Diet and cardiometabolic side effects in children treated with second-generation antipsychotics

Barker, Mikaela K; Sable, Carly; Montgomery, Sarah; Chow, Lorrie; Green, Timothy; Panagiotopoulos, Constadina; Devlin, Angela M.

doi:10.1016/j.clnesp.2017.09.013

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…In addition, obesity leads to a lower quality of life and 10 ~ 20 years of shorter life expectancy in schizophrenia 5 . Most studies have shown that weight gain in psychiatric patients is associated with lifestyle 6,7 , metabolic abnormalities 8,9 , and use of antipsychotic medications 10 .…”

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confidence: 99%

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

Huang

et al. 2020

Sci Rep

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Obesity is common comorbidity in patients with schizophrenia. Previous studies have reported that homocysteine (Hcy) is increased in schizophrenia. However, no study has reported the association between BMI and Hcy levels in schizophrenia. This cross-sectional naturalistic study aimed to evaluate the relationship between BMI, Hcy and clinical symptoms in Chinese Han patients with chronic schizophrenia. Clinical and anthropometric data as well as plasma Hcy level and glycolipid parameters were collected. Psychopathology was measured with the Positive and Negative Syndrome Scale (PANSS). Our results showed that compared with the low BMI group, the high BMI group had a higher PANSS general psychopathology subscore, higher levels of blood glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol (all p < 0.05). Hcy levels were negatively associated with BMI in patients (p < 0.001). Hcy level, the PANSS general psychopathology subscale, total cholesterol and education (all p < 0.05) were the influencing factors of high BMI. Our study suggest that Hcy level may be associated with BMI in patients with schizophrenia. Moreover, patients with high BMI show more severe clinical symptoms and higher glucose and lipid levels.

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confidence: 99%

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

Huang

et al. 2020

Sci Rep

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“…14 SGAs are increasingly being prescribed to children and adolescents and are often used off-label as an effective treatment of a variety of mental health disorders including attention deficit hyperactivity disorder, anxiety disorder, bipolar disorder, and autism spectrum disorder. [15][16][17] We and others have reported similar rapid weight gain, obesity, hypertension, and metabolic dysfunction in SGA-treated children, [18][19][20][21][22][23][24][25] and compared to adults, there is evidence that these complications appear faster and to a greater extent in children. 26,27 Recent studies also estimate that SGA-treated children have a 3-fold greater risk of type 2 diabetes compared to untreated children.…”

Section: Introductionmentioning

confidence: 77%

“…The goal of this study was to assess whether treatment with SGAs is associated with cardiovascular dysfunction in There are no published data on the cardiovascular health of SGA-treated children despite the well-known cardiometabolic side effects that occur with SGA treatment. [18][19][20][21][22][23][24][25] We assessed PWV and cIMT, as noninvasive indicators of vascular health and atherosclerosis, that are strongly associated with future cardiovascular events in adults. 35,55 Only 2 studies have been published that investigated vascular function in SGA-treated adults.…”

Section: Discussionmentioning

confidence: 99%

Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders: Rigidité Artérielle Plus Importante Chez Les Enfants Avec ou Sans Traitement Par Antipsychotiques de la Deuxième Génération Pour des Troubles de Santé Mentale

