The prevalence and independent influencing factors of obesity and underweight in patients with schizophrenia: a multicentre cross-sectional study

Wang, Juan; Yang, Yating; Liu, Zhiwei; Xia, Lei; Li, Wenzheng; Li, Zhongxiang; Xie, Xin; Deng, Wangqun; Zhang, Kai; Liu, Huanzhong

doi:10.1007/s40519-020-00920-9

Cited by 22 publications

(18 citation statements)

References 63 publications

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“…Down-regulation of ABCA13 expression affects lipid metabolism and leads to abnormal lipid metabolism in patients with schizophrenia. In fact, the malfunctions of lipid metabolism have been found in patients with schizophrenia in our previous studies 16 , 27 . In this study, we also found that ABCA13 mRNA levels were increased after 12 weeks antipsychotic therapy.…”

Section: Discussionmentioning

confidence: 72%

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ATP-binding cassette transporter 13 mRNA expression level in schizophrenia patients

Chen

et al. 2020

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The objective of this study was to investigate the expression and clinical role of ATP-binding cassette transporter 13 (ABCA13) gene previously shown to be associated with schizophrenia (SZ) through Genome-wide association studies studies. Thirty-two first-episode drug-naive SZ patients and forty-eight age and gender-matched healthy controls were enrolled in this study. We measured ABCA13 mRNA expression levels using quantitative real-time PCR at baseline and 12 weeks after antipsychotic therapy. Moreover, clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS) at baseline and 12-week follow-up. We found that ABCA13 mRNA levels were significantly lower in SZ patients compared with healthy controls at baseline. SZ patients’ symptoms were decreased, but ABCA13 mRNA levels were increased after 12 weeks antipsychotic therapy. In addition, there was a significant difference in ABCA13 mRNA levels among SZ patients at baseline and 12-week follow-up. The ABCA13 mRNA levels were not associated with age, BMI, years of education. Of the clinical symptoms measured, the ABCA13 mRNA levels were negatively associated with the PANSS scores at baseline and 12-week follow-up. The results indicated that the ABCA13 mRNA expression level is of interest, and upon further studies, it could be used as a biomarker for SZ treatment outcome.

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Section: Discussionmentioning

confidence: 72%

“…The PANSS scale was assessed by a senior psychiatrist at baseline and 12 weeks after drug therapy, and the intra-class correlation coefficient between the four raters was greater than 0.8. The procedure of PANSS assessment was performed as previously reported 15 , 16 .…”

Section: Methodsmentioning

confidence: 99%

ATP-binding cassette transporter 13 mRNA expression level in schizophrenia patients

Chen

et al. 2020

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“…This is consistent with the rationale above that SGAs likely affect different receptor systems based on the dose used, and may have therapeutic properties for anxiety and depression at lower doses. In contrast, based on data from multiple studies, chlorpromazine equivalents for people with schizophrenia were mostly greater than 400 mg/day [33][34][35]. When looking at specific antipsychotics in our sample, this principle held up.…”

Section: Discussionmentioning

confidence: 75%

Off-label use of antipsychotic medications in psychiatric inpatients in China: a national real-world survey

