Association between C-reactive protein and homocysteine with the subcomponents of metabolic syndrome in stable patients with bipolar disorder and schizophrenia

Vuksan-Ćusa, Bjanka; Šagud, Marina; Jakovljević, Miro; Peleš, Alma Mihaljević; Jakšić, Nenad; Mihaljević, Sanea; Živković, Maja; Mikulic, Suzan Kudlek; Jevtović, Saša

doi:10.3109/08039488.2012.745601

Cited by 44 publications

(26 citation statements)

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“…Of those, 76 were excluded on the basis of the title and the abstract, leaving 48 studies for further evaluation. Twenty-six studies fulfiled our inclusion criteria, 19 for the between-group meta-analysis of SZ versus control, 14,[17][18][19]21,24,25,[27][28][29][30][31][33][34][35][36]38,39,41 6 for the withingroup meta-analysis of CRP changes after initiation of antipsychotics 20,21,23,27,32,37 and 3 for the within-group metaanalysis of CRP changes with substitution of the type of the antipsychotic. 22,26,40 Some studies provided more than one pairwise comparison, as whenever possible we extracted data according to medication status.…”

Section: Resultsmentioning

confidence: 99%

“…14,[17][18][19]21,25,[28][29][30]35,38 Of the 19 included studies, 5 provided data on drug-naive or drug-free subjects. 27,31,34,35,38 In 11 of the studies, the control group was matched by age and BMI to the case group.…”

Section: Resultsmentioning

confidence: 99%

“…17,18,21,24,25,29,30,[33][34][35]41 Four studies were population studies 14,18,30,34 and the other 15 were case-control studies conducted in in-patient or out-patient units. 17,[19][20][21][22][23][24][25][26][27][28][29][31][32][33][35][36][37][38][39][40][41] Five studies provided data on subjects with first episode psychosis 19,27,31,34,38 and 14 studies provided data on subjects with chronic SZ 14,17,18,21,24,25,[28][29][30]…”

Section: Resultsmentioning

confidence: 99%

“…14,17,21,24,25,27,29,31,33,34,38,39,41 Seventeen of the 19 studies measured CRP levels employing a high-sensitivity assay. 14,[17][18][19]21,24,25,[28][29][30][31]33,35,36,38,39,41 Overall, random-effects between-group meta-analysis showed that serum and plasma CRP levels were moderately increased in subjects with SZ when compared with healthy controls (g = 0.66, 95% CI 0.43 to 0.88, P o0.001, 24 between-group comparisons, n = 82 962). When we carried out sub-group analyses according to the use of antipsychotics, we verified that CRP levels were increased with large ESs in subjects with SZ who were drug-naive or -free (g = 0.87, 95% CI 0.14 to 1.60, P = 0.021, 6 between-group comparisons, n = 708), and were moderately increased in subjects with SZ on antipsychotics (g = 0.58, 95% CI 0.36 to 0.79, P = 0.001, 18 between-group comparisons, n = 82 254).…”

Section: Resultsmentioning

confidence: 99%

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C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: meta-analysis and implications

