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

Küçükgöncü, Suat; Košir, Urška; Zhou, Elton; Sullivan, Erin L.; Srihari, Vinod H.; Tek, Cenk

doi:10.1111/eip.12749

Cited by 33 publications

(23 citation statements)

References 77 publications

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“…Our results are consistent with previous research showing that the frequency of type 2 diabetes is two-fold higher in people with severe mental illness that in the general population [3,4,42]. Although fetal birth dimensions, socioeconomic factors, and lifestyle have been associated with both, severe mental illness and diabetes, later adjustment for mothersage, fatherssocioeconomic position, BMI and cognitive performance at conscription only explained a minor part of this association in our cohort.…”

Section: Discussionsupporting

confidence: 92%

“…Birth weight was recorded in 100 g groups and analyzed in three categories: 2500 low birth weight; 2500-4000 normal birth weight; and !4000 g high birth weight. Ponderal index, calculated as birth weight [Kg]/birth length [meters] 3 , was also included as it is theoretically assumed to measure fetal growth and thereby discriminate between intra-uterine well-fed (high ponderal index) and disproportionate growth restricted newborns (low ponderal index) [40]. Ponderal index was analyzed as threecategory variable (1 st quintile; 2 nd -4 th quintile; 5th quintile).…”

Section: Fetal Growth: Birth Weight and Ponderal Indexmentioning

confidence: 99%

“…Individuals with severe mental illnesses are prone to develop different somatic diseases [1][2][3], with schizophrenia [2], bipolar disorder [4] and major depression [5] repeatedly associated with increased risk of type 2 diabetes [6]. Multiple explanations have been proposed, including impaired lifestyle (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Garriga

Wium‐Andersen

et al. 2019

Eur. psychiatr.

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Background: Birth dimensions have been associated with increased risk of both, severe mental illness and type 2 diabetes in adulthood, however, any influence on their co-occurrence has never been examined. This cohort study examine whether birth weight/ponderal index explain or modify the later association between severe mental illness and risk of type 2 diabetes. Methods: The Metropolit cohort included 10,863 Danish men born in 1953 with information from age at conscription (between1971-84) until February 15th, 2018. Severe mental illness was defined as the exposure and information was retrieved from the national Danish health registries. Information on type 2 diabetes diagnosis or oral antidiabetic prescriptions was also obtained, as they were the outcome of interest. Information on birth weight/ponderal index was available from birth certificates. Cox proportional hazards regression models were used to estimate the associations and interactions were tested. Results: After 47.1 years of follow-up, 848 (7.8%) and 1320 (12.2%) men developed a severe mental illness or diabetes, respectively. Men with severe mental illness presented higher risk of subsequent diabetes (HR = 1.92; 95%CI, 1.61–2.30). This association was stronger in severe mental ill men with low birth weight (HR = 3.58; 95%CI, 2.11–6.07), than in those normal birth weight (HR = 1.79; 95%CI, 1.45–2.20). This effect modification was most evident for men diagnosed with schizophrenia. Conclusions: Birth information on birth weight/ponderal index could be of interest in diabetes screening on severe mental ill populations (especially in schizophrenia) since they might play a critical role in the increased risk of type 2 diabetes following severe mental illness.

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Section: Discussionsupporting

confidence: 92%

Section: Fetal Growth: Birth Weight and Ponderal Indexmentioning

confidence: 99%

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Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Garriga

Wium‐Andersen

et al. 2019

Eur. psychiatr.

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“…However, the exactly mechanisms of abnormal glucose metabolism in patients with first-episode psychosis are unknown. Studies suggested that inflammation, genetic polymorphisms, and chronic stress can lead to glucose metabolism abnormalities in patients with first episode psychosis (Amare et al 2017, Belvederi Murri et al 2016, Kucukgoncu et al 2019). Recent study showed that familial abnormal glucose metabolism or primary insulin signaling pathway abnormality is related to risk for psychosis (Chouinard et al 2018).…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Abnormal Glucose Metabolism in First-Episode Drug-Naive Schizophrenia

