genotype and lipid abnormalities in patients with schizophrenia have been inconclusive, but primarily focused on adult patient populations. Therefore, we explored the correlations between the APOE genotype and glucose/lipid metabolism indicators and abnormalities in hospitalized patients 60 years or older with schizophrenia with a history of long-term antipsychotics use.MethodsWe assessed APOE genotype, age, weight, height, blood glucose, triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein in a total of 294 patients. APOE genotypes were divided into three groups: APOE ε2 (ε2/ε2 and ε2/ε3), APOE ε3 (ε3/ε3), and APOE ε4 (ε3/ε4 and ε4/ε4), and comparisons were conducted among these groups or according to ε2 carrier status.Results APOE ε3/ε3 was the most common genotype (68.3%) and at least one ε3 allele was present in 81.8% of patients. There were no differences in antipsychotics type or dose according to the APOE genotype, but serum cholesterol values varied near significantly (P = 0.052) and low-density lipoprotein values varied significantly according to genotype (P < 0.05, lowest in the APOE ε2 genotype). Men had lower cholesterol and low-density lipoprotein levels (P < 0.05) than women. Compared to patients administered typical antipsychotics, those administered atypical antipsychotics had higher triglyceride, cholesterol, and low-density lipoprotein levels (P < 0.05). Stepwise linear regressions showed that cholesterol and low-density lipoprotein levels were influenced by sex, the APOE ε2 genotype, and atypical antipsychotics use.ConclusionsIn the context of atypical antipsychotics use, carriers of the APOE ε2-genotype and male patients with schizophrenia 60 years or older may be less likely to develop a lipid metabolism abnormality.

Association between cognitive impairment and apolipoprotein A1 or apolipoprotein B levels is regulated by apolipoprotein E variant rs429358 in patients with chronic schizophrenia

“…The human apolipoprotein E (ApoE) variant originates from two functional polymorphisms (rs429358 and rs7412) in exon 4 of the ApoE gene, which can be combined to form three major subtypes (2,3 and 4) [15]. Previous studies have shown that ApoE gene polymorphism may affect the level of lipoprotein [16][17][18] and also affect the development of schizophrenia [19,20]. For example, one study found a significant association between ApoE 3 gene variation and schizophrenia in Asian populations [19]; Another study found a significant association between ApoE rs429358 or ApoE rs7412 polymorphisms and low-density lipoprotein levels (LDL) in whites and African Americans [21].…”

Sex Differences in Obesity and Cognitive Function in Chinese Elderly Patients With Chronic Schizophrenia

“…A complete physical examination, medical history, and laboratory tests were also performed for each subject. Detailed inclusion criteria and information collection process were introduced in our previous studies (33).…”

Homozygosity in the APOE 3 Polymorphism Is Associated With Less Depression and Higher Serum Low-Density Lipoprotein in Chinese Elderly Schizophrenics

“…This cross-sectional study was conducted between July 1, 2015, and December 31, 2015, and included 301 hospitalized elderly schizophrenics (age ranges from 60 to 92 years, with an average age of 67.31 ± 6.667; among them, 161 were males, accounting for 53.5%), who were recruited from three mental health centers (including the Shanghai Mental Health Center, the Mental Health Center of Fengxian District in Shanghai, and the Mental Health Center of Jiading District in Shanghai). The method of sampling has been described in our previous studies (14). The inclusion criteria were as follows: (1) aged 60 or more; (2) diagnosed with schizophrenia, which was diagnosed by a senior psychiatrist according to the International Classification of Diseases 10 diagnostic standard; (3) without major medical abnormalities, including unstable, acute, or life-threatening medical illness and central nervous system diseases; (4) was able to cooperate and complete relevant inspections.…”