Parental type 2 diabetes in patients with non-affective psychosis

Miller, Brian J.; Goldsmith, David R.; Paletta, Nina; Wong, Joyce; Kandhal, Prianka; Parker, Carmen Black; Rapaport, Mark Hyman; Buckley, Peter F.

doi:10.1016/j.schres.2016.04.035

Cited by 11 publications

(9 citation statements)

References 10 publications

(12 reference statements)

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“…An additional important contributing factor to the increased prevalence of diabetes in schizophrenia may be an inherent susceptibility to diabetes in people with schizophrenia. Patients with schizophrenia have an increased risk of diabetes in family members[ 7 , 8 ]. Also, parental diabetes is a significant predictor of diabetes in people with psychotic disorders[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with schizophrenia have an increased risk of diabetes in family members[ 7 , 8 ]. Also, parental diabetes is a significant predictor of diabetes in people with psychotic disorders[ 8 ]. Inflammatory markers are seen in both schizophrenia and metabolic syndrome and the increased inflammation may explain the association between these conditions[ 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of obesity and diabetes in patients with schizophrenia

Annamalai¹,

Košir²,

Tek³

2017

WJD

131

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AIMTo compare the prevalence of diabetes in patients with schizophrenia treated at a community mental health center with controls in the same metropolitan area and to examine the effect of antipsychotic exposure on diabetes prevalence in schizophrenia patients.METHODSThe study was a comprehensive chart review of psychiatric notes of patients with schizophrenia and schizoaffective disorder treated at a psychosis program in a community mental health center. Data collected included psychiatric diagnoses, diabetes mellitus diagnosis, medications, allergies, primary care status, height, weight, body mass index (BMI), substance use and mental status exam. Local population data was downloaded from the Centers for Disease Control Behavioral Risk Factor Surveillance System. Statistical methods used were χ2 test, Student’s t test, general linear model procedure and binary logistic regression analysis.RESULTSThe study sample included 326 patients with schizophrenia and 1899 subjects in the population control group. Demographic data showed control group was on average 7.6 years older (P = 0.000), more Caucasians (78.7% vs 38.3%, P = 0.000), and lower percentage of males (40.7% vs 58.3%, P = 0.000). Patients with schizophrenia had a higher average BMI than the subjects in the population control (32.11, SD = 7.72 vs 27.62, SD = 5.93, P = 0.000). Patients with schizophrenia had a significantly higher percentage of obesity (58.5% vs 27%, P = 0.000) than the population group. The patients with schizophrenia also had a much higher rate of diabetes compared to population control (23.9% vs 12.2%, P = 0.000). After controlling for age sex, and race, having schizophrenia was still associated with increased risk for both obesity (OR = 3.25, P = 0.000) and diabetes (OR = 2.42, P = 0.000). The increased risk for diabetes remained even after controlling for obesity (OR = 1.82, P = 0.001). There was no difference in the distribution of antipsychotic dosage, second generation antipsychotic use or multiple antipsychotic use within different BMI categories or with diabetes status in the schizophrenia group.CONCLUSIONThis study demonstrates the high prevalence of obesity and diabetes in schizophrenia patients and indicates that antipsychotics may not be the only contributor to this risk.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of obesity and diabetes in patients with schizophrenia

Annamalai¹,

Košir²,

Tek³

2017

WJD

131

View full text Add to dashboard Cite

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“…Despite many studies showing that drug‐naive SCZ patients have increased metabolic‐T2D risks (Dasgupta et al, ; Fernandez‐Egea et al, ; Kirkpatrick et al, ; Ryan et al, ; van Nimwegen et al, ) and that SCZ and/or NAP are significantly associated with familial metabolic risk (Fernandez‐Egea et al, ; Miller et al, ; Spelman et al, ), only a few studies have aimed to detect gene risk variants co‐shared by SCZ and T2D. These studies focused only on known SCZ or T2D risk genes, but reported significant associations of the SCZ‐risk DRD2 SNP with regulatory function with glycemia in SCZ (Lawford et al, ; Luykx, Broersen, & de Leeuw, ), and of the T2D‐risk genes insulin‐like growth‐factor‐2 mRNA‐binding protein‐2 ( IGF2BP2 ) and the strongest T2D‐risk gene TCF7L2 with SCZ (Hansen et al, ; Zhang, Hui, et al, ), the latter identified in a Danish and European study (Hansen et al, ).…”

