Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-14T05:19:16.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Dysmetabolic features of the overweight patients receiving antipsychotic drugs: A comparison with normal weight and obese subjects

Published online by Cambridge University Press:  15 April 2020

P. Manu ,
C.-U. Correll ,
M. Wampers ,
R. van Winkel ,
W. Yu ,
D. Shiffeldrim  and
M. De Hert
P. Manu*
Affiliation:
Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA Hofstra North Shore, LIJ School of Medicine, Hempstead, New York, USA Transilvania University, Brasov, Romania
C.-U. Correll
Affiliation:
Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA Hofstra North Shore, LIJ School of Medicine, Hempstead, New York, USA Feinstein Institute for Medical Research, Manhasset, New York, USA
M. Wampers
Affiliation:
Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium
R. van Winkel
Affiliation:
Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium School of Mental Health and Neuroscience (EURON), University Medical Center, Maastricht, The Netherlands
W. Yu
Affiliation:
Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium
D. Shiffeldrim
Affiliation:
Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
M. De Hert
Affiliation:
Department of Neurosciences, Katholiecke Univeristeit and University Psychiatric Center Campus, Kortenberg, Leuven, Belgium
*
*Corresponding author. Medical Services, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA. E-mail address: [email protected] (P. Manu).
Get access

Abstract

Background:

Extensive research indicates that obesity, defined by a body mass index (BMI) greater or equal to 30, is common in patients treated with antipsychotic drugs and is frequently associated with carbohydrate and lipid abnormalities leading to metabolic syndrome and diabetes. In contrast, the metabolic health of overweight patients (BMI = 25–29.9) without metabolic syndrome or diabetes has not been thoroughly investigated.

Objective:

To assess the metabolic health of overweight patients receiving antipsychotic drugs.

Methods:

We compared standard metabolic parameters (BMI; waist circumference; hemoglobin A1c; fasting lipids; and fasting and post-challenge glucose and insulin) of normal weight, overweight and obese individuals from a consecutive cohort of antipsychotic-treated patients without metabolic syndrome and/or diabetes.

Results:

Compared with the normal weight subjects (n = 286), overweight patients (n = 212) had higher fasting insulin resistance as assessed with the homeostatic model (P = 0.023), insulin secretion during the oral glucose tolerance test (P = 0.0037), triglycerides (P = 0.0004) and low-density lipoprotein cholesterol (P = 0.0089), and lower levels of high-density lipoprotein cholesterol (P = 0.0014). The obese (n = 50) were different from the overweight subjects only with respect to higher post-challenge insulin levels (P = 0.0002). The average fasting glucose, post-challenge glucose, and hemoglobin A1c, severity of psychiatric disorders and antipsychotics used were similar in the three groups.

Conclusions:

Overweight (BMI = 25–29.9) patients receiving antipsychotics are metabolically closer to the obese than to normal weight counterparts. The findings suggest that interventions promoting weight loss and metabolic health are required for overweight patients even in the absence of metabolic syndrome or diabetes.

Keywords

AntipsychoticsEpidemiology
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 3 , March 2014 , pp. 179 - 182
Copyright
Copyright © European Psychiatric Association 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Drs. Manu and Correll have contributed equally to this article.

