The prevalence and clinical correlates of metabolic syndrome and cardiometabolic alterations in 430 drug-naive patients in their first episode of schizophrenia

Lang, Xiaoe; Liu, Qinqin; Fang, Han-liu; Zhou, Yongjie; Forster, Mattew T; Li, Zezhi; Zhang, Xiangyang

doi:10.1007/s00213-021-05983-9

Cited by 26 publications

(21 citation statements)

References 44 publications

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“…Nevertheless, in clinical practice, patients with SCZ generally demonstrate a higher prevalence of dyslipidemia, obesity, hypertension, and hyperglycemia than the general population and often have an increased risk of premature death caused by cardiovascular disease 29,30 . Some epidemiological studies targeting first episodes among drug‐naïve patients reported that such individuals had already exhibited high BMI or dyslipidemia 31–33 . This may imply that second‐generation antipsychotics, which is a major risk factor for obesity, are “independent” of MetS‐related traits in the early stages of SCZ.…”

Section: Discussionmentioning

confidence: 99%

“…29,30 Some epidemiological studies targeting first episodes among drug-naïve patients reported that such individuals had already exhibited high BMI or dyslipidemia. [31][32][33] This may imply that second-generation antipsychotics, which is a major risk factor for obesity, are "independent" of MetS-related traits in the early stages of SCZ.…”

Section: Mets-related Traits and Sczmentioning

confidence: 99%

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Shared genetic components between metabolic syndrome and schizophrenia: Genetic correlation using multipopulation data sets

Aoki

Takeo

Ninomiya

et al. 2022

Psychiatry Clin Neurosci

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The genetic relationship between schizophrenia (SCZ) and other nonpsychiatric disorders remains largely unknown. We examined the shared genetic components between these disorders based on multipopulation data sets. Methods:We used two data sets for East Asian (EAS) and European (EUR) samples. SCZ data was based on the Psychiatric Genomics Consortium Asia with our own genome-wide association study for EAS and Psychiatric Genomics Consortium for EUR. Nonpsychiatric data (20 binary traits [mainly nonpsychiatric complex disorders] and 34 quantitative traits [mainly laboratory examinations and physical characteristics]) were obtained from Biobank Japan and UK Biobank for EAS and EUR samples, respectively. To evaluate genetic correlation, linkage disequilibrium score regression analysis was utilized with further meta-analysis for each result from EAS and EUR samples to obtain robust evidence. Subsequent mendelian randomization analysis was also included to examine the causal effect.Results: A significant genetic correlation between SCZ and several metabolic syndrome (MetS) traits was detected in the combined samples (meta-analysis between EAS and EUR data) (body mass index [r g = À0.10, q-value = 1.0 Â 10 À9 ], high-density-lipoprotein cholesterol [r g = 0.072, q-value = 2.9 Â 10 À3 ],blood sugar [r g = À0.068, q-value = 1.4 Â 10 À2 ], triglycerides [r g = À0.052, q-value = 2.4 Â 10 À2 ], systolic blood pressure [r g = À0.054, q-value = 3.5 Â 10 À2 ], and C-reactive protein [r g = À0.076, q-value = 7.8 Â 10 À5 ]. However, no causal relationship on SCZ susceptibility was detected for these traits based on the mendelian randomization analysis. Conclusion:Our results indicate shared genetic components between SCZ and MetS traits and C-reactive protein. Specifically, we found it interesting that the correlation between MetS traits and SCZ was the opposite of that expected from clinical studies: this genetic study suggests that SCZ susceptibility was associated with reduced MetS. This implied that MetS in patients with SCZ was not associated with genetic components but with environmental factors, including antipsychotics, lifestyle changes, poor diet, lack of exercise, and living conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Mets-related Traits and Sczmentioning

confidence: 99%

Shared genetic components between metabolic syndrome and schizophrenia: Genetic correlation using multipopulation data sets

Aoki

Takeo

Ninomiya

et al. 2022

Psychiatry Clin Neurosci

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“…Ward et al [ 44 ] have found that the incidence of metabolic syndrome in schizophrenia is higher than that of the normal population, which may be related to the use of atypical antipsychotics. Chen et al [ 45 – 47 ] have found that typical antipsychotics and atypical antipsychotics can also affect the glucose and lipid metabolism of patients with schizophrenia. It has been reported that among the many second-generation antipsychotic drugs, olanzapine and clozapine have the most obvious effects on glucose and lipid metabolism [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Influencing factors of obesity in community patients with deficit schizophrenia: a cross-sectional study

