Risk Factors Associated With Metabolic Syndrome in Bipolar and Schizophrenia Subjects Treated With Antipsychotics

Ellingrod, Vicki L.; Taylor, Stephan F.; Dalack, Gregory W.; Grove, Tyler B.; Bly, Michael J.; Brook, Robert D.; Zöllner, Sebastian; Pop‐Busui, Rodica

doi:10.1097/jcp.0b013e3182485888

Cited by 76 publications

(73 citation statements)

References 30 publications

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“…Interestingly, increasing age was negatively correlated with the likelihood of meeting MetS criteria, suggesting that this interaction exerts a stronger effect on relatively younger patients. Consistent with the studies by Ellingrod et al [106,107], Devlin et al [108] found that pediatric patients with ASDs carrying the 677T allele were at a greater risk of MetS compared to CC homozygotes. Similarly, Kao et al [109] reported a nominally significant association between the T allele and AIWG.…”

Section: Resultssupporting

confidence: 80%

“…Following up on the results of a previous study [106], Ellingrod et al [107] found that an interaction between the MTHFR 677T and COMT 158Val alleles was positively associated with risk of AP-MetS. Interestingly, increasing age was negatively correlated with the likelihood of meeting MetS criteria, suggesting that this interaction exerts a stronger effect on relatively younger patients.…”

Section: Resultsmentioning

confidence: 89%

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Genetics of Common Antipsychotic-Induced Adverse Effects

MacNeil

Müller

2016

Complex Psychiatry

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The effectiveness of antipsychotic drugs is limited due to accompanying adverse effects which can pose considerable health risks and lead to patient noncompliance. Pharmacogenetics (PGx) offers a means to identify genetic biomarkers that can predict individual susceptibility to antipsychotic-induced adverse effects (AAEs), thereby improving clinical outcomes. We reviewed the literature on the PGx of common AAEs from 2010 to 2015, placing emphasis on findings that have been independently replicated and which have additionally been listed to be of interest by PGx expert panels. Gene-drug associations meeting these criteria primarily pertain to metabolic dysregulation, extrapyramidal symptoms (EPS), and tardive dyskinesia (TD). Regarding metabolic dysregulation, results have reaffirmed HTR2C as a strong candidate with potential clinical utility, while MC4R and OGFR1 gene loci have emerged as new and promising biomarkers for the prediction of weight gain. As for EPS and TD, additional evidence has accumulated in support of an association with CYP2D6 metabolizer status. Furthermore, HSPG2 and DPP6 have been identified as candidate genes with the potential to predict differential susceptibility to TD. Overall, considerable progress has been made within the field of psychiatric PGx, with inroads toward the development of clinical tools that can mitigate AAEs. Going forward, studies placing a greater emphasis on multilocus effects will need to be conducted.

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Section: Resultssupporting

confidence: 80%

Section: Resultsmentioning

confidence: 89%

Genetics of Common Antipsychotic-Induced Adverse Effects

MacNeil

Müller

2016

Complex Psychiatry

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“…For example, compared with age-and gender matched general population groups, bipolar patients have a double increased risk for metabolic syndrome (odds ratio=1.98; 95% CI=1.74-2.25) (Vancampfort et al, 2013c) and diabetes (relative risk=1.98; 95% CI, 1.6-2.4) (Vancampfort et al, 2015b). Next to genetic predisposition (Ellingrod et al, 2012), shared pathophysiological mechanisms (Dargél et al, 2015), and side-effects of psychotropic medication (Vancampfort et al, 2015c), poor lifestyle habits including higher prevalence of smoking (Jackson et al, 2015) and substance abuse (Hjorthøj et al, 2015) and lower levels of physical activity (Janney et al, 2014) play prominent roles in the cardio-metabolic risk profile of people with bipolar disorder.…”

Section: Introductionmentioning

confidence: 99%

Physical activity as a vital sign in patients with bipolar disorder

Vancampfort

Probst

Wyckaert

et al. 2016

Psychiatry Research

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The most significant contributor to premature mortality in patients with bipolar disorder is preventable cardiovascular diseases. This study investigated if the Physical Activity Vital Sign (PAVS) assessment (two questions which clarify if a person meets the recommended 150 minutes of physical activity per week) can identify patients with bipolar disorder at higher risk of cardio-metabolic abnormalities.Clinical differences between those who adhere and those who did not adhere to the physical activity guidelines were investigated using an ANCOVA controlling for age and gender. Sixty-five (29♂) inand outpatients with bipolar disorder (age=45.1±9.8years) completed the PAVS-questions, underwent full-fasting metabolic screening, and performed a six-minute walk test (6MWT).Those patients not meeting the physical activity recommendations had a higher body mass index, performed worse on the 6MWT and were at a significantly higher risk for cardio-metabolic diseases. Relative risks ranged from 1.33 for having dyslipidemia to 5.33 for hyperglycemia. The current data offer the first evidence that the PAVS assessment might be a useful vital sign in the routine assessment of in-and outpatients with bipolar disorder.

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“…Patients with BD are known to have nearly twice the normal risk of dying from CVD (Ösby et al, 2011, 2016). Genetic vulnerability (Ellingrod et al, 2012), illness-related inflammatory processes (Rosenblat et al, 2014), cardiometabolic side-effects of pharmacotherapy (Correll et al, 2015), and lifestyle factors including a sedentary lifestyle (Janney et al, 2014), higher prevalence of substance abuse (Waxmonsky et al, 2005), and a poor diet (Bernstein et al, 2015) all contribute to the increased CVD risk.…”

Section: Introductionmentioning

confidence: 99%