et al. 2021

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Background The off-label use of antipsychotic medications is common in many countries, and the extent of such use in psychiatric inpatients in China has not been sufficiently studied. The purpose of this study was to survey the incidence and examine the correlates of off-label antipsychotic use in a large, nationally–representative sample in China. Methods This study included discharged psychiatric patients between March 19 and 31, 2019 from 41 tertiary psychiatric hospitals across 29 provinces in China. Their socio-demographic and clinical data were collected and analyzed. Results After excluding patients with schizophrenia spectrum disorder or bipolar disorder, 981 patients were included in the analysis. Overall, antipsychotics were prescribed to 63.2% (95%CI 60.2–66.2%) of the sample. Antipsychotics were used in a wide spectrum of psychiatric disorders, with the rate being the highest among patients with dissociative (conversion) disorders (89.9, 95%CI 83.0–94.8%), organic mental disorders (81.7, 95%CI 73.1–88.7%), dementia (79.0,95%CI 67.8–87.9%), obsessive-compulsive disorder (77.8, 95%CI 55.7–92.5%), mental disorders due to psychoactive substances (75.3,95%CI 64.7–84.2%), behavioural and emotional disorders with onset usually occurring in childhood and adolescence (71.4, 95%CI 45.5–90.1%), somatoform disorders (63.2, 95%CI 40.8%–82..2%), major depression disorder (53.7,95%CI 48.8–58.6%), anxiety disorder (38.8,95%CI 30.5–47.7%), and insomnia (25.0, 95%CI 8.5–28.9%). The top three most commonly used antipsychotics were olanzapine (29.1%), quetiapine (20.3%) and risperidone (6.8%), and their corresponding average doses were 9.04 ± 5.80 mg/day, 185.13 ± 174.72 mg/day, and 2.98 ± 1.71 mg/day, respectively. A binary logistic regression showed that younger age, having the Employee Health Insurance or Residents Health Insurance, having psychotic symptoms and requiring restraint during hospitalization were significantly associated with off-label use of antipsychotics. Conclusion Off-label use of antipsychotics is very common in psychiatric inpatients in China, mainly with moderate-dose use of single agents. However, the efficacy and safety of this practice is uncertain for many diagnoses and for the elderly. Clinicians should be cautious about this practice while waiting for more research data.

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“…In Yang Tian et al 's study, they found that the prevalence of obesity in Chinese patients with chronic schizophrenia was 16.4% 25 . In Juan Wang et al ' study, they found that the prevalence of obesity in patients with schizophrenia was 16.3%, which was not different from that (11.0%) of normal controls 26 . So our conclusions were consistent.…”

Section: Discussionmentioning

confidence: 84%

APOE E4 is associated with hyperlipidemia and obesity in elderly schizophrenic patients

Liu

et al. 2021

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Obesity is a critical issue in patients with schizophrenia, which is considered to be brought about by both environmental and genetic factors. Apolipoprotein E (APOE) gene polymorphisms might be involved in the pathogenesis of schizophrenia, however, the effect of APOE gene polymorphism on obesity has never been investigated in Chinese aging with schizophrenia. This cross-sectional study was to investigate the effect of obesity on cognitive and psychiatric symptoms in elderly participants with schizophrenia. At the same time, we also discussed the inner link between APOE E4 and obesity. 301 elderly participants with schizophrenia and 156 normal controls were included in the study. Their cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and APOE gene polymorphism was determined by polymerase chain reaction (PCR). The prevalence of obesity in elderly schizophrenic patients and healthy controls accounted for 15.9% (48/301) and 10.3% (16/156), respectively, with no statistically significant difference. By using stepwise linear regression analysis, we found that elevated fasting blood glucose, hypertension, and hyperlipidemia were risk factors for obesity in elderly schizophrenic patients. Although there was no direct correlation between APOE E4 and obesity in patients with schizophrenia, it was significantly correlated with hyperlipemia(r = − 0.154, p = 0.008), suggesting that APOE E4 may induce obesity in elderly patients with schizophrenia through hyperlipemia, However, the above conclusions do not apply to the normal elderly. What’s more, we did not find a link between obesity and cognitive function or mental symptoms for both patients with schizophrenia and normal controls. APOE E4 is associated with hyperlipidemia in elderly schizophrenic patients, which may be a risk factor for obesity, however, the above conclusion does not apply to the normal elderly.

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The prevalence and independent influencing factors of obesity and underweight in patients with schizophrenia: a multicentre cross-sectional study

Cited by 22 publications

References 63 publications

ATP-binding cassette transporter 13 mRNA expression level in schizophrenia patients

ATP-binding cassette transporter 13 mRNA expression level in schizophrenia patients

Off-label use of antipsychotic medications in psychiatric inpatients in China: a national real-world survey

APOE E4 is associated with hyperlipidemia and obesity in elderly schizophrenic patients

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