The metabolic syndrome and its constituting variables in atypical antipsychotic-treated subjects: Comparison with other drug treatments, drug-free psychiatric patients, first-degree relatives and the general population in Venezuela

Baptista, Trino; Serrano, Ana; Uzcátegui, Euderruh; ElFakih, Yamily; Rangel, Nairy; Carrizo, Edgardo; Fernández, Virgínia; Connell, Lisette; Baptista, Enma Araujo de; Quiroz, Segundo; Uzcátegui, Marycelvia; Rondón, Juana; Matos, Yimber; Uzcátegui, Lilia; Gomez, Rigoberto; Valery, Lenin; Novoa-Montero, Darío

doi:10.1016/j.schres.2010.10.014

Cited by 32 publications

(29 citation statements)

References 37 publications

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“…A consistent finding is the high frequency of abnormal triglyceride and low HDL-c levels, as defined in the MS criteria. [1][2][3][4]7,8 As a matter of fact, this profile, along with abnormal WC and insulin levels, accounts for most of the metabolic differences observed between psychiatric and internal medicine patients. 26 Total and LDL-c levels are not formally included in the MS criteria and are often unreported, but they are among the strongest predictors of atherosclerosis and cardiovascular diseases.…”

Section: Metabolic Profilementioning

confidence: 99%

“…By contrast, in a large epidemiological study comprising data from the general population (GP), the authors reported that drug-free BD relatives showed the highest frequency of MS, obesity, and abnormal glucose and diastolic blood pressure (BP) levels among several comparison groups, including drugtreated patients and their relatives. 7 In another study comprising subjects with schizophrenia or schizoaffective disorders and their first-degree relatives, the authors reported that, among the drug-treated groups, those receiving olanzapine displayed the highest blood levels of plasminogen activator inhibitor (PAI-1) and leptin, but levels were similar to those observed in their relatives after controlling for body mass index (BMI). 14 These results indicate that variables other than medication play a role in the development of metabolic dysfunction in patients with BD and their relatives, such as shared environmental and/or genetic factors.…”

Section: Introductionmentioning

confidence: 99%

“…These include metabolic syndrome (MS), migraine, type 2 diabetes mellitus, thyroid disorders, chronic kidney disease, cancer, chronic pain, and obstructive airway disease, among many others. [1][2][3][4][5][6][7][8] Particular emphasis has been placed on characterizing the elevated frequency of MS among patients with BD 4,9 and the postulated role of psychotropic medication in its development and maintenance. 6,7,10,11 Even though a genetically-based predisposition to metabolic dysfunction in BD has been consistently suggested, 12 few studies have evaluated metabolic status in relatives of patients with BD.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Baptista¹,

Sandia²,

Fernández

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: Evidence points to a high prevalence of metabolic dysfunction in bipolar disorder (BD), but few studies have evaluated the relatives of subjects with BD. We conducted a cross-sectional study in an extended family of patients with BD type I. Methods: The available relatives of the same family were interviewed (DSM-IV-R) and assessed in fasting conditions for body mass index, constituent variables of the metabolic syndrome (MS), leptin levels, insulin resistance index, and single nucleotide polymorphisms (SNPs) for the leptin receptor and promoter and PPAR-c2 genes. The frequency of MS was compared with that recorded in the local general population. Results: Ninety-three relatives of three adults with BD were evaluated (30 aged , 18 years, 63 aged . 18 years). The frequency of MS was similar to that of the general population. Significantly higher frequencies of abnormal glucose, total and low density cholesterol (LDL-c) levels (all p , 0.05), waist circumference (p = 0.057), and leptin and insulin resistance values (in adults only) were observed in the family. Adults with the QQ genotype of the leptin receptor displayed higher LDL-c levels than carriers of the R allele. Conclusions: The associations among BD consanguinity, familial hypercholesterolemia, and leptin receptor SNPs reported herein should be replicated and extended in other pedigrees.

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Section: Metabolic Profilementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Baptista¹,

Sandia²,

Fernández

et al. 2015

Rev. Bras. Psiquiatr.

