Metabolic issues and cardiovascular disease in patients with psychiatric disorders

Casey, Dympna

doi:10.1016/j.amjmed.2005.01.046

Cited by 134 publications

(127 citation statements)

References 56 publications

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“…An emerging literature suggests an association of certain antipsychotics with the development of metabolic abnormalities (Allison and Casey, 2001 ;Jin et al, 2004;Dufresne, 2007;Meyer and Koro, 2004;Newcomer, 2005Newcomer, , 2007a. These metabolic abnormalities may in turn contribute to the higher risk of cardiovascular disease in patients with schizophrenia (Casey, 2005;De Nayer et al, 2005;Haupt and Newcomer, 2001;Hennekens et al, 2005;Jin et al, 2002Jin et al, , 2004Newcomer, 2005;Newcomer, 2007a;De Hert, 2005, 2007;Tschoner et al, 2007). However, the mechanism underlying antipsychotic-induced metabolic dysregulation is still unclear.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional evaluation of adiponectin plasma levels in patients with schizophrenia and schizoaffective disorder

Hanssens

Winkel

Wampers

et al. 2008

Schizophrenia Research

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Abstract:Background: In recent years, several studies showed increased rates of hyperglycaemia, diabetes, dyslipidemia, metabolic syndrome as well as cardiovascular disease in schizophrenic patients. The underlying mechanism, however, is poorly understood. Adiponectin is a recently identified adipocyte-derived protein, with low adiponectin levels being associated with metabolic abnormalities such as obesity, insulin resistance and type 2 diabetes. Methods: Fasting adiponectin levels were assessed in a cross-sectional sample of 386 patients with schizophrenia or schizoaffective disorder. All patients were on monotherapy of second-generation antipsychotics (SGA) and underwent an extensive metabolic screening including an oral glucose tolerance test (OGTT). Results: Adiponectin plasma levels were inversely correlated with BMI, and differed significantly between patients with normal weight, overweight or obesity (p<0.05). Patients who met criteria for the metabolic syndrome, according to adapted National Cholesterol Educational Program -Adult Treatment Panel criteria (NCEP-ATP III) (29.3%), had significantly lower adiponectin levels than patients not meeting metabolic syndrome criteria (p<0.0001). Patients without glucose abnormalities (78%) had significantly higher adiponectin levels than patients with diabetes (5.7%) (p<0.05). After controlling for components of metabolic syndrome and sex, antipsychotic medication independently influenced adiponectin levels (p< 0.0001), with the lowest mean levels in patients on clozapine and olanzapine. Conclusions: Adiponectin levels in schizophrenic patients mirror what is observed in the general population, with the lowest levels in the most metabolically comprised subjects. However, antipsychotic medication may also influence adiponectin regulation independently, a finding that should be confirmed in longitudinal studies.

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Section: Introductionmentioning

confidence: 99%

A cross-sectional evaluation of adiponectin plasma levels in patients with schizophrenia and schizoaffective disorder

Hanssens

Winkel

Wampers

et al. 2008

Schizophrenia Research

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“…As early as the mid1960s, associations between diabetes and conventional neuroleptic drugs were reported, but evidence has accumulated that the risk is significantly greater for some of the SGAs. Thus, the exacerbation of obesity, diabetes, and cardiovascular disease risk in SGA-treated patients is increasingly being recognized as a critical issue in the overall care of the schizophrenic patient (Ananth and Kolli, 2005;Dwyer et al, 2001;Ananth et al, 2002;Casey, 2005).…”

Section: Introductionmentioning

confidence: 99%

Atypical Antipsychotic Drugs Directly Impair Insulin Action in Adipocytes: Effects on Glucose Transport, Lipogenesis, and Antilipolysis

Vestri

Maianu

Moellering

et al. 2006

Neuropsychopharmacol

139

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Treatment with second-generation antipsychotics (SGAs) has been associated with weight gain and the development of diabetes mellitus, although the mechanisms are unknown. We tested the hypothesis that SGAs exert direct cellular effects on insulin action and substrate metabolism in adipocytes. We utilized two cultured cell models including 3T3-L1 adipocytes and primary cultured rat adipocytes, and tested for effects of SGAs risperidone (RISP), clozapine (CLZ), olanzapine (OLZ), and quetiapine (QUE), together with conventional antipsychotic drugs butyrophenone (BUTY), and trifluoperazine (TFP), over a wide concentration range from 1 to 500 mM. The effects of antipsychotic drugs on basal and insulin-stimulated rates of glucose transport were studied at 3 h, 15 h, and 3 days. Both CLZ and OLZ (but not RISP) at doses as low as 5 mM were able to significantly decrease the maximal insulin-stimulated glucose transport rate by B40% in 3T3-L1 cells, whereas CLZ and RISP reduced insulin-stimulated glucose transport rates in primary cultured rat adipocytes by B50-70%. Conventional drugs (BUTY and TFP) did not affect glucose transport rates. Regarding intracellular glucose metabolism, both SGAs (OLZ, QUE, RISP) and conventional drugs (BUTY and TFP) increased basal and/or insulin-stimulated glucose oxidation rates, whereas rates of lipogenesis were increased by CLZ, OLZ, QUE, and BUTY. Finally, rates of lipolysis in response to isoproterenol were reduced by the SGAs (CLZ, OLZ, QUE, RISP), but not by BUTY or TFP. These experiments demonstrate that antipsychotic drugs can differentially affect insulin action and metabolism through direct cellular effects in adipocytes. However, only SGAs were able to impair the insulin-responsive glucose transport system and to impair lipolysis in adipocytes. Thus, SGAs directly induce insulin resistance and alter lipogenesis and lipolysis in favor of progressive lipid accumulation and adipocyte enlargement. These effects of SGAs on adipocytes could explain, in part, the association of SGAs with weight gain and diabetes. Neuropsychopharmacology (2007) 32, 765-772.

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“…With regard to cardiovascular risk in persons with severe mental illness, of most concern is the development of metabolic syndrome (Casey, 2005;Angst et al, 2002). It has also been found in 37% of patients with long-term schizophrenia (Heiskanen et al, 2003) compared with 24% in the general population and after adjusting for age, these data suggest that persons with schizophrenia have double the incidence of the metabolic syndrome compared with the general population (Ford et al, 2002).…”

Section: Metabolic Syndromementioning

confidence: 61%

The Impact of Cardiometabolic Risk in Patients with Severe Mental Illness: From Evidence to Clinical Management

Sciascio¹,

Calò²

2011

Psychiatric Disorders - Worldwide Advances

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Metabolic issues and cardiovascular disease in patients with psychiatric disorders

Cited by 134 publications

References 56 publications

A cross-sectional evaluation of adiponectin plasma levels in patients with schizophrenia and schizoaffective disorder

A cross-sectional evaluation of adiponectin plasma levels in patients with schizophrenia and schizoaffective disorder

Atypical Antipsychotic Drugs Directly Impair Insulin Action in Adipocytes: Effects on Glucose Transport, Lipogenesis, and Antilipolysis

The Impact of Cardiometabolic Risk in Patients with Severe Mental Illness: From Evidence to Clinical Management

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