Rate of Weight Gain and Cardiometabolic Abnormalities in Children and Adolescents

Calarge, Chadi A.; Xie, Diqiong; Fiedorowicz, Jess G.; Burns, Trudy L.; Haynes, William G.

doi:10.1016/j.jpeds.2012.05.051

Cited by 23 publications

(32 citation statements)

References 28 publications

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“…This also includes treatment with FGAs. Apart from monitoring absolute weight gain or BMI changes, the rate of weight gain might be even more important in assessing future cardiometabolic abnormalities [106]. Especially in children and adolescents, close monitoring of metabolic disturbances and weight gain appears to be crucial, as data point towards a lack in monitoring these parameters in youth [107].…”

Section: Monitoring Weight Gainmentioning

confidence: 99%

Weight gain and antipsychotics: a drug safety review

Musil

Obermeier²,

Russ

et al. 2014

Expert Opinion on Drug Safety

155

111

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Recently published data still support the hierarchical ranking of SGAs already proposed in previous reviews ranking clozapine and olanzapine as having the highest risk, followed by amisulpride, asenapine, iloperidone, paliperidone, quetiapine, risperidone and sertindole in the middle, and aripiprazole, lurasidone and ziprasidone with the lowest risk. Number needed to harm varied considerably in our meta-analysis. Younger patients and patients with a lower baseline body mass index are most vulnerable. The greatest amount of weight gain occurs within the first weeks of treatment. AIWG occurs in all diagnostic groups and is also common in treatment with first-generation antipsychotics; therefore, awareness of this adverse event is essential for anyone prescribing antipsychotics.

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Section: Monitoring Weight Gainmentioning

confidence: 99%

Weight gain and antipsychotics: a drug safety review

Musil

Obermeier²,

Russ

et al. 2014

Expert Opinion on Drug Safety

155

111

View full text Add to dashboard Cite

show abstract

“…To examine the association between ferritin concentration and change in weight after starting risperidone, we subtracted weight Z-score at study entry from the one extracted from the medical records, as long as it fell within 30 days before or 3 days after risperidone initiation (i.e., baseline weight). The rationale was as follows: (1) clinicians do not always measure weight at the onset of risperidone treatment, (2) using the suggested range would optimize the sample size without leading to significant error in estimating baseline weight, and (3) our previous research has shown a good agreement between measurements obtained in clinical versus research settings (Calarge et al 2012). …”

Section: Discussionmentioning

confidence: 99%

“…They can cause significant weight gain (Calarge et al 2012). Much has been written about the long-term cardiovascular sequelae of excessive SGA-induced weight gain, particularly when it starts in childhood.…”

mentioning

confidence: 99%

Serum Ferritin, Weight Gain, Disruptive Behavior, and Extrapyramidal Symptoms in Risperidone-Treated Youth

Calarge

Murry

Ziegler

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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Background: Iron deficiency disrupts dopaminergic signaling in rodents, resulting in cognitive deficits that may be reversed with psychostimulants. In humans, iron deficiency with or without anemia has similarly been found to cause neuropsychological and behavioral impairments. However, the clinical effects of low body iron stores in antipsychotic-treated children have not been examined. Methods: Medically healthy, 5-to 17-year-old boys treated with risperidone for at least 1 year were enrolled between February 2009 and November 2013 in a multiphase study, examining the skeletal effects of calcium and vitamin D supplementation in risperidone-induced hyperprolactinemia. Anthropometric measures were collected and medical and pharmacy records were reviewed to obtain treatment history. Psychiatric diagnoses were based on clinical interviews, structured interviews, rating scales, and a review of their medical records. Extrapyramidal symptoms were assessed, and a food frequency questionnaire was completed in a subsample. Laboratory tests, including ferritin concentration (a marker of body iron status), were obtained upon study entry. Results: A total of 114 participants (mean age: 11.0 -2.6 years) were included, the vast majority (>90%) having attentiondeficit/hyperactivity disorder and/or disruptive behavior disorder. They had taken risperidone for an average 3.1 -2.0 years. Their serum ferritin concentration was 37.3 -25.6 lg/L with 21% of the sample having a level <20 lg/L, despite appropriate daily dietary iron intake. Ferritin concentration was inversely associated with weight gain following risperidone treatment onset but was not significantly associated with prolactin. After adjusting for the weight-adjusted dose of psychostimulants and risperidone and the daily dose of selective serotonin reuptake inhibitors, ferritin was inversely associated with the severity of disruptive behavior and positively associated (albeit marginally) with prosocial behavior. No association was found between ferritin concentration and extrapyramidal symptoms. Conclusions: Body iron stores are inversely related to risperidone-induced weight gain, even after extended treatment and despite adequate iron intake. Low iron stores are associated with poorer treatment response. Future research should examine iron absorption during antipsychotic treatment and whether repleting iron stores would facilitate clinical response.

