154. Impaired Glucose Homeostasis in First-Episode Schizophrenia: A Meta-Analysis

Abstract

Between group comparisons revealed that those with social anxiety did indeed have worse social functioning, particularly in the domains of interpersonal communication (t(45) = 2.28, P = .025) and engagement (in conversations; t(45) = 2.89, P = .000). Participants with high social anxiety also had more difficulties in recognizing neutral emotional faces, compared to individuals with schizophrenia without social anxiety (t(31) = 2.19, P = .036).Although not specific to social anxiety, results on the facial emotional tasks were correlated with specific social functioning domains (e.g., those with poor facial recognition overall had fewer recreational (r = −.49) and social activities, r = −.56). The results were not linked to negative symptoms of schizophrenia or to psychiatric symptoms (BPRS). In the role-play, individuals with social anxiety were better than those without social anxiety at recognizing 2/4 of the emotions targeted (joy and anger, χ 2 = 3.58, P = .05). Conclusion: These findings suggest that specific comorbidities, such as social anxiety, might affect facial emotional recognition, particularly for neutral emotions. More studies are warranted in order to determine whether social anxiety brings an attentional bias, therefore making individuals more prone to seeing emotions (even when not present). This study did confirm that social anxiety and facial emotional recognition have an important impact on social functioning and should be targeted in treatments. IMPAIRED GLUCOSE HOMEOSTASIS IN FIRST-EPISODE SCHIZOPHRENIA:A META-ANALYSIS Toby Pillinger*, Katherine Beck, Cristian Gobjila, Jacek Donocik, Sameer Jauhar, and Oliver Howes King's College London Background: Schizophrenia is associated with an increased risk of type 2 diabetes mellitus. However, it is not clear whether schizophrenia confers an inherent risk for glucose dysregulation in the absence of the effects of chronic illness and long-term treatment. Our objective was to conduct a meta-analysis examining whether individuals with first-episode schizophrenia already exhibit alterations in glucose homeostasis compared with controls. Methods: The Embase, Medline and PsycINFO databases were systematically searched for studies examining measures of glucose homeostasis in drug-naive individuals with first-episode schizophrenia compared to controls. Of 3660 citations retrieved, 16 case-control studies comprising 15 samples met inclusion criteria. The overall sample included 731 patients and 614 controls. Standardized mean differences in fasting plasma glucose, plasma glucose post-OGTT, fasting plasma insulin, insulin resistance, and HbA1c were calculated. Results: Fasting plasma glucose (g = 0.199 (95% CI 0.022-0.376, P = .028)), plasma glucose post-OGTT (g = 0.605 (95% CI 0.163-1.047, P = .007)), fasting plasma insulin (g = 0.409 (95% CI 0.093-0.724, P = .011)) and insulin resistance (HOMA-IR; g = 0.334 (95% CI 0.135-0.534, P = .001)) were all significantly elevated in patients compared with controls. However, HbA1c levels (g = −0.08 (CI −0.340 to 0.18...

Antipsychotic treatment is associated with inflammatory and metabolic biomarkers alterations among first‐episode psychosis patients: A 7‐month follow‐up study

“…In this study, we found that antipsychotic-naïve FEP patients did not significantly differ from CS in their baseline measurements of fasting plasma levels of insulin, C-peptide and adiponectin. These findings are in contrast to previous studies reporting higher levels of insulin and C-peptide levels in the FEP patients' group compared to those in CS (Pillinger et al, 2017;Wu et al, 2013). However, other studies found no significant difference in insulin resistance between drug-naïve patients with psychosis and CS (Arranz et al, 2004;Sengupta et al, 2008).…”

Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta‐analysis

“…In patients with FEP, our cumulative analyses on glucose metabolism outcomes are in line with previous meta‐analyses, which showed significant increases in fasting insulin levels and impaired oral glucose tolerance in this patient population (Greenhalgh et al, ; Perry et al, ; Pillinger et al, ). Our meta‐analysis also confirms previous reports of an impaired oral glucose tolerance in first episode, treatment‐naïve patients with mood disorders (Garcia‐Rizo et al, ; Guha et al, ).…”

“…While research regarding glucose metabolism in treatment‐naïve, first episode patients with individual SMI suggest a pre‐diabetic condition, we have limited knowledge on the differences of glucose metabolism across different diagnostic categories of SMIs. Therefore, the first aim of this study is to extend previous findings in patients with FEP (Greenhalgh et al, ; Perry et al, ; Pillinger et al, ) by conducting a systematic review and a meta‐analysis of glucose intolerance in first episode, treatment‐naïve patients with FEP, as well as first episode, treatment‐naïve patients with depression and bipolar disorder. The second aim of this study is to compare the differences of pooled results from glucose metabolism outcomes between these diagnostic categories.…”

“…A recent Danish register study published in by Rajkumar et al reported 3.07 adjusted hazard ratio of diabetes diagnosis in treatment‐naïve FEP patients compared to population sample, suggesting an increased endogenic risk for DM2 in FEP patients (Cohen & De Hert, ; Rajkumar et al, ). Three recent meta‐analyses have shown significantly higher insulin resistance (IR), HbA1c, fasting insulin and glucose levels after oral glucose tolerance test (OGTT) in treatment‐naïve, FEP compared to healthy controls (Greenhalgh et al, ; Perry et al, ; Pillinger et al, ). One of these meta‐analyses (Greenhalgh et al, ) also showed higher fasting glucose levels in patients with FEP compared to healthy controls, whereas others reported no difference on fasting glucose levels between these two groups.…”

AICAR Prevents Acute Olanzapine-Induced Disturbances in Glucose Homeostasis

“…This is an important finding as those with schizophrenia often display perturbations in glucose homeostasis prior to treatment with SGAs (Bergman and Ader, 2005;van Nimwegen et al, 2008;Pillinger et al, 2017). Repeated, transient excursions in blood glucose are harmful as they may lead to cardiovascular complications including impaired endothelial function and increased oxidative stress (Ceriello et al, 2008).…”