References

Blokstra, A, Burns, CM, Seidell, JCPerception of weight status and dieting behavior in Dutch men and women. Int J Obes Relat Metab Disord 1999;23(1):7–17.CrossRefGoogle ScholarPubMed
Caccamese, SM, Kolodner, K, Wright, SMComparing patient and physician perception of weight status with body mass index. Am J Med 2002;112(8):626–662.CrossRefGoogle ScholarPubMed
Correll, CU, Druss, BG, Lomardo, I, O’Gorman, C, Harnett, JP, Sanders, KNet al.Findings of a U.S. national cardiometabolic screening program among 10,084 psychiatric outpatients. Psychiatr Serv 2010;61(9):892–898.CrossRefGoogle Scholar
De Hert, M, Dekker, JM, Wood, D, Hahl, KG, Holt, RI, Moller, HJCardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 2009;24(6):421–424 [Epub 2009].CrossRefGoogle Scholar
De Hert, M, Detraux, J, van Winkel, R, Yu, W, Correll, CUMetabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat Rev Endocrinol 2011;8(2):114–126.CrossRefGoogle ScholarPubMed
Diehr, P, Thielke, S, O’Meara, E, Fitzpatrick, AL, Newman, AComparing years of healthy life, measured in 16 ways, for normal weight and overweight older adults. J Obes 2012. http://dx.doi.org/10.1155/2012/894894 [894894 Epub 2012].CrossRefGoogle ScholarPubMed
Expert panel on the identification, evaluation and treatment of overweight in adults Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr 1998;68:899–917.CrossRefGoogle Scholar
Faulkner, G, Cohn, T, Remington, G, Irving, HBody mass index, waist circumference and quality of life in individuals with schizophrenia. Schizophr Res 2007;90(1–3):174–178.CrossRefGoogle ScholarPubMed
Fradkin, JE, Roberts, BT, Rodgers, GPWhat's preventing us from preventing type 2 diabetes?. N Engl J Med 2012;367:13.CrossRefGoogle ScholarPubMed
Hellerstein, DJ, almeida g, Devlin, MJ, Mendelsohn, N, Helfand, S, Dragatsi, Det al.Assessing obesity and other related health problems of mentally ill Hispanic patients in an urban outpatient setting. Psychiatr Q 2007;78(3):171–181.CrossRefGoogle Scholar
Homel, P, Casey, C, Allison, DBChanges in body mass index for individuals with and without schizophrenia, 1987–1996. Schixophr Res 2002;55(3):277–284.CrossRefGoogle ScholarPubMed
Katzmarzyk, PT, Reeder, BA, Elliott, S, Joffres, MR, Pahwa, P, Raine, KDet al.Body mass index and risk of cardiovascular disease, cancer and all-cause mortality. Can J Public Health 2012;103(2):147–151.CrossRefGoogle ScholarPubMed
Keys, A, Fidanza, F, Karvonen, MJ, Kimura, N, Taylor, HLIndices of relative weight and obesity. J Chrom Dis 1972;25:329–343.CrossRefGoogle ScholarPubMed
Klein, S, Burke, LE, Bray, GA, Blair, S, Allison, DB, Pi-Sunyer, Xet al.Clinical implications of obesity with specific focus on cardiovascular disease: A statement for professionals from the American Heart Association Council on nutrition, physical activity, and metabolism: Endorsed by the American College of Cardiology Foundation. Circulation 2004;110(18):2952–2967.CrossRefGoogle ScholarPubMed
Labounty, TM, Gomez, MJ, Achenbach, S, Al-Mallah, M, Berman, DS, Budoff, MJet al.Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients. Eur Heart J Cardiovasc Imaging 2012. Epub ahead of print.Google ScholarPubMed
Limosin, F, Gasquet, I, Leguay, D, Azorin, JM, Rouillon, FBody mass index and prevalence of obesity in a French cohort of patients with schizophrenia. Acta Psychiatr Scand 2008;118(1):19–25.CrossRefGoogle Scholar
Lurie, AObstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol 2011;46:1–42.Google Scholar
Manu, P, Correll, CU, van Winkel, R, Wampers, M, De Hert, MPrediabetes in patients treated with antipsychotic drugs. J Clin Psychiatry 2012;73(4):460–466.CrossRefGoogle ScholarPubMed
Moyer, VAScreening for and management of obesity in adults: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2012;157(5):373–378.Google ScholarPubMed
Priebe, S, Rohricht, FSpecific body image pathology in acute schizophrenia. Psychiatr Res 2001;101(3):289–301.CrossRefGoogle ScholarPubMed
Strassnig, M, Brar, JS, Ganguli, RBody mass index and quality of life in community-dwelling patients with schizophrenia. Schizophr Res 2003;62(102):73–76.CrossRefGoogle ScholarPubMed
Strassnig, M, Brar, JS, Ganguli, RSelf-reported body weight perception and dieting practices in community-dwelling patients with schizophrenia. Schizophr Res 2005;75(2–3):425–432.CrossRefGoogle ScholarPubMed
Weiden, PJ, Mackell, JA, McDonnell, DDObesity as a risk factor for antipsychotic noncompliance. Schizophr Res 2004;66(1):51–57.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.