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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).
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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

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Footnotes

1

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

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