Yang¹,

Zheng²,

Zheng³

et al. 2020

Psychiat Danub

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Background:Patients with schizophrenia exhibit a higher mortality rate compared with the general population. This mortality has been attributed predominantly by the high risk of type 2 diabetes mellitus in the patients. We aimed to assess the inherent risk of glucose metabolism abnormalities in first-episode drug-naïve schizophrenia.Subjects and methods: We searched English database (PubMed, EMBASE, MEDLINE, Cochrane Library databases) and Chinese database (Wan Fang Data, CBM disc, VIP, and CNKI) from their inception until Jul 2018 for case-control studies examining glucose metabolism abnormalities. Measurements, such as fasting plasma glucose levels, fasting plasma insulin levels, insulin resistance and HbA1c levels in first-episode antipsychotic-naive patients were used to test for prediabetes. Standardized/weighted mean differences and 95% confidence intervals were calculated and analyzed.Results: 19 studies (13 in English and 6 in Chinese) consisting of 1065 patients and 873 controls were included. Fasting plasma glucose levels (95% CI; 0.02 to 0.29; P=0.03), 2 h plasma glucose levels after an OGTT (95% CI; 0.63 to 1.2; P<0.00001), fasting plasma insulin levels (95% CI; 0.33 to 0.73; P<0.00001), insulin resistance (95% CI; 0.29 to 0.6; P<0.00001) in patients with firstepisode schizophrenia were significant elevated. There was no significant difference in HbA1c level (95% CI; P=0.54) in patients with first-episode schizophrenia compared with controls.Conclusions: This meta-analysis showed that glucose metabolism was impaired in patients with first-episode schizophrenia. Higher quality studies with larger samples are warranted to confirm these findings.

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“…Mood disorders (MD) have a bidirectional association with metabolic diseases . Accumulating cross‐sectional and prospective evidence has indicated that major depressive disorder (MDD) and bipolar disorder (BD) are associated with obesity, type 2 diabetes mellitus (T2DM) and metabolic syndrome, mostly independent of lifestyle (eg, smoking, sedentary behavior, and unhealthy diet) and treatment factors (eg, use of psychotropic medications) . This collection of observations indicates that there is a mechanistic connection between MD and metabolic conditions, which is supported by converging genetic studies, reporting extensive genetic pleiotropy .…”

Section: Introductionmentioning

confidence: 99%

Parsing metabolic heterogeneity in mood disorders: A hypothesis‐driven cluster analysis of glucose and insulin abnormalities

et al. 2019

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Objectives Metabolically based distinctions for disturbances in glucose and insulin may provide meaningful insights both clinically and mechanistically. Methods Data were derived from 352 subjects of previously completed clinical studies with a mood disorder (MD) (bipolar disorder: n = 179, major depressive disorder: n = 173) and 218 healthy controls from the Comprehensive Assessment of Long‐Term Effects of Reducing Intake of Energy. We conducted a factor analysis to replicate a priori dissociable factors informed by glucose and insulin levels and indices of insulin resistance and beta‐cell function: elevated insulin and insulin resistance (“insulin‐IR”), and increased fasting glucose and reduced insulin secretion (“glucotoxicity”). Cluster analyses were conducted, separately in men and women, to evaluate the clinical relevance of subtyping individuals with MDs using insulin‐IR and glucotoxicity (GT) factor scores. Results Factors insulin‐IR and GT explained 92.64% and 92.09% of the variance in men and women respectively. Three clusters were replicated in men and women separately: metabolically healthy (MH), high GT, and insulin‐resistant (IR). After adjusting for age, gender, study cohort, MD diagnosis, and antipsychotics use, body mass index (BMI) and mean arterial pressure were higher in IR‐ vs GT‐ or MH‐clustered individuals; GT‐clustered individuals had more metabolic syndrome components and higher C‐reactive protein. Glucotoxic‐clustered subjects reported greater impairments in cognitive function and global functioning when compared to MH‐ or IR‐clustered subjects. Conclusions Using simple, cost‐effective, and accessible measures, we identified stable, gender‐convergent, subgroups of individuals that significantly diverged on measures of cognitive dysfunction, self‐reported anhedonia, functional disability, BMI, and blood pressure.

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

Cited by 33 publications

References 77 publications

Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

Birth dimensions, severe mental illness and risk of type 2 diabetes in a cohort of Danish men born in 1953

A Meta-Analysis of Abnormal Glucose Metabolism in First-Episode Drug-Naive Schizophrenia

Parsing metabolic heterogeneity in mood disorders: A hypothesis‐driven cluster analysis of glucose and insulin abnormalities

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