et al. 2015

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The inflammatory hypothesis of schizophrenia (SZ) posits that inflammatory processes and neural-immune interactions are involved in its pathogenesis, and may underpin some of its neurobiological correlates. SZ is the psychiatric disorder causing the most severe burden of illness, not just owing to its psychiatric impairment, but also owing to its significant medical comorbidity. C-reactive protein (CRP) is a commonly used biomarker of systemic inflammation worldwide. There are some conflicting results regarding the behaviour of CRP in SZ. The aims of this study were to verify whether peripheral CRP levels are indeed increased in SZ, whether different classes of antipsychotics divergently modulate CRP levels and whether its levels are correlated with positive and negative symptomatology. With that in mind, we performed a meta-analysis of all cross-sectional studies of serum and plasma CRP levels in SZ compared to healthy subjects. In addition, we evaluated longitudinal studies on CRP levels before and after antipsychotic use. Our meta-analyses of CRP in SZ included a total of 26 cross-sectional or longitudinal studies comprising 85 000 participants. CRP levels were moderately increased in persons with SZ regardless of the use of antipsychotics and did not change between the first episode of psychosis and with progression of SZ (g=0.66, 95% confidence interval (95% CI) 0.43 to 0.88, P<0.001, 24 between-group comparisons, n=82 962). The extent of the increase in peripheral CRP levels paralleled the increase in severity of positive symptoms, but was unrelated to the severity of negative symptoms. CRP levels were also aligned with an increased body mass index. Conversely, higher age correlated with a smaller difference in CRP levels between persons with SZ and controls. Furthermore, CRP levels did not increase after initiation of antipsychotic medication notwithstanding whether these were typical or atypical antipsychotics (g=0.01, 95% CI -0.20 to 0.22, P=0.803, 8 within-group comparisons, n=713). In summary, our study provides further evidence of the inflammatory hypothesis of SZ. Whether there is a causal relationship between higher CRP levels and the development of SZ and aggravation of psychotic symptoms, or whether they are solely a marker of systemic low-grade inflammation in SZ, remains to be clarified.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: meta-analysis and implications

et al. 2015

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“…Moreover, the MTHFR and/or COMT polymorphic variants could represent a risk for the development of a metabolic syndrome concomitant with anti-psychotic drug use (14)(15)(16). The increase in body mass index (BMI), which is one of the sub-component of metabolic syndrome, was related to hyperhomocysteinaemia in patients with schizophrenia and bipolar disorder, but not in the non-psychiatric population (16).…”

Section: Hyperhomocysteinaemiamentioning

confidence: 99%

Homocysteine levels in schizophrenia patients newly admitted to an acute psychiatric ward

Lorenzo

Amoretti²,

Baldini³

et al. 2015

Acta Neuropsychiatr.

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Effects of second-generation antipsychotics on selected markers of one-carbon metabolism and metabolic syndrome components in first-episode schizophrenia patients

Misiak

Frydecka

Łaczmański

et al. 2014

Eur J Clin Pharmacol

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PurposeAlterations in one-carbon metabolism (OCM) have been repeatedly reported in schizophrenia. However, there is a scarcity of studies addressing the effects of antipsychotics on selected OCM markers in schizophrenia and provided results are inconsistent.MethodsWe recruited 39 first-episode schizophrenia (FES) patients and determined serum profile of total homocysteine (tHcy), folate, vitamin B12, lipoproteins and glucose at baseline and after 12 weeks of treatment with second-generation antipsychotics (SGA) including olanzapine and risperidone in monotherapy.ResultsAfter 12 weeks of treatment, all patients had significantly higher body mass index (BMI), serum levels of total cholesterol (TC), low-density lipoproteins (LDL), triglycerides (TG) and tHcy together with significantly lower levels of folate and vitamin B12. The analysis of differences between SGA revealed the same biochemical alterations in patients treated with olanzapine as in the whole group, while those receiving risperidone had no statistically significant changes in serum folate, vitamin B12 and TG. There was a significantly higher increase in BMI and TC in patients treated with olanzapine in comparison with those treated with risperidone. Patients receiving olanzapine had a higher decrease in vitamin B12 than those assigned to the treatment with risperidone. Changes in folate, vitamin B12, tHcy and TC levels were significant only in males, even after Bonferroni correction. Multiple regression analysis revealed that changes in tHcy levels are associated with gender and baseline metabolic parameters (BMI, glucose, TC, LDL and HDL) but not with selected SGA.ConclusionsThese results indicate that SGA may influence OCM, especially in first-episode schizophrenia (FES) males.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-014-1762-2) contains supplementary material, which is available to authorized users.

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Association between C-reactive protein and homocysteine with the subcomponents of metabolic syndrome in stable patients with bipolar disorder and schizophrenia

Cited by 44 publications

References 43 publications

C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: meta-analysis and implications

C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: meta-analysis and implications

Homocysteine levels in schizophrenia patients newly admitted to an acute psychiatric ward

Effects of second-generation antipsychotics on selected markers of one-carbon metabolism and metabolic syndrome components in first-episode schizophrenia patients

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