Pan²,

Li³

et al. 2022

Eur J Med Res

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Background Obesity is very common in patients with schizophrenia. We aimed to evaluate the influencing factors of obesity in community patients with deficit schizophrenia, to provide implication for schizophrenia management in community. Methods We selected patients with deficit schizophrenia who lived in 10 communities in our city from March 1 to June 30, 2021. The characteristics of included schizophrenia patients were evaluated and analyzed. Pearson correlation analysis was conducted to evaluate the obesity and related characteristics. Logistic regression analyses were conducted to assess the risk factors of obesity in patients with schizophrenia. Results A total of 284 patients with schizophrenia were included, the incidence of obesity in patients with schizophrenia was 56.70%. gender (r = 0.619), waist circumference (r = 0.644), BMI (r = 0.891), diabetes (r = 0.698), FG (r = 0.582), triglyceride (r = 0.618), HDL-C (r = −0.644), LDL-C (r = 0.583), apolipoprotein B (r = 0.595), and PANSS score (r = 0.813) were all correlated with the obesity in patients with schizophrenia (all p < 0.05). Logistic regression analysis indicated that female (OR 2.129, 95% CI 1.615–3.022), waist circumference ≥ 90 cm (OR 3.814, 95% CI 2.778 ~ 4.312), diabetes (OR 2.856, 95% CI 1.905 ~ 3.448), FG ≥ 88 mg/dL (OR 1.551, 95% CI 1.284 ~ 2.183), triglyceride ≥ 160 mg/dL (OR 1.804, 95% CI 1.236–2.845), HDL-C ≤ 0.8 mmol/L (OR 2.032, 95% CI 1.614–3.079), LDL-C ≥ 2.0 mmol/L (OR 1.926, 95% CI 1.442–2.041) and apolipoprotein B ≥ 0.70 g/L (OR 2.119, 95% CI 1.658–2.873) were the risk factors of obesity in patients with schizophrenia (all p < 0.05). Conclusions The obesity rate of patients with deficit schizophrenia in the community is high, and there are many associated risk factors. Early intervention targeted on those risk factors are warranted to reduce the obesity in schizophrenia patients.

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“…On the contrary, persons with schizophrenia appear to be at significant risk of developing metabolic syndrome regardless of whether they are receiving any antipsychotic medication [105]. A manifestation of metabolic syndrome risk factors in antipsychotic-naïve persons, persons with first-episode psychosis, and unaffected first-degree relatives suggests that metabolic syndrome could be independent of antipsychotic treatments [106,107]. Hence, schizophrenia itself is a risk for the increased onset of metabolic syndrome.…”

Section: Neurotransmitters and Hormones Of Metabolic Syndrome In Anti...mentioning

confidence: 99%

Crosstalk between Schizophrenia and Metabolic Syndrome: The Role of Oxytocinergic Dysfunction

Goh

Chen

et al. 2022

IJMS

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The high prevalence of metabolic syndrome in persons with schizophrenia has spurred investigational efforts to study the mechanism beneath its pathophysiology. Early psychosis dysfunction is present across multiple organ systems. On this account, schizophrenia may be a multisystem disorder in which one organ system is predominantly affected and where other organ systems are also concurrently involved. Growing evidence of the overlapping neurobiological profiles of metabolic risk factors and psychiatric symptoms, such as an association with cognitive dysfunction, altered autonomic nervous system regulation, desynchrony in the resting-state default mode network, and shared genetic liability, suggest that metabolic syndrome and schizophrenia are connected via common pathways that are central to schizophrenia pathogenesis, which may be underpinned by oxytocin system dysfunction. Oxytocin, a hormone that involves in the mechanisms of food intake and metabolic homeostasis, may partly explain this piece of the puzzle in the mechanism underlying this association. Given its prosocial and anorexigenic properties, oxytocin has been administered intranasally to investigate its therapeutic potential in schizophrenia and obesity. Although the pathophysiology and mechanisms of oxytocinergic dysfunction in metabolic syndrome and schizophrenia are both complex and it is still too early to draw a conclusion upon, oxytocinergic dysfunction may yield a new mechanistic insight into schizophrenia pathogenesis and treatment.

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The prevalence and clinical correlates of metabolic syndrome and cardiometabolic alterations in 430 drug-naive patients in their first episode of schizophrenia

Cited by 26 publications

References 44 publications

Shared genetic components between metabolic syndrome and schizophrenia: Genetic correlation using multipopulation data sets

Shared genetic components between metabolic syndrome and schizophrenia: Genetic correlation using multipopulation data sets

Influencing factors of obesity in community patients with deficit schizophrenia: a cross-sectional study

Crosstalk between Schizophrenia and Metabolic Syndrome: The Role of Oxytocinergic Dysfunction

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