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“…Few studies have investigated the relationship between weight gain during early childhood or adolescence and cardiovascular risk factors in later life (19,20). The Bogalusa Heart Study confirmed that obesity directly effects coronary atherogenesis in youth (21) and that this process is accelerated in the presence of combined metabolic abnormalities (22).…”

Section: Discussionmentioning

confidence: 99%

The Association of Rate of Weight Gain During Early Adulthood With the Prevalence of Subclinical Coronary Artery Disease in Recently Diagnosed Type 2 Diabetes: The MAXWEL-CAD Study

et al. 2014

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OBJECTIVETo investigate the association of the rate of weight gain (Rate max_wt ) between the age of 20 years and the age of maximum lifetime weight gain with indicators of subclinical coronary artery disease (CAD) at the time of diagnosis of type 2 diabetes (T2D). RESEARCH DESIGN AND METHODSWe studied 1,724 consecutive Korean subjects aged ‡30 years with recently diagnosed (within 3 months) T2D and one or more cardiovascular risk factors to investigate the association of Rate max_wt with subclinical CAD. We used 64-slice cardiac computed tomography angiography to evaluate the degree of coronary artery stenosis, multivessel involvement, plaque characteristics, and coronary artery calcium score (CACS). Body weight at age 20 years (Wt 20y ) was obtained from participant records. Participants recalled their maximum weight (Wt max ) before T2D diagnosis and age at maximum weight (Age max_wt ). The Rate max_wt was calculated as (Wt max -Wt 20y ) / (Age max_wt -20 years). RESULTSThe prevalence of coronary artery stenosis ( ‡50%), multivessel involvement (two or more vessels), plaque characteristics, and CACS ‡100 were 11.4%, 6.6%, 19.7%, and 12.8%, respectively. Mean Wt 20y and Wt max were 60.1 6 10.5 and 73.0 6 11.5 kg, respectively. Mean Age max_wt was 41.3 6 10.7 years, and Rate max_wt was 0.59 6 0.56 kg/year. After adjusting for cardiovascular risk factors, including current BMI, the highest quarter of prior weight gain was significantly associated with coronary artery stenosis, multivessel involvement, and plaque characteristics, particularly mixed and noncalcified plaque. CONCLUSIONSThe findings suggest that a greater rate of prior weight gain may accelerate the development of subclinical vascular complications in patients with newly diagnosed T2D.

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Rate of Weight Gain and Cardiometabolic Abnormalities in Children and Adolescents

Cited by 23 publications

References 28 publications

Weight gain and antipsychotics: a drug safety review

Weight gain and antipsychotics: a drug safety review

Serum Ferritin, Weight Gain, Disruptive Behavior, and Extrapyramidal Symptoms in Risperidone-Treated Youth

The Association of Rate of Weight Gain During Early Adulthood With the Prevalence of Subclinical Coronary Artery Disease in Recently Diagnosed Type 2 Diabetes: The MAXWEL-CAD Study

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