Cardiometabolic risk in first-episode schizophrenia (FES) patients with the earliest stages of both illness and antipsychotic treatment

Desheng Zhai, Yahui Xu, Ruiling Zhang, Desheng Zhai, Taizhen Cui, Yihang Feng, Songji Li, Dushuang Zhou, Gaopan Dong, Ying Zhao, Xin Wang, Yuxin Yang, Yunlei Yang

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. Methods We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. Results Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23 days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. Conclusion These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)41-49
Number of pages9
JournalSchizophrenia Research
Volume179
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

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Antipsychotic Agents
Schizophrenia
Metabolome
Therapeutics
Polypharmacy
Hypertriglyceridemia
Hypercholesterolemia
Lipid Metabolism
Hyperglycemia
Population
Insulin Resistance
Inpatients
Fasting
Diabetes Mellitus
Cohort Studies
Cardiovascular Diseases
Retrospective Studies
Morbidity
Lipids
Glucose

Keywords

  • Antipsychotic treatment
  • Cardiometabolic risk
  • Earliest stages
  • First-episode schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Cardiometabolic risk in first-episode schizophrenia (FES) patients with the earliest stages of both illness and antipsychotic treatment. / Zhai, Desheng; Xu, Yahui; Zhang, Ruiling; Zhai, Desheng; Cui, Taizhen; Feng, Yihang; Li, Songji; Zhou, Dushuang; Dong, Gaopan; Zhao, Ying; Wang, Xin; Yang, Yuxin; Yang, Yunlei.

In: Schizophrenia Research, Vol. 179, 01.01.2017, p. 41-49.

Research output: Contribution to journalArticle

Zhai, Desheng ; Xu, Yahui ; Zhang, Ruiling ; Zhai, Desheng ; Cui, Taizhen ; Feng, Yihang ; Li, Songji ; Zhou, Dushuang ; Dong, Gaopan ; Zhao, Ying ; Wang, Xin ; Yang, Yuxin ; Yang, Yunlei. / Cardiometabolic risk in first-episode schizophrenia (FES) patients with the earliest stages of both illness and antipsychotic treatment. In: Schizophrenia Research. 2017 ; Vol. 179. pp. 41-49.
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abstract = "Objective It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. Methods We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-na{\"i}ve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. Results Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5{\%} v.s. 14.9{\%}, 9.2{\%} v.s. 18.4{\%}, 8.1{\%} v.s. 14.9{\%}, 8.6{\%} v.s.18.3{\%}, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9{\%} v.s. 6.4{\%}). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23 days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. Conclusion These results indicated an early-onset nature of HDL-C abnormalities in drug-na{\"i}ve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.",
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AU - Xu, Yahui

AU - Zhang, Ruiling

AU - Zhai, Desheng

AU - Cui, Taizhen

AU - Feng, Yihang

AU - Li, Songji

AU - Zhou, Dushuang

AU - Dong, Gaopan

AU - Zhao, Ying

AU - Wang, Xin

AU - Yang, Yuxin

AU - Yang, Yunlei

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objective It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. Methods We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. Results Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23 days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. Conclusion These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.

AB - Objective It is well established that schizophrenia patients have high cardiovascular morbidity and mortality. However, the underlying risk factors in the earliest stages of both schizophrenia illness and antipsychotics treatment are less clear. This study aimed to characterize the metabolic features of those patients. Methods We performed a retrospective cohort study in a naturalistic setting, which included antipsychotic-naïve, first-episode schizophrenia (FES) inpatients with the baseline metabolic measurements and changes following a short term treatment with antipsychotic drugs. Results Although prevalence of hypertriglyceridemia, hypercholesterolemia, higher-LDL-C and hyperglycaemia in patients with FES were much lower than those of the general population (7.5% v.s. 14.9%, 9.2% v.s. 18.4%, 8.1% v.s. 14.9%, 8.6% v.s.18.3%, respectively), lower-HDL-C in patients with FES were much more prevalent than that of the general population (19.9% v.s. 6.4%). Despite significant metabolic risk profiles (as such lipid abnormalities and insulin resistance) increase, mean fasting glucose and glucosylated serum protein (GSP) were significantly decreased after the short term (median of 23 days) antipsychotics exposure, compared to baseline. There is no significant difference of the metabolic profile change between monopharmacy and polypharmacy. Conclusion These results indicated an early-onset nature of HDL-C abnormalities in drug-naïve FES patients. Lipids metabolism risk may develop early and quickly after antipsychotic exposure. Early monitoring is required for the purpose of early detection and hence prevention of the initial metabolic risk which may lead to diabetes mellitus and cardiovascular disease.

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KW - Cardiometabolic risk

KW - Earliest stages

KW - First-episode schizophrenia

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