et al. 2020

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Objective: Second-generation antipsychotics (SGAs) are used for a variety of mental disorders and are associated with cardiometabolic side effects in children. The objective of this study was to assess the cardiovascular health of children with mental disorders that are SGA-treated or SGA-naive. Methods: SGA-treated ( n = 47) or SGA-naive ( n = 37) children (aged 6 to 18 years) with mental disorders and control children ( n = 83, no mental disorder) underwent assessment for cardiac function and morphology by echocardiography, aortic pulse wave velocity (PWV), and carotid intima-media thickness (cIMT). Body mass index (BMI) z-scores, waist circumference z-scores, systolic and diastolic blood pressure (BP) percentiles for height and sex, and fasting plasma glucose, insulin, triglycerides, and cholesterol were also assessed. Differences between SGA-treated, SGA-naive, and control children were assessed by linear and log-linear regression models. Results: SGA-treated children had greater BMI z-scores and overweight/obesity (BMI ≥ 85th percentile for age and sex) and hypertension than SGA-naive and control children. The PWV geometric mean was 11.1% higher in SGA-treated (95%CI, 3.95 to 18.77) and 12.9% higher in SGA-naive children (95% CI, 5.60 to 20.59) compared to controls in models adjusted for age, sex, BMI, and systolic BP percentile. Left ventricular (LV) end-diastolic dimension/body surface area (BSA), LV end-systolic dimension/BSA, and LV ejection fraction were lower in SGA-treated and SGA-naive children compared to controls in models adjusted for sex and age. Conclusions: Children with mental disorders have greater arterial stiffness and altered cardiac structure/function than children with no mental health diagnosis. SGA treatment in children is not associated with alterations in cardiovascular structure/function.

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“…Three-day food records were collected on 2 weekdays and 1 weekend day; only the data from the subset of the participants (recruited between 2012 and 2018) who provided complete records were used to estimate dietary macronutrient intakes as described previously ( 28 ). Participants or their parents/guardians were instructed to record all food, drinks, and supplements consumed.…”

Section: Methodsmentioning

confidence: 99%

The FTO rs9939609 Variant Is Associated with Cardiometabolic Disease Risk and Dietary Energy Intakes in Children with Mental Health Disorders

Wiedeman

Ngai

Henderson

et al. 2022

Current Developments in Nutrition

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Background Second-generation antipsychotics (SGAs) are used to treat children for mental health disorders but in some children cause cardiometabolic complications including weight gain and type 2 diabetes. Genetic variants may place a child at risk for developing these metabolic complications. The fat mass and obesity-associated (FTO) rs9939609 A allele has been associated with obesity and dietary energy intakes in healthy children but its relationship to metabolic complications in SGA-treated children is not known. Objective This study investigated the association of the FTO rs9939609 variant and SGA treatment with cardiometabolic complications and dietary intakes in children with mental health disorders. Design A cross-sectional population of children (≤18y;n = 506) with mental health disorders that were SGA-treated (n = 197) and SGA-naïve (n = 309) were recruited through the Department of Psychiatry at BC Children's Hospital. Dietary intakes were estimated using three-day food records in a subset of children (n = 73). Results Genotype frequencies were not different between SGA-treated (TT 42.6%, TA 38.6%, AA 18.8%) and SGA-naïve (TT 41.1%, TA 39.5%, AA 19.4%) children. Children with the A allele had lower BMI z-sores compared to the TT genotype (0.84±1.19 vs 1.19±1.36; P = 0.005, adjusted for ethnicity). We observed an interaction between FTO genotype and SGA status on fasting glucose (P = 0.036). SGA-naïve children with the A allele had higher fasting glucose than those with the TT genotype (4.96±0.35 vs 4.81±0.35 mmol/L;P = 0.001), in adjusted models (age, sex, ethnicity, and zBMI). This was not observed in SGA-treated children. Children with the A allele had higher daily total energy intakes compared to the TT genotype (1994±619 vs. 1814±484 kcal/d;P = 0.048), in adjusted models (age, sex, ethnicity, and zBMI; no effect of SGA-treatment was observed. Conclusion Our findings suggest the A allele of the FTO rs9939609 variant is associated with higher BMI in children with mental health disorders, but only in those not treated with SGAs.

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Diet and cardiometabolic side effects in children treated with second-generation antipsychotics

Cited by 14 publications

References 28 publications

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia

Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders: Rigidité Artérielle Plus Importante Chez Les Enfants Avec ou Sans Traitement Par Antipsychotiques de la Deuxième Génération Pour des Troubles de Santé Mentale

The FTO rs9939609 Variant Is Associated with Cardiometabolic Disease Risk and Dietary Energy Intakes in Children with Mental Health Disorders

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