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

Publication Date

2014

Journal Title

Eur Psychiatry

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. (C) 2013 Elsevier Masson SAS. All rights reserved.

Volume Number

29

Issue Number

3

Pages

179-182

Document Type

Article

EPub Date

2013/02/19

Status

Faculty, Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

General Internal Medicine

Additional Departments

Psychiatry; Molecular Medicine

PMID

23415509

DOI

10.1016/j.eurpsy.2012.12.001

For the public and Northwell Health campuses

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