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“…Though a few researchers have studied the change in prevalence rates over time, largely the estimates have been cross-sectional. Amongst the cross sectional studies, as depicted in Table 1,[101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899] most studies have evaluated the patients who are already on treatment and only a few have assessed the prevalence of MetS in drug naive population. Most of the studies have ...…”

Section: Prevalence Of Metabolic Syndrome In Schizophreniamentioning

confidence: 99%

“…[142324308088] Some of the studies have been limited to patients with clozapine and suggest a prevalence of MetS in patients of clozapine to vary from 46% to 62%. [18355486]…”

Section: Prevalence Of Metabolic Syndrome In Schizophreniamentioning

confidence: 99%

Metabolic Syndrome in Schizophrenia

Malhotra¹,

Grover²,

Chakrabarti³

et al. 2013

Indian Journal of Psychological Medicine

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To review the data with respect to prevalence of metabolic syndrome (MetS) and its correlates in schizophrenia. For this review, electronic search engines PUBMED, Sciencedirect, and Google Scholar were used. Available data suggests that most of the studies have been of cross-sectional design. Prevalence rates of MetS have varied from 11% to 69% in medicated patients, and 4-26% in drug naive patients in cross-sectional evaluations. Longitudinal studies have shown the prevalence rates to range from 0% to 14% at the baseline in drug naive patients, which increase to as high as 52.4% by 3 months of antipsychotic medication treatment. The prevalence rates of MetS in patients with schizophrenia are much higher than that seen in general population or healthy controls. Though there is no causal association with any demographic or clinical variables, the risk increases with increase in age. Among antipsychotics, there seems to be an association between MetS and atypical antipsychotics like clozapine and olanzapine. Therefore, the psychiatrists should be more vigilant regarding the presence of MetS in these high risk groups. Research on biological correlates of MetS in schizophrenia is still in its primitive stage, however, these is some evidence to suggest an association of MetS with adiponectin levels, hematological indices, methylenetetrahydrofolate reductase (MTHFR) and Alpha-1A adrenergic receptor (ADRA1A) gene. These areas hold promise, and targeting these with appropriate interventions may help us to prevent the occurrence of MetS in patients with schizophrenia in future.

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Neural Responsivity to Food Cues in Patients With Unmedicated First-Episode Psychosis

et al. 2019

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ImportanceSchizophrenia is associated with a reduced life expectancy of 15 to 20 years owing to a high prevalence of cardiometabolic disorders. Obesity, a key risk factor for the development of cardiometabolic alterations, is more prevalent in individuals with schizophrenia. Although obesity is linked to the altered reward processing of food cues, no studies have investigated this link in schizophrenia without the confounds of antipsychotics and illness chronicity.ObjectiveTo investigate neural responsivity to food cues in first-episode psychosis without the confounds of antipsychotic medication or illness chronicity.Design, Setting, and ParticipantsA case-control study was conducted from January 31, 2015, to September 30, 2018, in London, United Kingdom, of 29 patients with first-episode psychosis who were not taking antipsychotic medication and 28 matched controls.Main Outcomes and MeasuresParticipants completed a food cue paradigm while undergoing a functional magnetic resonance imaging scan. Neural activation was indexed using the blood oxygen level–dependent hemodynamic response. The Dietary Instrument for Nutrition Education was used to measure diet, and the International Physical Activity Questionnaire was used to measure exercise.ResultsThere were no significant differences in age, sex, or body mass index between the 29 patients (25 men and 4 women; mean [SD] age, 26.1 [4.8] years) and 28 controls (22 men and 6 women; mean [SD] age, 26.4 [5.5] years). Relative to controls, patients consumed more saturated fat (t46 = –3.046; P = .004) and undertook less high-intensity (U = 304.0; P = .01) and low-intensity (U = 299.5; P = .005) weekly exercise. There were no group differences in neural responses to food vs nonfood cues in whole-brain or region-of-interest analyses of the nucleus accumbens, insula, or hypothalamus. Body mass index was inversely correlated with the mean blood oxygen level–dependent signal in the nucleus accumbens in response to food vs nonfood cues in controls (R = –0.499; P = .01) but not patients (R = 0.082; P = .70).Conclusions and RelevanceRelative to controls, patients with first-episode psychosis who were not taking antipsychotic medication consumed more saturated fat and showed an altered association between body mass index and neural response to food cues in the absence of differences in neural responses to food cues. These findings highlight how maladaptive eating patterns and alterations in the association between body mass index and neural responses to food cues are established early in the course of schizophrenia.

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The metabolic syndrome and its constituting variables in atypical antipsychotic-treated subjects: Comparison with other drug treatments, drug-free psychiatric patients, first-degree relatives and the general population in Venezuela

Cited by 32 publications

References 37 publications

Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Metabolic Syndrome in Schizophrenia

Neural Responsivity to Food Cues in Patients With Unmedicated First-Episode Psychosis

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