Metabolic profile of antipsychotic-naive individuals with non-affective psychosis.

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Title: Metabolic profile of antipsychotic-naive individuals with non-affective psychosis.
Authors: Fernandez-Egea, Emilio, Bernardo, Miguel, Donner, Thomas, Conget, Ignacio, Parellada, Eduard, Justicia, Azucena, Esmatjes, Enric, Garcia-Rizo, Clemente, Kirkpatrick, Brian
Source: British Journal of Psychiatry. May2009, Vol. 194 Issue 5, p434-438. 5p. 3 Charts.
Subjects: Schizophrenia risk factors, Diabetes, Antipsychotic agents, Psychoses, Glucose tolerance tests, Interleukins, Blood sugar, C-reactive protein, Comparative studies, Growth factors, Research methodology, Medical cooperation, Regression analysis, Research, Research funding, Schizophrenia, Evaluation research, Case-control method, Adiponectin, Glucose metabolism disorders
Abstract: Background Some studies suggest individuals with schizophrenia have an increased risk of diabetes prior to antipsychotic use. Small sample sizes and the potential for confounding by hypercortisolaemia have decreased confidence in those results. Aims To examine diabetes-related factors in newly diagnosed, antipsychotic-naive people with non-affective psychosis. Method Participants with psychosis (the psychosis group; n= 50) and matched controls (the control group; n = 50) were given a 2 h oral glucose tolerance test. Fasting concentrations were also determined for adiponectin, interleukin-6 and C-reactive protein. Results Compared with the control group, the psychosis group had significant increases in 2h glucose and interleukin-6 concentrations, and in the prevalence of abnormal glucose tolerance (16% of psychosis group v. 0% of control group). Adiponectin and C-reactive protein concentrations did not differ significantly between the two groups. These findings could not be attributed to differences in cortisol concentrations, smoking, gender, neighbourhood of residence, body mass index, aerobic conditioning, ethnicity, socioeconomic status or age. Conclusions Individuals with non-affective psychosis appear to have an increased prevalence of abnormal glucose tolerance prior to antipsychotic treatment, as well as abnormalities in a related inflammatory molecule. These underlying problems may contribute to the metabolic side-effects of antipsychotic medications. Declaration of interest E.F.-E. received consulting fees and honoraria from Pfizer. T.D. received honoraria from Sanofi Aventis, Pfizer, Merck, Novartis and Amylin, and has received research grants from Eli Lilly. M.B. received consultant fees from Bristol-Myers Squibb and Wyeth, and honoraria from Janssen-Cilag, Eli Lilly, Pfizer, Synthelabo, GlaxoSmithKline and AstraZeneca. E.P. received research grants and consultant fees from Janssen-Cilag and GlaxoSmithKline, and served on the speakers/advisory boards for Janssen-Cilag. E.E. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Servier, Bristol-Myers Squibb, Abbott and Novartis. I.C. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Novartis, Bayer, Eli-Lilly. B.K. received consulting and/or speaking fees from Pfizer, Organon, AstraZeneca, Wyeth, Bristol-Myers Squibb, and Solvay. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:Background Some studies suggest individuals with schizophrenia have an increased risk of diabetes prior to antipsychotic use. Small sample sizes and the potential for confounding by hypercortisolaemia have decreased confidence in those results. Aims To examine diabetes-related factors in newly diagnosed, antipsychotic-naive people with non-affective psychosis. Method Participants with psychosis (the psychosis group; n= 50) and matched controls (the control group; n = 50) were given a 2 h oral glucose tolerance test. Fasting concentrations were also determined for adiponectin, interleukin-6 and C-reactive protein. Results Compared with the control group, the psychosis group had significant increases in 2h glucose and interleukin-6 concentrations, and in the prevalence of abnormal glucose tolerance (16% of psychosis group v. 0% of control group). Adiponectin and C-reactive protein concentrations did not differ significantly between the two groups. These findings could not be attributed to differences in cortisol concentrations, smoking, gender, neighbourhood of residence, body mass index, aerobic conditioning, ethnicity, socioeconomic status or age. Conclusions Individuals with non-affective psychosis appear to have an increased prevalence of abnormal glucose tolerance prior to antipsychotic treatment, as well as abnormalities in a related inflammatory molecule. These underlying problems may contribute to the metabolic side-effects of antipsychotic medications. Declaration of interest E.F.-E. received consulting fees and honoraria from Pfizer. T.D. received honoraria from Sanofi Aventis, Pfizer, Merck, Novartis and Amylin, and has received research grants from Eli Lilly. M.B. received consultant fees from Bristol-Myers Squibb and Wyeth, and honoraria from Janssen-Cilag, Eli Lilly, Pfizer, Synthelabo, GlaxoSmithKline and AstraZeneca. E.P. received research grants and consultant fees from Janssen-Cilag and GlaxoSmithKline, and served on the speakers/advisory boards for Janssen-Cilag. E.E. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Servier, Bristol-Myers Squibb, Abbott and Novartis. I.C. received consulting or speaking fees from Sanofi-Aventis, GlaxoSmithKline, Merck, Sharpe & Dohme, Novartis, Bayer, Eli-Lilly. B.K. received consulting and/or speaking fees from Pfizer, Organon, AstraZeneca, Wyeth, Bristol-Myers Squibb, and Solvay. [ABSTRACT FROM AUTHOR]
ISSN:00071250
DOI:10.1192/bjp.bp.108.052605