Section: Mental and Metabolic Comorbiditymentioning

confidence: 99%

“…SCZ also increases T2D risk, unrelated to antipsychotic therapy, and SCZ patients have higher rates of prediabetes, T2D, MetS, and obesity than control subjects (Q. Li et al, ; Subashini, Deepa, Padmavati, Thara, & Mohan, ) and share common risk variants with MetS traits (Andreassen et al, ). Several studies have demonstrated that drug‐naive SCZ patients have impaired fasting glucose (IFG), impaired insulin action, and increased T2D risk (Dasgupta, Singh, Rout, Saha, & Mandal, ; Fernandez‐Egea et al, ; Ryan, Collins, & Thakore, ; van Nimwegen et al, ); and SCZ/nonaffective psychosis (NAP) are significantly associated with increased odds of parental T2D and first‐degree relatives' impaired‐glucose tolerance (IGT) (Fernandez‐Egea, Miller, Bernardo, Donner, & Kirkpatrick, ; Miller et al, ; Spelman, Walsh, Sharifi, Collins, & Thakore, ). Furthermore, distinct SCZ phenotypes differentially associate with varying glucose levels (Kirkpatrick, Fernandez‐Egea, Garcia‐Rizo, & Bernardo, ).…”

Section: Introductionmentioning

confidence: 99%

Co‐shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome

Postolache

Bosque-Plata

Jabbour

et al. 2019

American J of Med Genetics Pt B

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Schizophrenia (SCZ) and major depressive disorder (MDD) in treatment-naive patients are associated with increased risk for type 2 diabetes (T2D) and metabolic syndrome (MetS). SCZ, MDD, T2D, and MetS are often comorbid and their comorbidity increases cardiovascular risk: Some risk genes are likely co-shared by them. For instance, transcription factor 7-like 2 (TCF7L2) and proteasome 26S subunit, non-ATPase 9 (PSMD9) are two genes independently reported as contributing to T2D and SCZ, and PSMD9 to MDD as well. However, there are scarce data on the shared genetic risk among SCZ, MDD, T2D, and/or MetS. Here, we briefly describe T2D, MetS, SCZ, and MDD and their genetic architecture. Next, we report separately about the comorbidity of SCZ and MDD with T2D and MetS, and their respective genetic overlap. We propose a novel hypothesis that genes of the prolactin (PRL)-pathway may be implicated in the comorbidity of these disorders. The inherited predisposition of patients with SCZ and MDD to psychoneuroendocrine dysfunction may confer increased risk of T2D and MetS. We illustrate a strategy to identify risk variants in each disorder and in their comorbid psychoneuroendocrine and mentalmetabolic dysfunctions, advocating for studies of genetically homogeneous and phenotype-rich families. The results will guide future studies of the shared predisposition and molecular genetics of new homogeneous endophenotypes of SCZ, MDD, and metabolic impairment.

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“…Most of the known risk factors for diabetes in people with schizophrenia on antipsychotic medication are the same as those in the general population, such as age,4 weight gain5 6 and a family history of diabetes 7. While specific genetic risk variants for T2DM have been suggested,8 such data are not yet available in routine clinical care.…”

Section: Introductionmentioning

confidence: 99%

Birth weight, family history of diabetes and diabetes onset in schizophrenia

Fernández-Egea

Walker

Ziauddeen

et al. 2020

BMJ Open Diab Res Care

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IntroductionThe prevalence of diabetes in schizophrenia is twice that in the general population, but there are few reliable predictors of which individuals will develop glucose dysregulation.ObjectiveTo test if abnormal birth weight (either too low or too high) and parental diabetes, both variables that can be ascertained in the clinic, can predict diabetes onset in patients with schizophrenia.Research design and methodsElectronic records of a cohort of 190 clozapine-treated patients (37% treated for more than 20 years) and Cox regression survival analysis (with any type of glucose dysregulation as the event) to account for differences in length of treatment before the event and age at clozapine treatment initiation.ResultsAge at clozapine initiation (Exp(B)=1.098; p<0.001), family history of diabetes (Exp(B)=2.299; p=0.049) and birth weight2 (Exp(B)=0.999; p=0.013) were significant predictors of glucose dysregulation onset, while gender was not (Exp(B)=0.1.350; p=0.517). Among individuals with 10 years of follow-up, 80% of those with both abnormal birth weight and a family history of diabetes developed diabetes compared with 56% with only abnormal birth weight, 40% with only a family history of diabetes and 20% in those with neither.ConclusionsSince 48% of cases had at least one risk factor and 6% had both risk factors, there is a substantial proportion of patients for whom preventive strategies could be implemented.

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Parental type 2 diabetes in patients with non-affective psychosis

Cited by 11 publications

References 10 publications

Prevalence of obesity and diabetes in patients with schizophrenia

Prevalence of obesity and diabetes in patients with schizophrenia

Co‐shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome

Birth weight, family history of diabetes and diabetes onset in schizophrenia

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